Discussion
Most
of patients referring to TPM clinics were suffering from chronic
diseases, which had not received appropriate treatment from modern
medicine(16). The literature revealed
that the most patients who referred to TPM clinics had selected
traditional treatment as the end step of their therapeutic process and
they hope that they would have had an acceptable therapeutic response to
improve the quality of life (17,
18).
The findings of the present study showed that the majority of patients
referred to TPM clinic were married, because it seems that married
people tend to seek treatment and follow-up for their skin condition due
to their appearance and cosmetic factors. Also, the education level of
the most of the patients with dermatologic problems referring to the TPM
clinic was a bachelor’s degree. This finding demonestrated that people
with a higher degree of education probably had more tendency to try TPM
remedies for treatment of their disease which also confirms the result
of the study done by Dastgheib et
al. (19,
20). The study of Hunt et al.showed that the people who were university educated were are more
inclined to use complementary
medicine(21). Moreover, Frass et
al. showed that the more education was one of the important predictive
factors for using complementary and alternative medicine, such a way
that the people with higher education used complementay and alternative
medicine 1.2 times more than other population
(22). These results were in-line with the
results of our study.
The results of the present study indicated that the most of the patients
were housewives and the least were retired ones. This may be because of
that the housewives often have more free time to visit TPM clinics;
however, the reason for lack of follow up for skin lesions among the
retirees may be because of the lower life expectancy and a lack of
attention to their appearance. Kaushal et al. demonestrated that
the housewives in India used allopathic medicines more than other drugs
(23). This result was similar to the
result of our study.
The most frequencies of patients referred to TPM clinics in our study
were in spring and autumn. This may be resulted from increasing the
incidence rate of many skin disorders or aggravition of skin disorders
such as atopic dermatitis, eczematous disorders and other inflammatory
skin conditions in spring and autumn. In addition, seasonal allergies
and skin lesions are more common in these both seasons because of
distribution of the pollens in the air
(24, 25).
Furthermore, changing in seasonal temperature and humidity of the
climate of maybe the other contributing factors to differnaces
distribution of patients to visit the physician because of dermatology
conditions.
According to our study, acne was the most dermatologic conditions that
the patients had explained in their medical chief chief complaints. Acne
is an inflammatory disease with polymorphic lesions including papules,
pustules, nodules and cysts that affect the face, chest, and back of the
trunk commonly seen in adolescents. According to the previous studies,
it is estimated that 9.4% of the global population are affected by
acne, making it the eighth-most prevalent disease worldwide. This
condition may affect the pscychological and social aspects of patients
with acne (26). Several studies revealed
that many of dermatologic conditions are multifactorial disorders. For
example, seborrheic dermatitis is significantly associated with the
disappearance of normal gastrointestinal flora
(27). Moreover, some patients suffering
from acne rosacea were found to be infected by Helicobacter pylori
(28). In addition, while the exact
pathogenesis of sebaceous gland diseases is unknown, some reports
suggest that gastrointestinal disorders increase sebaceous gland
secretions (29). Our findings showed that
the most patients were also suffering from a gastrointestinal problem.
Moreover, sleep disturbance, neurological and psychiatric problems were
the other common comorbid complaints in patients in our study. In this
regard, previose studies confirmed that the dermatological conditions
were related to gastrointestinal problems, sleep disterbance, and
psychiatric problems (7,
30-33).
There were a few studies around using complementary and alternative
medicine in patients with sermatologic conditions. In a study done by
Arye et al ., 77 patients who referred to an outpatient
dermatology clinic were evaluated in the aspect of using complementary
and traditional medicine in treating psoriasis. 62% used complementary
medicine of which 58% of them receive such treatments from an expert in
traditional medicine. Also, according to the study, the use of
complementary medicine (mostly traditional medicine) among Arabs was
significantly higher compared to Jews. The reason these patients used
complementary medicine was they believed that it can increase their
quality of life. Some also believed that the side effects and toxicity
of herbal remedies were less, and even the usage of complementary
medicine reduced their stress (34). All
of the patients in our study were visited by one or more dermatologist
but they did not have the acceptable therapeutic responses to
conventional medicine, so they decided to choose TPM as their last
chance. Therefore, since more than 50% of the patients in our study had
moderate and good therapeutic response from TPM, it can be very
promising, and it can open wide avenues for further studies.
There were some limitations in our study. First, this was a
retrospective study, so for evaluating the exact effects of using TPM in
patients with dermatologic conditions, we suggest that the chohort
studies should be conducted and the patients are followed up, regularly.
Next, some of our patients’ document were not complete, so we were faced
with few missing data on some issuses, such as the therapeutic response
of the patients. Therefore, designing powerful electronic systems can
improve studies in this area. Finally, our project was a single-center
study, so multi-center studies are recommended for future studies.