Symposium “Exploring Traditional Medicine”Published by mkareithi on Mon, 2017-03-06 07:50
23 – 24 September， 2015
Lecture hall at CACMS
Session Chairs (L to R)
Prof. Zuguang Ye (CACMS) &
Prof. Liu Depei (CAE)
The meeting was opened by IAMP co-chair, Lai Meng Looi, who highlighted the fact that soaring healthcare costs in many countries mean that they are investigating the potential of traditional healthcare practices such as Ayurveda from India or Chinese traditional medicine (TCM), both of which are based on thousands of years’ of accumulated wisdom. She also thanked the reviewers, nominated by IAMP member academies, for selecting the case studies to be presented at the meeting, especially those attending who would also help to critically review the presentations.
Also at the opening ceremony, Daiming Fan, vice president of CAE, noted that, in the case of TCM: “There are those who argue that it is not science-based. It is true that we have not identified the scientific evidence for how it works. We must start to do that.” He also proposed a future integrated approach – the development of innovations from a merging of Western and traditional medical practices.
Boli Zhang, CACMS president, also accepted that the methodologies of TCM have not been standardized and that there are still many questions relating to safety and efficacy. “Traditional medicine can be effective”, he said, “and we must carry on traditional practices while improving them, using modern techniques to generate scientific evidence and identify solutions.”
Established 60 years ago, this is exactly the mission of CACMS, which currently employs 6,000 staff spread across 13 research institutes and two hospitals.
“Traditional medicine attracts both uncritical enthusiasm and uninformed criticism,” said Bernhard Schwartländer, representation of the World Health Organization (WHO) in China, during his opening address. “But it is arrogant to ignore thousands of years of wisdom. We need to explore it and exploit it. After all, 40% of the population of China and 80% of the population of Africa are using traditional medicines.”
The WHO, via a resolution taken at its 2014 World Health Assembly, has a strategy for traditional medicine, and recognizes the role it can play in national healthcare systems.
“But there are still many gaps and grey areas in traditional medicine practices”, he added. “We need to build the evidence – what works and what doesn’t, develop standards and regulatory frameworks, undertake controlled clinical trials, and find innovative ways of documenting the evidence base, such as ‘big data’.” Schwartländer ended by expressing his hopes that the experts assembled in Beijing by IAMP and its partners could help galvanize this process.
“We still have traditional medicine after thousands of years because it is safe and effective,” claimed Wenming Yu, deputy director of the State Administration of Traditional Chinese Medicine (SATCM). “TCM is, in fact, both traditional and modern as it makes good use of modern developments and has been enriched over the years. Our hope now is that, with IAMP, CAE and others, we can push ahead with the global development of traditional medicine, boost international cooperation in the subject, and contribute to the global development of medical practice.”
The symposium itself, held on 23-24 September, featured 24 presentations from the invited experts. More than 300 people registered to attend the event, many of them students and scholars of the CACMS institutes, but also presidents and vice presidents of CACMS institutes, as well as presidents of four Beijing-based TCM hospitals and editors of TCM journals.
The first session included seven presentations on clinical aspects. Boli Zhang, for example, highlighted that studies following good clinical practices and rigorous ethical standards had been carried out on Qi-Shen-Yi-Qi, a traditional medication for heart conditions. This formula can inhibit the inflammatory reaction, improve blood lipid content, and alter the structure of plaque tissue in the blood vessels, said Boli. A trial with more than 3,000 patients also demonstrated that it was as effective as aspirin, the allopathic drug of choice for certain heart conditions, but with less severe side effects. Qi-Shen-Yi-Qi has now been on the market for 15 years.
From Tanzania, Jichola Masanja introduced his research into the effects of Prunus africana on benign prostate hyperplasia. Using standard international Prostate symptom scoring system (IPSS) and measured for quality of life (QoL), his 80-patient study, however, showed no improvement in IPPS or QoL when compared to a placebo treatment.
In the session on acupuncture and moxibustion, one of the four papers presented also focused on benign prostate hyperplasia. More than 80 patients aged between 50 and 70 and showing mild to moderate signs of benign prostate hyperplasia were enrolled in the study, which included two treatment groups. One group received acupuncture with electrostimulation at the prescribed points (acupoints), while the other group received a similar treatment but with needles inserted at other sites. By the sixth week of treatment, and carried over 16 sessions through to the 18th week, IPSS scores improved for the acupoint group.
“Electrostimulation was the same in both groups, so it must be the acupoint that accounts for the difference in IPSS,” concluded Zhishun Liu of the Guang’an Men Hospital, CACMS.
Two additional randomized control trials illustrating positive results with acupuncture were described, one for functional dyspepsia and another for migraine prophylaxis. Fanrong Liang of Chengdu University of TCM, for example, elicited significant changes in dyspepsia symptom index for the patients receiving acupuncture compared to those who were subjected to sham acupuncture and, using PET-CT (positron emission tomography-computed tomography), further demonstrated changes in the central nervous system in those who responded to the treatment. These findings have recently been published in the mainstream scientific literature.
The session on public health featured two presentations, from Nceba Gqaleni, South Africa, and Senaka Pilapitya, Sri Lanka.
Comparing these two countries and China shows the different amounts of integration of traditional medicine into mainstream medical practices. While TCM is widely adopted and supported at government level in China, there is no government support for traditional medicine practitioners in South Africa. Gqaleni, for example, described a project designed to educate practitioners working in the large ‘informal’ heath sector in South Africa through five-day courses followed by two-years where trainers would work alongside the traditional practitioners. “The aim,” confirmed Gqaleni, “is to integrate health messages so that interventions on HIV or tuberculosis, for example, are consistent. Participants also learn how to protect themselves, for example when working with coughing TB patients.”
In Sri Lanka, as described by Pilapitya, the system of integration is more advanced, with a Ministry of Indigenous Medicine regulating the process. Even so, there are thousands of unregulated traditional medicine practitioners in the country who are technically operating illegally. The challenge is to identify these, register them and eventually regulate them, ensuring that only those who are qualified continue to practice.
In the meantime, a pilot project in Anuradhapura, Sri Lanka’s largest region, has trained 55 so-called health promotion officers’ via a university-certified 6-month course. (Another 55 are currently receiving training). These officers work in the community, typically with ageing patients and perhaps those being rehabilitated after strokes, often referring to Ayurveda techniques. In parallel, mainstream medical doctors in the country are being introduced to Ayurveda with positive results. The 127th Congress of the Sri Lanka Medical Association, for example, included a special side-event on traditional medicine that was well received.
Of the eight papers on drug discovery, two novel approaches were particularly interesting. Aiping Lu of the Hong Kong Baptist University attempted to bridge the classification concepts of the mainstream International Classification of Diseases (ICD) and traditional Chinese medicine’s Zheng system, while Shao Li of Tsinghua University demonstrated a network target approach for deciphering TCM in the era of ‘big data’. ust be the acupoint that accounts for the difference in IPSS,” concluded Zhishun Liu of the Guang’an Men Hospital, CACMS.
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