The need for systematic research in traditional Chinese medicine

Article type
Authors
Liu J, Li T, Lin H, Wang S
Abstract
Background: Traditional Chinese Medicine (TCM) constitutes the major part of Complimentary/ Alternative Medicine. The practice of Evidence-Based Medicine (EBM) lies in integrating clinical experience (TCM typically a kind of empirical medicine) with the contemporaneous research findings as the basis to improve quality of alternative therapies.

Objectives: To know about the current status of randomized controlled trials (RCTs) of TCM and pharmacology so as to furnish references for introducing EBM into therapeutic practice of TCM.

Methods: Handsearching was performed to identify clinical trials published in 28 TCM journals in China. The inclusion criteria for clinical trials were based on the Cochrane Collaboration Handbook (1998).

Results: From 1977 to 1996, there were 2938 pieces of RCTs on TCM published in the 28 TCM journals in China, among which, 869 RCTs were published in "Chinese Journal of Integrated Traditional and Western Medicine" from its first publication in 1981 to the end of 1996. Analysis to the published RCTs of TCM showed that most of them were not indexed in MEDLINE. And for design of the trials, there existed problems, such as inadequate, pseudo-randomization, small sample size, and lack of end point outcomes. Furthermore, there also lacked systematic review on TCM drugs or therapies in China.

Conclusions: Systematic research is needed in Chinese medicine and pharmacology. In order to change TCM from experience-based practice into evidence-based one, following aspects should be advocated: 1. to conduct international recognized randomized, placebo controlled trials with long-term endpoint events or outcomes as efficacy indicators to produce high quality evidence; 2. to establish effectiveness databases for individual TCM therapy and for different diseases; 3. to perform systematic reviews based on RCTs of TCM and pharmacology; 4. to list priority of diseases for studies to those TCM therapies showed efficacious, but still Western Medicine could not do; 5. to evaluate cost-benefit for TCM and pharmacology therapy for making health care decision more scientifically in China.