Naturheilkunde und Komplementärmedizin bei rheumatischen Erkrankungen

 

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Zusammenfassung

Naturheilkunde und Komplementärmedizin werden von Patienten mit rheumatischen Erkrankungen häufig nachgefragt und in Anspruch genommen. Durch die wachsende wissenschaftliche Evidenz können Naturheilverfahren zunehmend besser gewichtet und im Konzept der integrativen Rheumatologie sinnvoll in die medizinische Versorgung implementiert werden. In der Therapie der rheumatoiden Arthritis und der Spondylarthropathien sind insbesondere das modifizierte Fasten, Verfahren der Mind-Body Medizin, systemische Thermotherapien, spezifische Nahrungsmittel und Supplementierungen, probiotische Therapie und die Ayurveda Medizin geeignet die konventionelle Therapie zu ergänzen. Für die Behandlung der Arthrosen sind v. a. die Verfahren der Blutegeltherapie und der Akupunktur in ihrer Wirksamkeit gut belegt. Darüber hinaus sind Schröpfen, Ayurveda Medizin, systemische Thermotherapie, Hydrotherapie, spezifische externe Auflagen und Mind-Body Techniken wie Tai-Chi in der Therapie bewährt. Für die Therapie der Fibromyalgie wird eine multimodale Komplexbehandlung unter Einbezug der systemischen Thermotherapie und der mit guter Evidenz belegten Mind-Body-Techniken Tai-Chi und Yoga als intensivierter Therapieansatz erfolgreich eingesetzt. Schwerpunkt der Naturheilkunde bilden die Konzepte der Salutogenese, Selbstwirksamkeit und des gesundheitsfördernden Lebensstils. Weitere klinische Forschung und zugrundeliegende Forschungsförderung sind notwendig. In der medizinischen Versorgung erscheint vor dem Hintergrund der Inanspruchnahme eine bessere Implementierung der Naturheilkunde und seriösen Komplementärmedizin im Konzept der integrativen Rheumatologie in ausgewiesenen Zentren angemessen.

Abstract

Patients with rheumatic diseases frequently use treatment methods such as naturopathy and complementary medicine. With the growing body of scientific evidence, the value of these methods can better appraised and the methods can be implemented into medical care as part of the concept of integrative rheumatology. The most promising treatment methods for rheumatoid arthritis and spondylarthropathy consist of modified fasting, relaxation techniques of mind-body medicine, whole-body thermal therapy, specific foods and supplements, probiotics and the whole-system approach of ayurvedic medicine. The effectiveness of leech therapy and acupuncture in the symptomatic treatment of osteoarthritis has been shown in clinical trials. Further treatment options for osteoarthritis consist of cupping, ayurvedic medicine, systemic thermotherapies, hydrotherapy and various external local packs and mind-body techniques such as Tai-Chi und yoga. For the treatment of fibromyalgia, a complex multimodal treatment approach has been successfully used, including systemic thermotherapy and the well-evidenced mind-body techniques of Tai-Chi and yoga. The principal focus of naturopathy is set on the concept of salutogenesis, the enhancement of self-efficacy and the promotion of a health-promoting lifestyle modification. Further clinical research and research support in the field of integrative rheumatology are needed. On the background of the high demand and usage of naturopathy and evidence-based complementary medicine, a better implementation of high-quality integrative rheumatology in selected centres might be an appropriate approach.

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