"For the modernization of Chinese Medicine in the 21st century, it is our goal to establish standard preparations of traditional Chinese herbal medications using modern biochemical techniques. This will allow us to assess their efficacy, and potential toxicity including herb-herb and herb-western drug interactions."
Ren Denquan, Deputy Commissioner (Retired), State Food and Drug Administration of the Peoples Republic of China, and Honorary Director of the Association for Modernized Chinese Medicine (MCMIA)
The Modernized Chinese Medicine International Association (MCMIA) was the organizer for this annual conference in Hong Kong. Each year, the MCMIA focuses on one particular disease or condition and invites traditional Chinese medicine (TCM) and western practitioners/scientists to exchange their views on treatment of a particular disease state. This year's topic was about the therapy of rheumatoid arthritis with a focus on herbal therapy in combination with other herbs and with western medicines.
As a "western" rheumatologist attending this meeting, there is increasing awareness that a large proportion (perhaps a majority) of our patients are using nutritional supplements including herbs. Some health insurance providers even pay for the cost of such supplements. However, most western physicians remain largely unaware of the use of these medications (supplements) by their patients, as well as their potential efficacy or their toxicity when combined with other herbs or with western medications.
The goals and presentations of the conference were:
To enhance cooperation and understanding between practitioners of western medicine and traditional Chinese medicine ("TCM"), as evidenced by the presentation of methods of diagnosis and treatment for rheumatoid arthritis (RA) treatment by western medicine as well as by TCM practitioners. This task was facilitated by moderation of the sessions by western trained physicians with experience in TCM.
To recognize the immediate need to develop methodology for the quality control of herbal medications and their correct dosages. The presentations included application of western methods of biochemical analysis of herbal medications and elucidation of their mechanism of action using methods of gene expression profiling and application of bioinformatics.
To develop databases with chemically validated herbs to promote the study of herb-herb and herb-western medication interactions. This goal is facilitated by the Hospital Authority of Hong Kong to use information technology methods to create the database.
To design protocols that conform to western models of randomized double-blind placebo-controlled studies when chemically validated herbs (or their extracts) are available.
As a specific example of differences between western and TCM, we will review RA as a diagnostic category. Although criteria for RA are considered "well defined" in western medicine, RA does not clearly fit into a specific TCM classification based on concepts of "ying," "yang," and "qi." This leads to a lack of agreement on diagnosis and use of herbs even among TCM practitioners. Also, the mixture of herbs used by TCM is continually varied based on the patient's symptoms. Therefore, an integrated approach to RA will be the systematic evaluation of herbs as an adjunct to western therapy in patients fulfilling western RA criteria.
This conference is important to western rheumatologists because our patients are using herbal medications on an increasingly frequent basis and these agents are currently not standardized. Patients may be obtaining their herbs from unscrupulous manufacturers or practitioners who may have minimal experience in herbal medicine. Thus the quality control of both herbs and licensing of the practitioners who dispense them must be carefully examined if we are to make progress in determining either the efficacy or toxicity of these agents.
This meeting neither endorsed nor rejected the efficacy or toxicity of herbal treatments for arthritis. However, it did propose guidelines to determine the standardized preparation of herbs to assess drug interactions and toxicity, as well as protocols to assess efficacy in future studies.
Medscape Rheumatology. 2005;7(2) © 2005 Medscape
Cite this: Highlights of the International Conference and Exhibition of the Modernization of Traditional Chinese Medicine and Health Products - Medscape - Sep 15, 2005.