Can East meet West in medicine? Integration is a slow process

Liberian Joel Carnoen came to China two years ago to study Western medicine, but has now expanded her specialization to include traditional Chinese medicine.

Now a graduate student at Shanghai University of Traditional Chinese Medicine, Carnohayn is taking courses that integrate Chinese and Western medicine.

“My clinical practice shows me that TCM improves blood flow to the eyes in the treatment of conditions such as dry eyes, optic atrophy and diabetic macular edema,” she said. “In addition, I have found that it can help treat insomnia, lower back pain, constipation and facial paralysis and can also enhance beauty.”

Can East meet West in medicine?  Integration is a slow process

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Liberian Joel Karnoen, who has a PhD from Shanghai, sees great opportunities for TCM in Africa.

She also found traditional therapy helpful for herself.

Carnohayn said massaging several acupoints on her head helped her relieve long-term migraine attacks.

“Now whenever I feel a migraine starting, I start massaging the acupoints, and the headache goes away instantly,” she said. “For about eight months, I haven’t taken any migraine pills.”

In recent years, TCM has become more and more internationally known. Schools were opened for its study in the West. In the United States alone, about 50 programs are accredited by the American College of Acupuncture and Oriental Medicine.

There are more than 12,000 acupuncturists working throughout the United States, with more than 10 million acupuncture treatments performed annually, said Lawrence Tian, ​​a 17-year acupuncturist and oriental medicine physician in California.

Can East meet West in medicine?  Integration is a slow process

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Acupuncture has become popular in the United States with office workers seeking muscle pain relief and weight loss.

“Because acupuncture is considered an ‘invasive treatment’ in California, it requires a license to practice it, issued by the California Acupuncture Board,” Tian said.

Most of Tien’s clients are office workers seeking to relieve muscle pain, lose weight, or enhance general physical and emotional well-being.

“Although many people in the United States believe that the theories and practices underlying TCM are not based on scientific knowledge, I am still fascinated by the rich culture behind it,” Tian said. “It has a tradition of preventative treatment. So for Chinese medicine, maintaining health is the goal and treating disease is just a means.”

An American patient who identified herself only as Lisa M said that acupuncture cured her of a long-standing TMJ disorder associated with painful clicking in the jaw.

“Everything any dentist or doctor ever told me was, ‘Yeah, there’s something wrong with your jaw,'” she said. Try not to open your mouth wide or eat tough things.”

But after a massage and acupuncture, the symptoms disappeared for the first time in 10 years.

While acupuncture and massage are becoming more and more popular in the United States, herbal medicine is having more difficulty entering the mainstream market.

Tian said traditional Chinese medicines are still classified as “dietary supplements” and are not as stringently regulated as prescription or over-the-counter medicines. No license is required to sell it.

The road to classifying these “supplements” as prescription or over-the-counter drugs is long and tortuous, especially for combination formulations. The requirement of three phases of clinical trials prevents most Chinese traditional medicine makers from seeking to enter the US market.

“It’s a massive investment, potentially billions of dollars – beyond the interests of most Chinese companies,” said Dr. Zhan Changsen, vice president of Shanghai Hutchison Pharmaceuticals.

One example is a type of “combined drip” pill widely used in China to treat angina. Clinical trials in the United States have been on and off for nearly two decades, but the treatment has not yet been approved by the U.S. Food and Drug Administration.

“We need to find other ways to bring our drugs to foreign markets, but it depends on what market it is,” Zahn said.

Can East meet West in medicine?  Integration is a slow process
Can East meet West in medicine?  Integration is a slow process

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Shanghai Hutchison Pharmaceuticals Danning herbal tablets are now sold in the Canadian market.

Hutchison makes a traditional medicine called “Danning (胆 片) tablets” which has received a “Natural Product Number” issued by Health Canada and is now available in Canadian pharmacies as an over-the-counter drug under the trade name Biliflow. The drug is used to treat chronic cholecystitis and constipation.

“Different countries have different requirements for herbal medicine,” Zahn said. “Canada does not require three phases of clinical trials to register TCM preparations and acknowledges data collected from China.”

Before entering the Canadian market, Hutchison spent years “consolidating” Biliflow. He has set standards for the entire production process to ensure that each batch of Biliflow contains the same amount of active ingredients and has the same potency.

“Measuring how the active ingredients are metabolized in the body has been a huge challenge because the content is generally very low,” Zahn said.

Can East meet West in medicine?  Integration is a slow process

Zhan explained that the effectiveness of TCM is questioned mainly abroad because of the different theoretical systems underpinning Western and Chinese medicine.

Under the Chinese system, prepared herbs are classified by “taste and character (性)” and “swelling channel (归)”. The latter is a key feature of herbal properties theory, which categorizes drugs that act in the “viscera and meridians of the body” to elucidate the effects of a drug on a specific part of the body.

In the Western system, a drug is defined by its content, character, definition, composition, and contaminants, as well as other criteria.

Currently, 15 herbs, such as panax notoginseng (三七) and red sage (丹参), are included in the US Pharmacopoeia, and 14 are in the EU system.

“But there is still a long way to go, especially since CTM preparations are universally recognized,” Zahn said. “But the success of Biliflow has broadened our horizons, and we believe there will be more herbal remedies reaching overseas markets.”

Carnoen is also confident about her future career in traditional medicine.

“I feel like it has so much potential that most parts of the world haven’t tried it yet,” she said. “I intend to open a traditional Chinese medicine hospital in my country one day and possibly expand to other African countries to give people access to effective and affordable treatment without excessive costs.”

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