Evaluation of medicinal plants as part of Tibetan medicine prospective observational study in Sikkim and Nepal.

OBJECTIVE: Medicinal plants are the primary ingredients of Tibetan medicinal formulae. The aim of the present study was to evaluate the spectrum of medical complaints treated by a Tibetan doctor in Sikkim and Nepal, and to determine which plants the doctor used most frequently to treat these complaints. DESIGN: Two prospective observational studies were carried out at two locations (Sikkim and Nepal). Patients who visited the participating Tibetan doctor were included consecutively. Medical symptoms, Tibetan syndrome diagnoses, and treatments were documented. The most frequently used plants were identified retrospectively. RESULTS: A total of 238 patients were included (Sikkim: n = 135, 62.2% women, mean age 33.9 3.4 years; Nepal: n = 103, 54.4% men, mean age 42.9 2.4 years). The most frequent medical complaint was pain (Sikkim: 46% of patients; Nepal: 51% of patients). The most frequent Tibetan syndrome diagnosis was Bad-kan in Sikkim (20.7% of patients; a cold disorder affecting the lower body) and a combination of Bad-kan and mKhris-pa in Nepal (28.2%; a mixed cold/hot disorder affecting the lower and middle body). A total of 71 different Tibetan medicines were prescribed, including 138 different plants. Of these 138 plants, 81 typically grow at high and medium altitudes, and 57 grow in tropical and subtropical areas. Nevertheless, most (93%) of the prescribed formulae contained high-altitude plants. CONCLUSIONS: For the first time, information on medical complaints and treatments has been evaluated systematically for patients receiving treatment from a Tibetan doctor. These data provide a good foundation for further research on Tibetan medicine. Further studies should go a step farther and include follow-up data and information about the effectiveness and safety of Tibetan medicines.