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Science gets behind traditional medicine

Published On: Thursday, May 28, 2015
Category: Acupuncture

The journal Science has just published a three-part series, ‘The Art and Science of Traditional Medicine’

 

The journal Science has just published a three-part series, ‘The Art and Science of Traditional Medicine’, which presents a persuasive set of arguments for the integration of traditional Chinese medicine into modern medical practice. Each of the 25-page issues contains ten articles, covering a range of topics, from the WHO’s Traditional Medicine Strategy to the application of OMICS technologies in the study of TCM, and the importance of quality control and safety for traditional therapies. The overall focus is heavily slanted towards herbal medicine, although acupuncture does get a few mentions. World Health Organisation (WHO) director Margaret Chan waves the banner for traditional medicine (TM) as an accessible, affordable alternative/addition to expensive allopathic medicine, which is desperately needed in a time of soaring healthcare costs. The WHO‘s strategy for the next decade therefore seeks to strengthen the role that TM plays in keeping populations healthy. The authors frequently contrast the ‘bottom-up’ approach of Western biomedical sciences, where ‘data are collected to generate information, knowledge, and, ultimately, a form of wisdom’ with traditional medical systems like TCM that have focused on using empirical evaluation ‘to gain a holistic understanding of systems, and on applying that wisdom in a “top-down” manner in the search for knowledge, information and data’. Most of the pieces advocate a ‘middle way’, where the two traditions meet to produce a combination in which ‘detail and context are optimally balanced’. This meeting of medical hemispheres is furthered by the adoption of scientific principles and techniques by those researching TM, and by the fact that modern biomedical science is expanding beyond its formerly reductionist paradigm to embrace the concepts of systems biology, which views human diseases as the result of a multifactorial instability in homeostasis. Past successes are touted, like the screening herbal of medicines to identify novel multi-target drugs. One interesting example cited is the analysis of herbs used to treat blood stasis and qi deficiency in coronary heart disease. This has indicated that the herbs for eliminating blood stasis have vasodilatory and anticoagulant activity, and can improve microcirculation and regulate blood lipids, while qi-tonifying herbs enhance energy metabolism and exhibit anti-inflammatory activity. Other papers are forward-looking, envisioning the creation of useful research resources, such as a comprehensive and easily searchable database storing molecular and biological data for herbal medicines. One far-thinking piece imagineers a nanobiochip the size and shape of an acupuncture needle - an ‘intelligent’ needle or ‘i-needle’. This sci-fi-sounding device would use carbon nanotubes and nanobiosensors to monitor levels of metabolites at its insertion site, enabling us to follow, in real time, the flow of molecular events during the activation of the acupoint, and revealing the biochemical intricacies of the cellular signalling symphony that is initiated by acupuncture. On a more down-to-earth level, there is widespread acknowledgement by many writers that in order for TM to be accepted into a global, evidence-based health care system, there is a pressing requirement for rigorously collected data demonstrating its efficacy, and an imperative for the development of robust international standards of safety and quality, supported by appropriate regulation. An article co-authored by Professor Nicola Robinson of London’s South Bank University proposes the combination of comparative effectiveness research principles with systems biology-based OMICS technologies in order to collect evidence for TCM that can be used to legitimise its use and optimise clinical decision-making. It is a big deal that one of the most prestigious and widely-cited scientific journals in the world takes up the cause of traditional medicine (even if it is presented in the form of a sponsored supplement edited by a panel of TM experts, rather than inside the peer-reviewed pages of the journal itself). This series represents a useful resource that could be used to lobby global policymakers in healthcare and government on behalf of acupuncture and herbal medicine, highlighting the benefits of a future that includes an integrated healthcare system. One that, in the words of Alan Leshner, PhD, CEO of the American Association for the Advancement of Science and Executive Publisher of Science, ‘takes the best of East and West and brings them together for the benefit of all.      

The Art and Science of Traditional Medicine Part 1: TCM Today — A Case for Integration. Science 2014 Dec; 346(6216):1569

The Art and Science of Traditional Medicine Part 2: Multidisciplinary Approaches for Studying Traditional Medicine. Science 2015 16 Jan; 347(6219):337.

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