A huge challenge: traditional Chinese medicine vs Cochrane systematic review

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Taixiang W, Na Z, Guanjian L, Juan N

General: Traditional Chinese Medicine (TCM) is a 3000-year-old holistic system. It combined the use of medicinal herbs, acupuncture, food therapy, massage, and therapeutic exercise for both treatment and prevention of disease. TCM has its unique theories for concepts of etiology, systems of diagnosis and treatment that are vital to its practice. TCM itself consists of Chinese classical philosophy, clinical practice experiences, and material medica including usage experiences of herbs. TCM drug treatment consists typically of complex prescriptions of a combination of several components. The combination based on the Chinese diagnostic patterns (i.e., inspection, listening, smelling, inquiry, and palpation) follows a completely different rationale than many western drug treatments. Herbal medicine is the most important part of TCM. There are more than twenty thousands of herbal medicine preparations, including capsules and decoctions, involve in national essential drug list. The botanists, pharmacologists and clinicians are keeping on seeking new herbs and on making more and more preparations.

Many Chinese physicians believe that herbal medicines are effective for alleviating symptoms and shortening the duration of diseases. Herbal medicines are not only routinely used for most diseases in hospital, but are also commonly used by many Chinese people at home. More than equal to billions US dollars are spent on TCM per year.

Chinese government is powerfully pushing the modernization course of TCM, particularly herbal medicine.

Traditional medical practice is also worldly wide increasing in public interest and use of therapies. For example, 42% colorectal cancer patients used herbs in Canada, and 49% of cancer patients used complementary and alternative medicine (CAM), with vitamins, antioxidants, alternative diets, and herbal therapies in New Zealand.

Gaps: TCM one of the most complete systems with a huge database of clinical studies and experiences versus poor quality and inadequate methodology. TCM one of the most complex and the oldest systems versus an advanced evaluation system. Herbal medicine a huge treasury of natural medicine and a huge market of consumption versus a few clear evidences been proved.

What do we want: 1. To assess the effectiveness and safety of TCM by Cochrane Systematic Review. 2. To promote the capability of clinical study for Chinese medical researchers through learning knowledge of evidence-based medicine and doing Cochrane systematic review. 3. To influence healthy policy maker through producing Cochrane systematic review for TCM. 4. To supply best evidences for developing new natural drugs. 5. To develop an approach to evaluate TCM according to the principles of both Cochrane Systematic Review and TCM.

What are we doing and have done in the Complementary Medicine Field: 1. We are training reviewers since the summer of 2002. 2. There are 26 review groups are working on TCM. 3. Eleven protocols have been published. 4. Five reviewers were funded to participate INCLEN XX Global Meeting, Agra, India, to present their abstract of review. Four of the reviews are related herbal medicine. 5. We are planning to organize a new team including more than thirty reviewers focused on TCM in the treatment of neurology, mental and development disorders.