IN the past, carrying out scientific research on alternative therapies was unheard of. However, Dr Charlie Xue, head of the Chinese Medicine Unit at RMIT University in Australia pointed out that clinical trials could be carried out on Chinese medicine despite the complex issues involved. In his paper, Strategies to incorporate the Chinese medicine principles in clinical trials, Dr Xue said evidence-based practice in Chinese medicine tends to be problema-tic because Chinese medicine emphasises individualised treatment and syndrome differentiation.
Dr. Charlie Xue: "Chinese medicine has a more complex theory than Western medicine."Chinese medicine has been used for thousands of years and it is practised under a very unique physiological framework, he said. In syndrome differentiation, a patient may have the same disease but the disease can belong to various categories of subgroups. For example, the cause of headache can be divided into four different subgroups common cold, injury, hypertension and stress therefore the treatment is different for each case. Individualised treatment means prescribing herbal dosage to patients based on their age, gender, size and dietary preference, lifestyle and other medication use.
Chinese medicine takes a lot of things into consideration and is very specific and comprehensive. Chinese medicine has a more complex theory than Western medicine and that makes the former difficult in designing clinical trials, said Dr Xue. Western medicine tends to look at one treatment for one disease. For example, a new trial for a drug for hypertension will include all patients who are hypertensive. But hypertension in Chinese medicine is divided into four subgroups. If you apply one treatment for all those patients then the study will not reflect the actual clinical practice where the patient might be treated in one of the four different ways, he said. Clinical trials in Chinese medicine need to address this issue. What we did was we used a double patient selection process. That means for the first stage, we used the same approach as Western medicine does all patients who have the tendencies were selected for the study. Then, we used the Chinese medicine selection process to put them into four different subgroups based on Chinese medicine theory. On that basis, we selected one group to study, and then you can design another study for another group. So this will not compromise the scientific data of randomised controlled trials. At the same time, you also adhere to Chinese medicine theory. The outcome of the study would be more reliable because it addresses the criteria of both Western and Chinese medical approaches, he said.
He said in carrying out trials for herbal medicine, there should be sufficient details about herbal identification, the quality of herbs and the manufacturing process. This is to ensure that one is actually testing what is supposed to be tested, he said. By Loh Foon Fong