Tamamlayıcı ve integratif tıp (TİT) yöntemleri, günümüzde sağlık profesyonelleri tarafından idiyopatik, kronik hastalıkların tedavisinde yardımcı/ek yöntem olarak tercih edilebilmektedir. Bilimsel literatürde bu yöntemlere ilişkin plasebo kontrollü, kör ve randomize çalışmaların az olması, yöntemlerin güvenilirliği ve etkinliği ile ilgili eleştirilere neden olmaktadır. Sıklıkla doğu felsefesi ve tıp anlayışını içeren bu uygulamaların çeşitli hastalıklarda kullanılması ve etkili olabilmesi, ortak bir mekanizmayı içerebileceklerini akla getirmektedir. Vücutta meydana gelen fizyolojik olayların bilinçdışı kontrolünden sorumlu olan otonom sinir sistemi (OSS) sempatik sinir sistemi ve parasempatik sinir sistemi olmak üzere ikiye ayrılmaktadır. Stres faktörleri sempatik sinir sistemi aracılığı ile vücutta 'savaş veya kaç' tepkisine yol açarken, parasempatik sinir sistemi 'dinlen ve sindir' olarak özetlenen, stresin vücutta yarattığı etkileri sönümleyen bir yapıya sahiptir. OSS fonksiyonel bozukluklarının, primer veya sekonder olarak vücuttaki birçok rahatsızlıkla bağlantısı bulunmaktadır. Genellikle kronik stresin de eşlik ettiği ve sempatik hiperaktivite lehine olan bu durum, homeostazı ve iyileşmeyi bozmaktadır. Bu çalışmada, yaygın kullanımı olan akupunktur, yoga, tai chi chuan, qi gong, nefes terapisi, masaj, refleksoloji, hipnoz, kayropraksi ve osteopati gibi yöntemlerin etkinliğinin OSS aktivitesi üzerinden değerlendirilmesi amaçlandı. Mevcut literatür ışığında, TİT yaklaşımlarının OSS aktivitesini etkilediği öne sürülebilir. Sempatik ve parasempatik sistem aktivitesindeki değişimler TİT uygulamalarının iyileştirici etkilerinden kısmen de olsa sorumlu olabilir. Sonuç olarak bahsedilen uygulamalar OSS regülasyonuna katkıda bulunuyor olabilir. Gelecekte TİT uygulamalarını içeren ve irdeleyen çalışmaların OSS aktivitesini de değerlendirmeleri etki mekanizmalarını anlama konusunda daha aydınlatıcı olacaktır.
Anahtar Kelimeler: Otonom sinir sistemi bozuklukları; sempatik sinir sistemi; parasempatik sinir sistemi; tamamlayıcı tıp; integratif tıp
Complementary and integrative medicine (CIM) methods can be preferred by healthcare professionals as an adjunct/additional method in the treatment of idiopathic and chronic diseases. The scarcity of placebo-controlled, blinded and randomized studies of these methods in the scientific literature causes criticism about the reliability and effectiveness of the methods. The fact that these applications, which often include eastern philosophy and understanding of medicine, are used in various diseases and are effective, suggests that they may include a common mechanism. The autonomic nervous system (ANS), which is responsible for the unconscious control of physiological events in the body, is divided into two as the sympathetic nervous system and the parasympathetic nervous system. While stress factors cause a "fight or flight" response in the body through the sympathetic nervous system, the parasympathetic nervous system has a structure that can be summarized as "rest and digest", dampening the effects of stress on the body. ANS functional disorders are associated with many disorders in the body, either primary or secondary. This situation, which is often accompanied by chronic stress and favors sympathetic hyperactivity, impairs homeostasis and healing. In this study, it was aimed to evaluate the effectiveness of widely used methods such as acupuncture, yoga, tai chi chuan, qi gong, breathing therapy, massage, reflexology, hypnosis, chiropractic and osteopathy through ANS activity. Based on the available literature, it can be argued that CIM approaches affect ANS activity. Changes in sympathetic and parasympathetic system activity may be partially responsible for the curative effects of CIM applications. As a result, the applications mentioned may contribute to ANS regulation. It will be more enlightening to understand the mechanisms of action of studies that include and examine CIM applications in the future, if they also evaluate the ANS activity.
Keywords: Autonomic nervous system diseases; sympathetic nervous system; parasympathetic nervous system; complementary medicine; integrative medicine
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