This week is dedicated to the debunk – debunking the absolute need for anti-anxiety medications (it may be your flashes, not your mood), debunking the myth underlying the lack of published data supporting the use of traditional Chinese Medicine (TCM, e.g. acupuncture and herbal medicine) and debunking the one-sided, endless loop about hormone replacement therapy.
Because Wednesday falls in the middle of the week, I want to focus on traditional Chinese medicine, which is considered part of the offerings that fall under the umbrella of “complimentary and alternative medicine.” As a practice, TCM was created roughly two thousand years ago and refined in the centuries that followed. And yet, Western practitioners continue to question its value because they claim that there is no real evidence supporting its therapeutic effectiveness. No evidence? A quick search on Google yields countless databases, with one example housing over 400,000 studies and abstracts, many of which have been published in reputable Chinese biomedical journals over the past several decades.
The challenge and the solution
Unquestionably, the evidence doesn’t look quite as strong when strict Western methodology is applied to Eastern philosophies without addressing their distinctions. In fact, a prime example of what happens when the paradigm shifts is the ACUFLASH study, which as I reported earlier this year and late last, demonstrated the benefits of acupuncture when the investigator practitioners were allowed to incorporate some invidualized therapy into the mix.
So what exactly does that mean – to incorporate individualized therapy into the mix?
A unique aspect of the ACUFLASH study was the ability of the practitioners to work within a defined framework but with the addition of directing therapy to each participant’s specific needs. In other words, the practitioners met before treatment and agreed on the specific symptoms or conditions they would include in the study as well as the specific acupuncture treatment points they could work on. This organized system meets some of the strict criteria of Western scientific study. However, they could then choose which of the the treatment points would most benefit a given participant’s system imbalance as well as provide possible diagnoses and self care recommendations (e.g. soy, herbs, physical activity and relaxation techniques) which participants were free to add at their own discretion. This ability to work within the confines of both Western and Eastern practice resulted in significantly beneficial results.
TCM versus Western Medicine
TCM and other similar philosophies emphasizes various body systems that together, form a network or grid connected by a meridien, if you will, as well as the relationship of the body to its social and natural environment. Its primary focus on maintaining health and enhancing the body’s ability to fight off disease. TCM will not focus, for example, on treating specific pathogens but rather, on addressing non-specific factors that create disturbances or imbalances within a certain network. TCM also examines how these imbalances may occur in unique parts of a specific system, such as the heart and blood vessels and small intestine (all of which are part of the heart system) and how they change over time. Western medicine, on the other hand, focuses primarily on treating morbidities, or symptoms related to various conditions and diseases.
Another point of distinction is that while Western practice is geared towards treating specific causes and symptoms of a disease, it doesn’t do so well when the causes or influences are less specific or more importantly varied. Sexual desire, or lack thereof, is a perfect example. It’s been demonstrated time and again that certain aspects of menopause or aging, for example, sexual desire, are not only related to physiology but also to environmental factors. And while the addition of estrogen can certainly help to keep vaginal juices flowing, so to speak, it can’t address social, psychological or behavioral factors that might also be influencing that desire.
I have said it before and I’ll say it again: my dream will be fulfilled when East meets West. I’d like to see greater integration of of the two philosophies and less push back from the Western Medical Establishment against TCM. Calling it a ‘sham,’ because it doesn’t fit into the traditional mold, calling it snake medicine because it isn’t based on medical school learnings, and refusing to examine published scientific papers that have been translated, however roughly, into English, does a disservice to the patients who might benefit from the integration of the two.
Since when are hot flashes and mood swings ‘pathologies,’ symptoms of a disease that requires drug treatment?
Isn’t it time to separate fact from fiction, hype from hope and myth from truth. TCM isn’t a sham. And menopause? It can truly be addressed without drug therapy.
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Herbal teas are actually quite excellent, as is acupuncture and chinese reflexology.
I like your article as an interesting springboard regarding TCM. As a practicing physician, I am intrigued by any approach that may provide substantial benefit to my patients. I also take seriously the oath to “First, do no harm.”
Although there is evidence of the benefit of acupuncture and ‘TCM’ in China, there is little evidence to recommend the use of the same treatment in a different and varied population as in the US. I would like to see more studies conducted regarding the use of these modalities. I personally would like to see more case reports of the efficacy of the methods and practices, followed by observational and cohort studies where different populations of patients with similar symptoms are divided into groups seeking traditional western medicine/allopathic and TCM/acupuncture in addition to traditional western medicine/allopathic. At present, there is a dearth of these studies that would be useful to then pose various treatments for rigorous RCT trials. Developing an RCT trial without prior research will likely result in wasteful spending and possibly even hurt TCM practitioners as poorly designed studies may provide erroneous data setting the field back.
I hope to learn more about these practices. However, I am cautious and skeptical that these practices will prove to as effective as claimed. Perhaps I am skeptical because that is my nature. After all, I need empiric and rational evidence as a physician.