Classical or Hi-tech?Adina Stanescu, R.TCMP February 1, 2009
Latest Research Findings on the Effects of Chinese Herbs versus Western Drugs
The spread of Traditional Chinese Medicine worldwide has generated considerable interest on the part of scientific researchers and pharmaceutical companies. In the 1970s, TCM was dismissed by many as novel quackery, but is now seen as a potentially vast source of new drugs by west and east alike. The Chinese government is eagerly encouraging the new research, and an avalanche of studies is pouring forth from the TCM universities and hospitals on the mainland.
However, many practitioners and teachers fear that the requirements of the scientific model may unwittingly compromise the best that TCM has to offer by forcing it to abandon traditional diagnostic and treatment principles in favour of a reductionist, linear western model. Examples of recent studies will show some of the tension and promise in this field.
A double blind study published in the Chinese Journal of Integrated Traditional and Western Medicine treated 153 patients suffering from intractable ulcerative colitis, one of the most serious inflammatory bowel diseases. Patients were divided into three groups. One group was treated with a Chinese herbal formula in pill form and Chinese herbal enemas. The second group was treated with the standard western drugs sulfasalazine and steroids – orally and by enema. The third group was treated with a placebo and a herbal enema.
After three months, the Chinese herb group was 53.1% symptom-free and an additional 32.8% improved. The western drugs group was 27.7% symptom-free and 21.9% improved, while the placebo group was 19% symptom-free and 26.2% improved.
These are dramatic results, especially if we consider a few points. In a TCM clinical setting, ulcerative colitis would be treated much longer than three months, and up to one year. This would give many of the improved patients the likelihood of a permanent cure. Secondly, while the Western treatment may initially be effective when steroids are used, these are not feasible as a long-term treatment due to side effects, and over time the Western results can be expected to decline. Thirdly, even the placebo group received a herbal enema and consequently showed some results. Enemas are indispensable to the treatment of ulcerative colitis, and can, by themselves, stop the bleeding from the colon within one to two weeks. Finally, in order to blind the study (neither doctor nor patient knows who is taking medicine or placebo), the herbs had to be in pill form. In a clinical TCM setting, patients with this disease would be prescribed much stronger herbal decoctions, which may bring even more positive results.
This is a good example of how the requirements of the scientific model may partially hamper the effectiveness of traditional treatment.
In 2007, a study was published in the Journal of Allergy and Clinical Immunology by researchers at Mount Sinai School of Medicine in New York. The randomized study compared the use of a standard western treatment, the steroid prednisone, with a Chinese three-herb formula for the treatment of moderate to severe asthma. The conclusion of the four week trial was that the herbal combination was nearly as effective as prednisone at managing the symptoms, and without the side effects to the adrenal glands, immune suppression and weight gain caused by steroids. On the contrary, immune function markers improved on the Chinese herbal therapy. Researchers called the herbal treatment “remarkable” and concluded that it was effective and well tolerated.
One question a TCM doctor may pose is whether this treatment, composed of only three herbs, has a chance of being curative. Alternatively, will it merely control symptoms the way that western drugs do, albeit with less side effects? Classical TCM treatments ordinarily aim for a cure of asthma, with a complex protocol of much larger individualized formulas divided into acute and chronic stages. A study which evaluated such an approach would be much more illustrative of TCM’s full potential.
Peanut allergies are increasing exponentially and have absolutely stumped western medicine; the cause of this increase is unknown and there is no cure. This poses a constant threat to the lives of patients. In this field, the work of Dr. Xiu-Min Li, who is a pediatric researcher at Mount Sinai School of Medicine in New York as well as a TCM doctor, has been stunning.
Dr. Li chose a classical anti-parasitic formula called Wu Mei Wan as her starting point. This formula originally appeared in the famous herbal text Shang Han Lun around 200 A.D. (It is worth noting that this is the oldest clinical manual in the world.) Her savvy hypothesis was that the formula, with its balanced mix of hot and cold, cleansing and strengthening ingredients, would be able to modulate the immune response at the level of the gastrointestinal lining.
The study was performed on mice with confirmed peanut allergy. Half were treated with the herbal formula for seven weeks and half were given no treatment. At the end, all of the mice were exposed to peanuts.
The results? All of the untreated mice developed severe anaphylactic signs and significantly increased levels of histamine. In contrast, there were no signs of anaphylaxis or elevation of histamine in any of the Chinese herb treated mice. These results were replicated at one, three and five weeks after the herbal treatment was stopped, indicating a continuing beneficial effect of the herbal formula.
This study had a significant follow-up. Researchers wondered if all of the nine herbs were necessary to block the allergic response. This, indeed, has been one of the obstacles to studying TCM properly: researchers dislike testing multiple-herb formulas. Science likes to zero in on the “active ingredient” and eliminate uncomfortable variables and interactions. Unfortunately, when the herbs were studied individually or in smaller combinations, they were not able to produce the desired effect. The published conclusion was that “component herbs . . . work synergistically to produce the curative therapeutic effects produced by the whole formula.” (Of course, synergy, variables and interactions are the very foundation of TCM herbalism!)
Now, testing has moved to human subjects and is currently recruiting participants in the U.S. The study is FDA approved and will be run by Mount Sinai’s Center for Chinese Herbal Therapy for Allergy and Asthma. Thanks to a 2000 year-old formula, there is hope for anaphylactic sufferers after all.
TCM research has the potential to make a priceless contribution to the treatment of complex, modern diseases. This potential will only be realized, however, if studies incorporate and accommodate traditional diagnostics, therapeutic methods and standards of practice.
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