While the recent debate to abolish traditional Chinese medicine
(TCM) from official medical system has been fading from media
spotlight, it has ignited a wide and continuous discussion on the
approaches for the TCM modernization.
"The primary reason for the call to abolish TCM from the
medicine is it is less scientific. It seems to me that the term
'scientific' has been used in a misleading way," said Zhang
Shitian, a former drug evaluator at the State Food and Drug
Administration (SFDA) and now a consultant to Health, Welfare and
Food Bureau of Hong Kong Special Administrative Region.
The debate on the fate of TCM was aroused by Zhang Gongyao, a
professor of philosophy of science at Changsha-based Central South
University.
In early October, Zhang posted an article in his blog (http://hexun.com/zhgybk),
suggesting the government abolish TCM from the official medical
system but still retain it as an unfunded, grass-roots service. He
said that TCM had too many unscientific components, high toxicity
and uncertain therapeutic effects.
The blog article quickly triggered wide-spread public debate. By
the end of last month, most denounced Zhang as ignorant of TCM.
An online survey launched by the popular news portal Sina.com.cn
attracted more than 40,000 votes by the end of October, and more
than 80 per cent supported TCM.
The professor fell, not answering calls and responding to any
e-mail.
Zhang's call to abolish TCM from official medical system
occurred amidst several widely reported cases concerning TCM
toxicity and irregular practices.
In August, the UK drug authorities banned a TCM Fufang Luhui
Jiaonang, a capsulated compound based primarily on aloe used as
nutritious supplements in that country because they have been found
with high amount of mercury 11,700 times of the UK standard.
In mid October, three kinds of anti-diabetes TCM were found by
Shanghai drug authorities to illegally contain chemical compounds.
These compounds were found to have a fast effect to reduce blood
sugar, but their side effects were so major that they had been
banned in the mid 1980s.
In China, adding chemical compounds into TCM to compose a
Chinese-Western joint medicine is theoretically legal, as long as
it is strictly reviewed and approved by the SFDA.
However, Song Jun, a TCM doctor with Beijing Xiyuan Hospital
affiliated to the Chinese Academy of Chinese Medical Sciences
(CACMS), said if the TCM makers add chemical compounds to their
medicine, their drugs were very unlikely to be approved.
Mao Qun'an, spokesperson for the Ministry of Health, has
rebuffed Zhang's proposal by saying it is ignorant of the Chinese
history.
While calling Zhang's proposal an irresponsible farce, Fang
Shuting, deputy director of the State Administration of TCM, vowed
that China will continuously support the development of TCM and its
modernization.
Meanwhile, at a time when genes and proteins are dominating the
attention in the medical researches, studies have yet to reveal the
genetic or molecular mechanism of TCM-based therapies in lab
experiments.
For Wang Xudong, a professor of TCM at Nanjing University of
TCM, however, the medicine's lack of results in the molecular level
should not be considered as its failure. "Modern Western medicine
and TCM are two totally different approaches. For the previous one,
all therapeutic approaches are based on a clear understanding of
the pathogenic targets; but for TCM, its role is mainly embodied in
strengthening the natural human functions. You cannot bet
everything (of TCM) be clearly understood in the molecular level
before using it," Wang said.
Most doctors and experts involved in the TCM debate, however,
say that the prosperity of TCM relies on how well TCM comply with
modern medical sciences. "You cannot explain all the traditional
philosophy such as yin and yang backing TCM to an era featured with
genes and proteins," said Wang Zhao, a professor of natural
medicine at Tsinghua University.
Yet Zhang Shitian argued that TCM's complying with modern
medical sciences does not mean it must be totally evaluated with
the paradigm of modern sciences.
"It has been stressed that TCM is not modernized until each
pharmaceutical molecule of a TCM prescription is well understood
and its function in human bodies clearly elaborated in the
molecular level," Zhang said at the 10th Healthcare Industry Forum,
organized by Beijing Pharma and Biotech Centre late last month.
"But for TCM, which commonly involves several herbal ingredients
for a single prescription, this is impossible and often
unnecessary, because they have been tested in human bodies for
thousands of years," Zhang Shitian told China Daily.
Despite the accumulated efforts in China over the past 50 years,
no more than 10 TCM-based herbals have been clearly understood in
the single molecule level.
Wang Zhimin, director of natural herb department at the CACMS,
argued that the lack of research results in the molecule level does
not mean the scientific studies on TCM are less successful.
"In the process of the studies, we have better understood the
TCM mechanism and our understanding can be accelerated with the
better combination of TCM and modern molecular biology," Wang
said.
Zhang said that the right way is to use modern chemistry or
molecular biology to purify and standardize the most
pharmaceutically active compounds of TCM no matter they are a
single molecular or a group of molecules whose very names remain
unknown.
"In this way, we can ensure to maximize the therapeutic effects
of TCM while minimizing its side effects and toxicity," Zhang
said.
Ye Zuguang, a famous researcher at CACMS, agreed. While the
molecular studies on TCM herbs are necessary in the basic research,
strict procedures for clinical trial can be introduced to
re-evaluate the efficiency and safety of the existing TCM and newly
approved ones, Ye said.
"The molecular studies and the practical re-evaluation of TCM
can be combined together. With this innovative approach, TCM can
keep a new and booming life in China," Ye concluded.
(China Daily November 22, 2006)