The Effectiveness Of Traditional Chinese Medicine

At this juncture, a better appreciation of the developmental differences between the East and West suggests at least some mitigating factors for the lack of scientific data in TCM.

For one, the western scientific systems and standards are, after all, very much a thing of the West. While these standards are good standards to use, they are by no means the only systems and standards for science that exist and that have brought progress to society.

The Easterners, having developed an entirely different way of living from the Westerners, have entirely different systems of philosophies, society, politics, culture, knowledge as well as science. These different systems and standards too have brought the Easterners progress in other ways.

Ignoring how the alternative systems and standards of the Chinese had allowed them to establish an affordable health care system (using Traditional Chinese Medicine) for billions of people [3] over many centuries suggest some degree of myopia on the part of the on-looker.

Another mitigating factor is that, unfortunately, the inherent nature of TCM also makes it difficult for TCM to be studied using western scientific methods.

With a clinical research study, the inclusion and exclusion criteria for participant selection, the actual treatment to be evaluated, and the measures/indicators of effectiveness need to be clearly defined prior to the start of the study.

Yet the use of TCM diagnostic methods can make it difficult to obtain a homogenous group of participants. For example, a homogenous group of depression patients (as diagnosed by western psychiatry) may represent more than a dozen diagnostic types when evaluated by TCM [4].

In turn, patients with different diagnostic types would require different treatments [4]. In fact, given the individualized nature of TCM treatment, even patients with the same diagnostic type may be given treatment that is at least slightly different.

And ironically, the “one-size-fits-all” approach (e.g. giving a standardized treatment for the average diagnosis) that makes it so much easier to test using western scientific methods, is often frowned upon by TCM practitioners [1, 3], and has been proven by Bensoussan and colleagues [3] to render Traditional Chinese Medicine less effective.

Some have proposed ways of getting round the above problem using a double classification approach. In a double classification approach, participants that meet the pre-determined western diagnostic criteria (e.g. are diagnosed to have depression by western psychiatry) are then further classified using TCM into their diagnostic types. Treatment is then delivered according to TCM principles and then outcomes of the TCM treatments are evaluated using criteria and measures from both the western and TCM systems. [4]

Nonetheless, such a study design is considerably more complicated. A larger participant sample would be needed, since there would be more experimental groups within the study. Stringent inclusion and exclusion criteria would have to be established beforehand, least the study ends up dealing with more experimental groups than it is prepared to handle.

There are other challenges when evaluating Traditional Chinese Medicine using randomized, double-blind, placebo-controlled clinical trials.

Finding appropriate placebos for placebo-controlled TCM studies can also be challenging. For example, placebos for TCM herbal formulas will need to be matched in terms of color, odor and taste, etc. Replicating these properties in a placebo can be rather challenging, though not impossible, given the distinctive properties of different herbs [4]. Similarly, when it comes to acupuncture studies, placebo acupuncture points would have to be used [1].

With hands-on therapies like acupuncture, double-blind study designs can be challenging. Acupuncturists who perform fake treatment for the control group may unconsciously convey a lack of outcome confidence to the participants, as such contributing to biasness in the study [1].

Yet if trained technicians, instead of real acupuncturists, are used to carry out the treatment for both treatment and control groups, in all likelihood (and it is not unreasonable to suppose so), the treatment administered would be much less effective than if the real acupuncturist had delivered the treatment [1]. The sacrifice of treatment efficacy in order to achieve double-blind study standards arguably defeats the purpose of the study.

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