• Chinese Medicine: A Healing Tradition

    rerun imageTraditional Chinese Medicine (TCM) is one of the most complex, highly-developed traditional healing theories in the world. The major components of TCM are acupuncture and herbal medicine . Other aspects include acupressure massage, exercise systems such as Tai Chi (pronounced “tie chee”) and Chi Gung , and theories about architecture and interior decoration known as Feng Shui (pronounced “fung shwee”). TCM attracts many people today because of its holistic emphasis, its ancient origins, and its Eastern feel. However, as yet, there is only limited scientific evidence that it actually works.

    History of Chinese Medicine

    Primitive acupuncture needles dating back to around 1000 BC have been discovered in archeological finds of the Shan dynasty in China. The theoretical framework underlying the practice of acupuncture was first set forth in the Inner Classic of Medicine or Nei Jing , first published in 206 BC. Chinese herbal medicine received its first rudimentary theoretical foundations at about the same time, but it was not until the twelfth century that the depth of medical theorizing associated with acupuncture was fully applied to herbal treatment.
    Over subsequent years, both acupuncture and herbal medicine evolved greatly, with major changes occurring at different points in history. The 19th century was a time of ferment, and many “traditional” techniques popular today actually originated during that period. A further major revision took place during the Maoist period in China.

    Principles of Traditional Chinese Medicine

    Traditional Chinese medicine is an all-embracing system that—at least in theory—encompasses every aspect of human existence. According to the principles of TCM, health exists when life-energy (“Qi”) flows freely and the opposing forces of “yin and yang” are balanced.
    Exercise systems such as Tai Chi and Chi Gung (Qigong) are said to help maintain this healthy flow. Feng Shui principles are said to provide the proper living environment to enhance health. Acupuncture and Chinese herbal medicine are used to restore balance and free flow of energy when it has become disturbed.

    The Practice of Traditional Chinese Medicine

    Acupuncture involves the use of hair-thin needles inserted in specific spots on the body called acupuncture points. These points are chosen according to the principles of TCM. Their application is not based on the Western concept of the disease involved. Acupuncture is practiced primarily by certified acupuncturists, although other health professionals may use it as well.
    Chinese herbal medicine involves the use of complex, herbal combinations. Again, these combinations are chosen according to the specific pattern of imbalance in the individual. Acupuncturists often prescribe Chinese herbs, and there are also people who practice Chinese herbology alone.
    Tai Chi and Chi Gung involve special movements and ways of breathing. These methods are usually taught in group classes, and daily practice is necessary for the best results.
    The art of Feng Shui involves arranging the living situation so that the outer circumstances support health. It can be learned in classes or from books. Feng Shui counselors are also available.

    Current Uses

    In theory, TCM can address all possible physical, psychological, and spiritual problems. It is primarily used to treat long-term chronic conditions (eg, rheumatoid arthritis and menopausal symptoms ), as well as some acute or recurrent conditions that are not life threatening (such as menstrual pain , migraine headaches , and colds and flus ). TCM is also widely used to promote wellness and prevent disease.

    Scientific Evidence

    At present, there is no meaningful scientific evidence that the principles of TCM reflect true insights into health. There is some evidence, however, that certain TCM therapies may be helpful for specific conditions.
    For example, acupuncture is one therapy that has undergone a great deal of study. The overall results from numerous studies found that acupunture produces at least a modest benefit for the relief of nausea and vomiting. In addition, several small studies have found acupuncture to be helpful for tendonitis. But the research on other common conditions, like back pain and neck pain, have produced inconsistent results or have been low-quality studies.
    Chinese herbal medicine has undergone less scientific evaluation. For most conditions studied, at most two double-blind trials have been reported, and even these were generally not up to current scientific standards. Weak evidence of this type hints that Chinese herbal treatment may be helpful certain conditions, such as for allergies, asthma , constipation , menstrual pain, muscle spasm, and osteoarthritis.

    Safety Concerns

    There are serious safety concerns regarding traditional Chinese herbal therapy. Chinese herbal medicine traditionally uses treatments that are now recognized as potentially dangerous, such as mercury, arsenic, lead, licorice, and the herb Aristolochia. In Hong Kong, poisoning caused by the herb aconite (used in numerous Chinese herbal formulas) was sufficiently widespread that public health authorities felt it necessary to launch an information campaign to combat the problem.
    Besides toxicity caused by Chinese herbs, other problems have been caused by adulteration of herbal products with unlisted ingredients. For example, the Chinese herbal formula PC-SPES, used for prostate cancer, turned out to contain three pharmaceutical drugs—diethylstilbestrol (DES), warfarin (Coumadin), and indomethacin. In another episode, eight out of 11 Chinese herbal creams sold in the United Kingdom for the treatment of eczema were found to contain strong pharmaceutical steroids.
    For these reasons, take precautions before trying Chinese medicine and make sure that you talk to your doctor before taking any herbs.

    RESOURCES

    National Center for Complementary and Alternative Medicine http://nccam.nih.gov/

    National Institutes of Health http://www.nih.gov

    CANADIAN RESOURCES

    Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research http://www.incamresearch.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    Acupuncture. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated February 12, 2012. Accessed April 16, 2012.

    Bensky D, Barolet R. Chinese Herbal Medicines Formulas and Strategies . Seattle, WA: Eastland Press;1990.

    Bensoussan A, Talley NJ, Hing M, et al. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. JAMA . 1998;280:1585-1589.

    Ceecherelli F, Bordin M, Gagliardi G, et al. Comparison between superficial and deep acupuncture in the treatment of the shoulder's myofascial pain: a randomized and controlled study. Acupunct Electrother Res. 2001;26:229-238.

    Chan TY. Incidence of herb-induced aconitine poisoning in Hong Kong: impact of publicity measures to promote awareness among the herbalists and the public. Drug Saf . 2002;25:823-828.

    E Ernst. Adulteration of Chinese herbal medicines with synthetic drugs: a systematic review. J Intern Med. 2002;252:107-113.

    Fink M, Wolkenstein E, Karst M, et al. Acupuncture in chronic epicondylitis: a randomized controlled trial. Rheumatology . 2002;41:205-209.

    Fung AY, Look PC, Chong LY, et al. A controlled trial of traditional Chinese herbal medicine in Chinese patients with recalcitrant atopic dermatitis. Int J Dermatol . 1999;38:387-392.

    Hu G, Walls RS, Bass D, et al. The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial. Ann Allergy Asthma Immunol. 2002;88:478-487.

    Ishizaki T, Sasaki F, Ameshima S, et al. Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. Eur Respir J . 1996;9:2691-2696.

    Japan's Health Ministry confirms efficacy of another of Tsumura's Kampo drugs. Kampo Today [serial online]. 2000:4. Available at: http://www.tsumura.co.jp/ . Accessed November 4, 2002.

    Jung YB, Roh KJ, Jung JA, et al. Effect of SKI 306X, a new herbal anti-arthritic agent, in patients with osteoarthritis of the knee: a double-blind placebo controlled study. Am J Chin Med . 2001;29:485-491.

    Kaptchuk TJ. Acupuncture: theory, efficacy, and practice. Ann Intern Med . 2002;136:374-383.

    Kleinhenz J, Streitberger K, Windeler J, et al. Randomized clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendonitis. Pain . 1999;83:235-241.

    Kotani N, Oyama T, Sakai I, et al. Analgesic effect of a herbal medicine for treatment of primary dysmenorrhea—a double-blind study. Am J Chin Med . 1997;25:205-212.

    Li JX, Hong Y, Chan KM. Tai chi: physiological characteristics and beneficial effects on health. Br J Sports Med. 2001;35:148-156.

    Liu JP, McIntosh H, Lin H. Chinese medicinal herbs for chronic hepatitis B. Cochrane Database Syst Rev. 2001;CD001940.

    Molsberger A, Hille E. The analgesic effect of acupuncture in chronic tennis elbow pain. Br J Rheumatol . 1994;33:1162-1165.

    Sheehan MP, Atherton DJ. A controlled trial of traditional Chinese medicinal plants in widespread non-exudative atopic eczema. Br J Dermatol . 1992;126:179-184.

    Sheehan MP, Rustin MH, Atherton DJ, et al. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet. 1992;340:13-17.

    Traditional Chinese herbal medicine. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated September 27, 2011. Accessed April 16, 2012.

    Urata Y, Yoshida S, Irie Y, et al. Treatment of asthma patients with herbal medicine TJ-96: a randomized controlled trial. Respir Med. 2002;96:469-474.

    Verucchi G, Calza L, Attard L, et al. Acute hepatitis induced by traditional Chinese herbs used in the treatment of psoriasis J Gastroenterol Hepatol . 2002;17:1342-1345.

    White AR, Filshie J, Cummings TM; International Acupuncture Research Forum. Clinical trials of acupuncture: consensus recommendations for optimal treatment, sham controls and blinding. Complement Ther Med . 2001;9:237-245.

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