Is TCM Evidence-Based and Safe?

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Of all of the systems of complimentary and alternative medicine, TCM has probably undergone the most vigorous testing and research. TCM herbal medicine and acupuncture have many studies supporting their efficacy.

However, Western medicine has had a lot of difficulty understanding how Chinese medicine works or even how to assess what Qi is or how to measure it. Our tendency in the West has often been to dismiss phenomenon we cannot explain in familiar terms. We sometimes mistake absence of western-style scientific proof for proof of absence.

Although there is much work to be done before we can truly understand the mechanisms of TCM, there is a growing body of solid evidence that suggests Chinese medicine is both safe and effective for the treatment of many conditions.

More importantly, Chinese medicine may have much to offer us in the West in terms of things we can do to prevent illness and disease, optimize our health, and enhance our well-being.

Has the US government recognized TCM?

In 1996, the Food and Drug Administration (FDA) recognized acupuncture needles as “accepted medical instruments.” In 1997, NIH published a consensus report by an objective panel of experts summarizing the results of available research on acupuncture.

The report states: “there is clear evidence that needle acupuncture is efficacious for adult postoperative and chemotherapy nausea and vomiting and probably for the nausea of pregnancy.”

Many physicians now feel comfortable referring their patients to acupuncturists, at least for the conditions specified in the NIH consensus statement. However, in almost every case the referral is for the use of acupuncture, not TCM.

What is the state of the research?

Very little research has been done (or is at least available in the West) that has focused on the theory, diagnostic capabilities, or treatment strategies of TCM as a whole. Instead, researchers primarily focus on a single type of treatment, like acupuncture, and how it works or can be applied from a conventional medical perspective.

While this approach may prove useful in expanding the repertoire of conventional medicine, it does very little to promote an understanding of the Chinese medical perspective on human health and wellness, preventative medicine, and the treatment of disease.

Apple and orange Many TCM practitioners also feel that this approach does not recognize or honor the integrity of their paradigm. Trying to understand one medical perspective in terms of another, they argue, is like trying to understand the taste of oranges in terms of apples.

Below are examples of current research on acupuncture. There is similar research on many of the other TCM treatments, such as herbal remedies and moxibustion. Again, it is worth considering the limitations of research that focuses on one aspect of TCM instead of the system as a whole.

What is the research on acupuncture?

Acupuncture is the most widely studied therapy among the various modalities of Traditional Chinese Medicine. More than 500 randomized, controlled trials have been conducted on the efficacy and effectiveness of acupuncture.

For what conditions?

Clinical evidence supporting the efficacy of acupuncture in treating certain conditions is as strong as those for many accepted conventional therapies. For example, the majority of published clinical trials found acupuncture to be effective in treating nausea resulting from cancer, chemotherapy, pregnancy, and surgery. It has even been found to work as effectively as certain anti-nausea drugs for pediatric patients.

Acupuncture is also indicated as beneficial in treating fibromyalgia and myofascial pain, epicondylitis, and chronic tennis elbow. Various studies show that acupuncture offers relief for pain conditions like low back pain, arthritis, surgery, labor, and dental issues. Asthma and allergy sufferers have also found relief through acupuncture, as have those facing mood-related disorders like anxiety and depression. Finally, preliminary research is showing acupuncture’s positive impact on addic Acupuncture on hand tion, smoking cessation, stroke and tinnitus, but more studies are needed about using this treatment with these conditions.

How do I find studies?

To find studies on the use of acupuncture for specific conditions, go to PubMed and conduct a search, using both the word "acupuncture" and the name of the condition.

Examples

Below are examples of recent studies you can find.

Ezzo JM, Richardson MA, Vickers A, Allen C, Dibble SL, Issell BF, Lao L, Pearl M, Ramirez G, Roscoe J, Shen J, Shivnan JC, Streitberger K, Treish I, Zhang G. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD002285
Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C, Trampisch HJ, Victor N. Acupuncture and knee osteoarthritis: a three-armed randomized trial. Ann Intern Med. 2006 Jul 4;145(1):12-20.
Vas J, Perea-Milla E, Mendez C, Navarro CS, Leon Rubio JM, Brioso M, Obrero IG. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study. Pain. 2006 Aug 22.

What's the bottom line?

One of the most important research questions yet to be addressed is whether TCM, as a system of medicine, is a rational and reliable methodology for determining safe and effective ways of treating disease and enhancing health. Addressing this question in a way that recognizes and honors the integrity of the TCM paradigm will require a new approach in research design as well as a willingness to fund such research.

There does seems to be a growing interest in the United State in a more collaborative approach to research between the conventional medical community and practitioners of complementary and alternative medicine. This indicates openness to other systems of medicine and to considering not only the tools, but the whole perspective of TCM.