Traditional Chinese Medicine and Science

There are two questions about TCM which can be investigated scientifically:
Does it work?

How does it work?


Does it work?

Most scientific research in the West about TCM has focused on acupuncture. The National Institutes of Health Consensus Statement on Acupuncture summarizes research on the efficacy of acupuncture as follows:
...promising results have emerged, for example, efficacy of acupuncture in adult post-operative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma for which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.
Much less work in the West has been done on Chinese herbal medicines, which comprises much of TCM in China. It is clear, however, that many if not most of these medicines do have powerful biochemical effects. An example is the herb ephedra which was introduced into the West as a stimulant, and later banned in the United States after deaths were attributed to its use. A less controversial example is artemisinin, derived from an herb long-used used in TCM, and now used worldwide to treat multi-drug resistant strains of falciparum malaria. In the West, many Chinese medicines have been marketed as herbal supplements and there has been considerable controversy over the regulatory status of these substances.
TCM practitioners have no philosophical objections to scientific studies on the effectiveness of treatments. The main barrier to the adoption of Chinese herbal medicines into Western practice is economic. It requires a large amount of expertise and money to conduct, for example, a double-blind drug trial, making it a large venture to test even one of the thousands of compounds used by TCM. Because these compounds cannot be patented and owned exclusively, there is a distinct disincentive to sponsor such expensive protocols.
There are also great a priori doubts about the efficacy of many TCM treatments that appear to have their basis in magical thinking, e.g. plants with heart-shaped leaves will help the heart, ground bones of tiger give a person energy because tigers are energetic animals and so on. To researchers, this is a very small base to start serious research on.

How does it work?

The basic mechanism of TCM is akin to treating the body as a black box, recording and classifying changes and observations of the patient using a traditional philosophy. In contrast to many alternative and complementary medicines such as homeopathy, practically all techniques of TCM have explanations for why they may be more effective than a placebo, which Western medicine can find plausible. Most doctors of Western medicine would not find implausible claims that qigong preserves health by encouraging relaxation and movement, that acupuncture relieves pain by stimulating the production of neurotransmitters, or that Chinese herbal medicines may contain powerful biochemical agents. However, the metaphors used in TCM theory often concern areas not readily measured or described by Western science.

This article is part of NCCAM documentation in public domain...