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Chinese medicine may have been around for more than 5000 years, but it has only recently begun to catch on in the West. Still, as our interest in what we call ?alternative? medicine grows, more space is created in our society--and in our minds--to welcome approaches that we have dismissed in the past as exotic (at best). But the East and the West rarely meet without creating a few sparks, and it seems that renewed interest in Chinese medicine is about to generate a hot one. While the use of a system of medicine over 5 millennia across half a continent is arguably the best clinical trial ever performed, what we Westerners need to convince us is solid scientific data. And this is where the spark, along with a promising new hot topic, is lying.

?Chinese medicine is very scientific ? the problem is that research has not been in the agenda of any government for so long,? says Dr. Ming Zhao Cheng, Senior Lecturer and Consultant in Chinese Medicine and Acupuncture, School of Health and Social Sciences, Middlesex University. China started applying scientific research into this field only in the late 1950s and the West got involved even later, in the 1990s. ?In contrast Western medicine has a research history of hundreds of years,? which creates ?a huge gap,? he adds.

But before exploring the opportunities for a research career in Chinese medicine, you may want to know what some of the concepts behind Chinese medicine actually are. In the UK, we have been familiar with some of them since the early 1960s, when acupuncture was first introduced to the West. However, the way Chinese medicine is used traditionally--and the way in which it is now hitting our culture--is through a holistic approach and the use of a combination of treatments, or formulae. Acupuncture is only part of the system of medicines developed by the Chinese, and so it is traditionally prescribed along with herbs, minerals, animal products, massage, and exercise. Also, although Western medicine is geared more toward treating the symptoms of a disease, Chinese medicine treats its underlying causes as well, so that the same disease may be treated differently according to its manifestations.

What propelled Chinese medicine to its current popularity in the UK was the recognition 10 years ago that Chinese remedies could successfully treat skin disease. ?The normal treatment for eczema is creams of steroids,? says Cheng. ?But if it is good in the short-term, it also damages your skin in the long-term.? From the early 1990s, though, a combination of Chinese medicines--administered in a tea--began to be used and ?worked well.? The findings were so positive that people immediately recognised the potential that Chinese medicine might have to cure diseases that couldn?t be cured with conventional treatments.

?Some people brought the formula back to their normal doctor and this prompted research,? Cheng continues. But this is where the worlds of Chinese and Western medicines clash, perhaps most strikingly: Researchers investigating the eczema-fighting tea were unable to find a single active ingredient. Dr Ding Hui Luo, one of the UK?s better known Chinese medicine researchers, commented that the reason they came up empty-handed was because their approach was ?against the principle of Chinese medicine?--the belief that remedies work in combination.

While there is no doubt that research should be conducted according to Western methodologies (i.e., searching for and finding active ingredients before submitting them to laboratory tests and clinical trials), the question of what approach should be taken is still roaring. Researchers have to choose between the difficulty of working with an incredibly complex system or the danger of working against the fundamental tenet of Chinese medicine. ?Some people say we should use the combination, others say we should use one herb at a time,? comments Cheng. ?I personally think it is appropriate to go in and do one herb at a time.? Although the odds of finding an active ingredient in a single herb are lower, Cheng argues that it should still be possible, as the finding of digoxin in foxglove--a successful treatment for heart failure--shows.

Cheng himself is interested in finding out more about how Chinese medicine may help to treat osteoporosis, or brittle-bone disease. Initially trained as a Chinese doctor at the Guangzhou University of Traditional Chinese Medicine, he did a PhD and a postdoc at the Royal Veterinary College, London, to investigate the synergy between weight-bearing and oestrogen that causes bone cells (osteoblasts) to produce more bone. One reason that osteoporosis occurs frequently in postmenopausal women is the drop in oestrogen, and this is where Chinese medicine steps in. Whereas oestrogen levels in these women may be boosted by hormone replacement therapy (HRT), a standard Western approach, Chinese medicine may also use a combination of herbs believed to have similar physiological benefits but fewer side effects.

The research Cheng intends to conduct would look at the effects the extracts of individual herbs have on the proliferation and production of bone by osteoblasts derived from clinical samples following hip and knee replacements. The aim of his research would both validate the use of Chinese medicine and optimise it. ?Usually people have to make teas from the herbs, and it is quite a lot of work,? he explains. Some concentrates are available, but Cheng would hope his research to lead to the production of more effective tablets. ?We are very far from it and we have to convince a lot of people before we can do this,? he sighs.

And the people Cheng needs to convince are, as usual, the people who hold the purse strings. ?We have to talk to the funding bodies and pharmaceutical companies to make sure they are interested and believe it can work,? he explains. The Government and charities may also eventually chip in, in response to the increasing interest of the UK population in alternative medicine.

As if the cash wasn?t hard enough to come by, another problem Chinese medicine researchers in the UK are obliged to circumvent is a general lack of facilities. Cheng advises interested researchers to establish relationships with clinical labs and do their work in collaboration with them. Cheng himself works with the college in which he did his PhD, and would recommend approaching places such as King?s College, Middlesex University and London?s top hospitals.

But these impediments should not discourage researchers who are interested in assessing the potential of Chinese medicine. The stakes are high for those who are ambitious and persistent. ?It?s a good time to get into this field,? says Cheng. ?You will be leading the field, [and] if you can publish one or two papers, everybody will know you.? Cheng hopes to get the funding and be able to start work by the end of next year.

Once you bring a remedy that you?re interested in into your lab, the research should be just like that in any other lab. ?I will be looking for PhD students and postdocs with a strong background in biology and who know how to do cell and tissue culture and HPLC [high-performance liquid chromatography],? says Cheng. However, he stresses how useful a basic knowledge of Chinese medicine would be, and this has not only to do with lab work. ?Because the funding is very difficult to come by, ideally the researcher should also be a practitioner so he or she is guaranteed a living.?

Research in Chinese medicine is already big in China, Hong Kong, the United States, Japan, and Australia, so why should young scientists refrain from flying there to do their research? ?We have to get the system set up here as well,? Cheng enthuses. ?We are going to have a breakthrough very soon because it is so popular. The question is who is going to get the funding first.?

Please contact Dr Cheng if you would like to discuss further the opportunities in research in Chinese medicine.

Elisabeth Pain is contributing editor for Europe.