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Clinical Research on TCM

Chinese medical tradition includes a long history of research, dating back thousands of years. Early masters of herbal knowledge conducted crude empirical research to determine the actions of plants. In fact, documented research on TCM herbs was begun about fifteen centuries before the first empirical research on Western drugs was begun. There is an element of either ignorance or arrogance in the frequent Western assumption that TCM is based largely on anecdotal evidence.

Furthermore, in modern China, a plethora of research is now being conducted. There are more than one hundred Chinese medical journals currently providing reports on TCM research. Even so, some of this research is considered suspect by many Western physicians, mostly because of the innate philosophical differences between the two medical traditions. TCM clinicians, for example, prefer to use complex, individualized combinations of herbal ingredients. Also, they consider it unethical to give an ineffective placebo to a patient who is suffering. When they do use placebos, they object to randomization of patients in clinical studies, because they feel that patients should have the right to choose whether they will receive the treatment or the placebo.

Within this cultural tradition, modern Chinese herbal research rarely involves a randomized, placebo-controlled study in which a life-threatening ailment is involved. Instead, Chinese double-blind studies generally compare two agents that are both presumed to be effective. TCM clinicians also tend to believe that Western research relies too heavily on laboratory test results, and not enough on the patient's relief of symptoms and the quality of life. Furthermore, because Chinese medicine does not describe health in terms of disease conditions, but rather in syndrome patterns that are unique to the individual, it is difficult to establish comparable groups of subjects for clinical trials. Similarly, treatment is individualized to the specific syndrome pattern presented in each patient, and it runs counter to the principles of TCM to provide a standardized treatment to all people.

Despite these problems, a number of Chinese herbal treatments have been adopted in the West, largely because of research conducted in China. Chinese clinical research dating back to 1972 found Ginkgo biloba effective in Parkinson's disease, cerebral thrombosis, and cerebrovascular spasms. This laid the groundwork for Western research published in the Journal of the American Medical Association in October of 1998 indicating that ginkgo was effective in alleviating Alzheimer's disease. Researchers for this study included Dr. Alan Schatzberg, chairman of the Department of Psychiatry at the Stanford University School of Medicine. This study was a double-blind, placebo-control RCT over one year. During that time, the mental functioning was stable and social functioning improved mildly in the Gingko biloba group while both deteriorated in the placebo group.

Acceptance of certain TCM treatments in the West appears to be growing. Following is a review of a number of medical conditions that respond to TCM therapies, and particularly to TCM herbal therapies. Conditions chosen are those that have been studied most strenuously, according to Western research concepts. However, because of this selection criterion, the studies cited are in no way representative of the full breadth and scale of Chinese herbal research. Studies do, however, illustrate that some Chinese herbal interventions can, under carefully defined conditions, be appropriate treatment for conditions that remain resistant when treated with the best Western therapies.




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Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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