Posted on Sep 13, 2012 by Sergio Ulloa
Ever since the Renaissance, Western science has become increasingly sceptical of traditional medicine. It seems, however, that the tide may be turning, as scientific exploration is adding more credibility to the pharmacology behind Eastern medicine, one study at a time.
A recent report published in the Archives of Internal Medicine
this week gives a detailed analysis of 29 studies carried out involving almost 18,000 patients in the USA and Europe on the effect of acupuncture on chronic pain. The trials compared acupuncture with patients who had no treatment, and those who had a pseudo treatment, through incorrect use of acupuncture by inserting needles in incorrect positions and depths.
The results showed that patients who had acupuncture reported at least a 50% decrease in their pain, compared to 43% for the faked treatment and 30% for no treatment. However, given the marginal increase in reported positive outcome of real acupuncture over sham acupuncture and other concerns over methodology, some doctors remain unconvinced
The precise physical mechanism by which acupuncture works has not yet been established, with a majority of Western scientists and medical practitioners still attributing its effectiveness to the stimulation of nerves, muscles and connective tissue to boost blood flow and encourage release of the body's natural painkillers.
Eastern philosophy, on the other hand, not hampered by the limitations of naturalistic thinking, explains acupuncture in terms of restoring balance to the energy flow in the human body, with needles inserted in specific areas on the body to alter or 'tune' the flow.
It seems that Traditional Chinese Medicine (TCM) is undergoing a kind of renaissance of its own. Not only is it making great strides in acceptability in the West, but it has been receiving a lot of new found appreciation and attention in China, where TCM has been the de facto source of primary healthcare for more than a millennium.
TCM has received less promotion in China during the last 50 years, with the State's focus on providing Western style medical services mostly through large public hospitals, leaving very little support and funding for any other forms of medical care. A mix of tradition, affordability and availability have enabled TCM to survive and even flourish, especially in rural areas, where public healthcare has been hard to come by.
That is all about to change. Just this week, the Chinese vice minister of health, Wang Guoqiang, announced a national campaign to promote TCM services at grassroots levels. According to figures provided by the ministry, almost 76% of community health centres provide some form of TCM, although there are concerns about the service quality as there is no official grading systems for TCM practitioners.
The campaign will aim to enable 95% of community health centres, and 90% of those at village or town level, to offer TCM services by 2015. This will require training of at least 15,000 TCM clinicians for hospitals at the town/county level, and 30,000 general TCM practitioners at the community level.
The campaign follows a national crackdown on the use of substandard or fake materials in TCM, which focused on improving awareness of and testing for heavy metal ions, pesticides and aflatoxins.
In Beijing, education authorities are publishing new textbooks on TCM, and will be distributing them to secondary schools before the end of the year.
There is no obligation on Beijing schools to teach TCM as a subject, but for those teachers who would like to be qualified to teach TCM, the the city administration for traditional Chinese medicine is offering courses to prepare teachers to deliver the subject. On top of completing this course, teachers will also be required to have experience teaching Chinese History, language, and biology.
"China's education system is rather Westernized," said Mao Jialing, director of the Cultural Research and Propagation Center of Traditional Chinese Medicine at the Beijing University of Chinese Medicine. Western thinking tends to break everything down into small parts and deal with each part one at a time. This means that in school, students learn mathematics, physics and chemistry as completely separate subjects. This mindset affects Western medicine also, meaning there is an inordinate focus on individuals problems, often to the detriment of the health of the rest of the body.
"The logic inherent in traditional Chinese medicine and traditional Chinese culture is quite different," he said. "We do not pay an inordinate amount of attention to a particular body part that is diseased, but instead place emphasis on the general state of a person's health."
"There are circumstances that Western medicine cannot deal with," he said. "For example, chemotherapy will destroy the immune systems of some cancer patients and kill them faster than their tumors."
According to Ju Baozhao, a professor of traditional Chinese medicine studies at Liaoning University of Traditional Chinese Medicine, the ancient methods still provide good ways to cure chronic disorders. He said people who use TCM to treat some chronic disorders will find that it is both effective and saves them a lot of money. Even though TCM is generally quite low cost, the industry in China is currently valued at USD 50 billion, and estimates are that it will triple in value by 2015.
The TCM renaissance is not limited to China. A lot of effort is being made to raise understanding and lower suspicions of TCM internationally.
Last month, a database providing a link between TCM herbs and their active chemical ingredients, along with translation into Western terminology was unveiled. The Chem-TCM database is the most comprehensive of its kind, linking and translating more than 12,000 chemicals found in more than 300 Chinese herbs.
TCM remedies have rarely been used as a basis for developing new medicines because their complexity have made registering with Western regulatory agencies difficult. The information provided by the TCM-Chem database is sure to make this process easier, and should significantly boost the credibility and acceptance of TCM-based remedies in the West.
While this database will go a long way towards removing TCM from the realm of fantasy in the minds of traditional Western health professionals, the holistic nature of TCM should not be forgotten, as merely turning traditional cures into modern drugs will remove the expertise of the TCM practitioner, which, in the traditional mindset, is crucial to the whole process of providing effective treatment.
In the Netherlands, a TCM medicine has been approved for sale in an EU country for the first time ever. Di'ao Xin Xue Kang, a well-known herbal medicine produced by the Chengdu-based Di'ao Group, received marketing authorization from the Medicines Evaluation Board of the Netherlands, making it the first herbal medicine approved as a therapeutic drug from anywhere outside the EU.
"This is an important step for TCM to enter mainstream markets of developed countries," Chinese Health Minister, Chen Zhu, said at a news conference organized by the Chinese Academy of Sciences in Beijing on Wednesday.
Traditional Chinese medicines were banned by the EU in May 2011, to prevent unlicensed herbal medicines to be sold as food supplements. The successful registration of Xin Xue Kang follows two years of research to identify the active ingredients in the medicine. Xin Xue Kang contains only a single TCM herb, and this was why it was chosen to be the first to be registered. Most other traditional medicines contain a complex mix of herbs, which makes identification of all the active ingredients very difficult. Ongoing research into the active ingredients of TCM remedies, as well as availability of new resources like the TCM-Chem database, will hopefully speed up this process for future registrations of more complex medicines.
It is hoped that the heightened interest in TCM, and the increasing research into active ingredients, will yield a host of new medicines; marrying millennia of traditional experience with modern manufacturing and testing methods.
Chinese pharmaceutical companies are also pushing beyond the traditional boundaries and are working hard to gain a foothold in the Western mainstream. One such company, Tianjin based Tasly Group Co. Ltd, has partnered with local governments and universities to promote TCM in places like Europe, North America and South Africa. It recently opened a TCM exhibition facility in South Africa to help local people gain an understanding of TCM, its philosophy and its history, and is currently completing another such facility in Maryland in the USA.
Tasly also purchased a research and manufacturing facility in Maryland, where it intends to produce its flagship Tasly Danshen Plus Capsule, a drug that protects the heart and helps it function, with ingredients such as Notoginseng and other traditional Chinese herbs. The drug is currently in the process of obtaining FDA certification.
Traditional Chinese medicine has been around for longer than just about any other form of medicine, and touches on elements of the human being that Western science has a hard time even accepting the existence of. Energy fields, Qi, internal 'fire' and all the associated treatments are often hard for scientists to take seriously, however, studies are adding more and more credibility to the pharmacological basis of TCM.
A marriage between Eastern and Western mindsets, allowing for the respective strengths to complement each other, is an exciting prospect. Western study and detailed analysis of TCM will hopefully weed out those treatments that not only rip off the customer, but do significant harm to the environment. Rhino horn and tiger products are pertinent examples of this. At the very least, one hopes that alternatives to these products will be developed, and in the process save many other species from extinction.
As TCM gains momentum it will be interesting to see if it begins to make inroads into Western treatment regimens, whether through the pharmacology of the ingredients used, or in the worldview itself. With the Chinese government also stepping up its efforts to monitor TCM ingredients and incorporate it into the national healthcare infrastructure, it will be worth watching whether TCM can become a cost-effective way to provide healthcare, especially since it is already deeply ingrained in Chinese rural life.