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Chinese Traditional Medicine
Posted: 27 November 2007 11:11 PM   [ Ignore ]
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Just a quick observation about something that seriously annoys me: my insurance company will cover all sorts of pseudo-medicine I will never use such as homeopathy, chiropractors, etc but will not cover any Chinese medicine.

On one hand I understand because it’s such a massive field and some of it is likely unproven/harmful/placebo, etc. But on the other hand I personally suffered from an intestinal problem for a number of years that was only solved when I finally got so desperate that I decided to check out Chinese medicine because I had lost hope after seeing specialists in both Canada and Australia (I was travelling for work/school over the years and my problem followed me). I was told time and again my only option was surgery, which I was loathe to do. After two months of Chinese medicine, problem gone. Since then it occasionally comes up again when I’m under severe stress, but then I just take some medicine and it goes away in a day or two.

In retrospect I realised I was being both narrow-minded and Eurocentric by looking down on and even mocking Chinese medicine. Of course, my experience was only with two types of medication that only represent a fraction of what could be categorised as Chinese medicine.

My suggestion for a solution: someone should set up a private research council that will test all Chinese medicine by peer-review, double-blind standards and sort out the good from the bad, end of story. (This line was edited to specify private research, as I originally meant).

[ Edited: 29 November 2007 01:49 PM by traveller888 ]
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Posted: 28 November 2007 09:44 AM   [ Ignore ]   [ # 1 ]
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Well, I think adequate scientific review is always appropriate. But there are lots of things to investigate and limited time and money to do the work. I think the resources we have are best spent on those ideas with the greatest promise, which I think are those for which a reasonable scientific hypothesis can be formulated based on already understood principles. Not that I’d discourage anyone from investigating Trad Chinese Med. privately, but I’d rather not see the government spend money on it, and I’m not convinced that legitimizing it for insurance purposes is any more jsutified than legitimizing homeopathy or chiropractic.

You obviously understand science and standards of evidence, so you know that your personal experience, as compelling as it is for you, doesn’t really demonstrate anything about the efficacy of even the specific therapy you took, much less the entire field of CTM. In clinical practice, I face such anecdotes all the time. For decades we gave young cats with blood in their urine and discomfort while urinating antibiotics for urinary tract infections. They all got better during the treatment. Then some smartass decided to give half of them nothing, and they all got better over the same time period. Hard to make conclusions about therapeutic effect from temporal association between treatment and improvement of signs.

Anyway, I wouldn’t automatically label a preference for Western therapies as Eurocentric, implying it is an unreasonable prejudice. Scientific standards of evidence have proven themselves superior for evaluating medical treatments tiem and time again, and even in China the medical community is often skeptical of folk medicine and prefers evidence-based diagnosis and treatment. It is not prejudice to prefer what has been proven to be a better approach, even if the approach initially emerged in one particular cutlure.

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Posted: 28 November 2007 08:36 PM   [ Ignore ]   [ # 2 ]
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I agree that gov’t funding is not the way to go with this, and in fact private funding is already shown to work in at least one case: one common Chinese medicine product that was tested privately and ended up being a successful product in the North American market is “Cold FX.” They’re pills you take when you start to feel a cold coming on. It was approved the Canada Drug Agency (I think that’s the name) after testing a couple years ago, and got approval from the US FDA this year I believe.

In fact, it’s just 100% ginseng that has been packaged in pill form. It was tested by scientific standards and passed. Of course, this wouldn’t be covered my health insurance either as it isn’t a prescription drug, but it’s a step in the right direction.

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Posted: 29 November 2007 06:15 AM   [ Ignore ]   [ # 3 ]
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I believe that ginseng’s active ingredients may work as a slight stimulant. But I really would follow the NIH’s National Center for Complimentary and Alternative Medicine site’s bottom line here: “To date, research results on Asian ginseng are not conclusive enough to prove health claims associated with the herb.” The NCCAM is, if anything, an overly credulous organization.

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Posted: 29 November 2007 08:25 AM   [ Ignore ]   [ # 4 ]
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dougsmith - 29 November 2007 06:15 AM

I believe that ginseng’s active ingredients may work as a slight stimulant. But I really would follow the NIH’s National Center for Complimentary and Alternative Medicine site’s bottom line here: “To date, research results on Asian ginseng are not conclusive enough to prove health claims associated with the herb.” The NCCAM is, if anything, an overly credulous organization.

Although I was only mentioning ginseng as an example of private funding to try and legitimize certain Chinese medicines, and didn’t mean to get off on a tangent, I’d be happy to offer some proof.

The results of a new study to be published in the Canadian Medical Association Journal show that COLD-fX, an anti-flu, anti-cold pill, reduced the incidence and frequency of recurrent colds by more than half. It also cut the” duration of colds and significantly reduced their severity.

The results of the double-blind, placebo-controlled study on the prevention and relief of upper respiratory infections will be published tomorrow. Edmonton, Alberta’s Medical Officer of Health and a professor at the University of Alberta conducted the clinical trial.

...

CV Technologies Inc. CEO and Chief Scientific Officer and co-discoverer of COLD-fX, Dr. Jacqueline Shan said, “This is the first publicly known study to be completed under the new regulations established by Health Canada’s Natural Health Product Directorate. We were pleased that the Canadian Medical Association Journal decided to publish the study. Like all published clinical trials it has undergone a rigorous peer-review process by experts chosen by the Journal.”

In two previous trials involving 198 nursing home seniors conducted under FDA’s drug regulations by Dr. Janet McElhaney, the newly appointed head of geriatric medicine at the University of British Columbia, COLD-fX showed an 89% reduction in clinical illness caused by influenza and cold viral infection confirmed by virological testing. The four month study conducted while Dr. McElhaney was a professor at Eastern Virginia Medical School also demonstrated an excellent safety profile in that group. The results of that study were published in 2004 in the peer reviewed Journal of the American Geriatrics Society.

A multi-centre and multi-dosage, double-blind, placebo-controlled clinical trial on COLD-fX involving 720 community living healthy seniors was launched this month in Canada. This trial is being jointly conducted by Dr. Gerry Predy, Medical Officer of Health in Edmonton, Dr. Andrew Simor, a leading infectious disease expert and the head of microbiology at Sunnybrook and Women’s College Health Sciences Centre in Toronto and Dr. Janet McElhaney, an internationally recognized influenza expert and head of geriatric medicine at the University of British Columbia in Vancouver.

I just found that by briefly looking on Google before I go to work this morning. I’m sure there’s more information about the multi-centre study complete now, as this article was published in 2005.

Anyway, my point is simply that this is a good way for Chinese medicine, and any alternative-medicine I suppose, to enter the mainstream in a legitimate way, and purely through private funding.

By the way, for the record, I’ve never even used Cold FX, it’s just a well-known example.

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Posted: 29 November 2007 08:56 AM   [ Ignore ]   [ # 5 ]
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When it comes to this sort of fringe medicine stuff, I wouldn’t take any one test (particularly a relatively small one) as definitive. As for these studies, one would have to look at their methodologies to decide if they were well designed or not. As these happened back in 2005 and the NCCAM website is still going with their “not conclusive” statement, I’m inclined to believe that these were not particularly well-designed or convincing.

On that same issue, you should check out THIS article from the Edmonton Journal, Feb. 10, 2007, which goes into more detail on the whole matter. Apparently the larger study will not be complete until 2008. However,

... Among the many points raised in The Sun’s analysis:
- Based on the first two trials, the researchers, who reported their results in the Journal of the American Geriatrics Society, said COLD-fX cut the risk of colds, flu and respiratory illness by 89 per cent. The UBC profs called this “technically accurate, but quite misleading.”

The actual incidence and severity of cold or flu, as measured by symptoms such as cough or sore throat—the primary endpoint of the trial—was in fact the same for those who took Cold-fX and those who took a placebo. There was also no difference in the severity or duration of such symptoms.

Only by looking at the incidence of lab-confirmed flu—nine per cent for the placebo group, versus one per cent for the COLD-fX group, for an actual difference of eight percentage points, or a relative spread of 89 per cent—was there a clear difference, they noted.

Moreover, this finding only emerged after the two trials were combined. McCormack’s conclusion: “Taking two studies that don’t show a benefit and then adding them together to get a positive result is a form of data mining. It’s torturing the data until it confesses.”

For his part, Loewen dismissed the lab-confirmed numbers as essentially irrelevant, saying patients don’t care whether their symptoms are lab-confirmed or not. Baines and the UBC profs also questioned the cost and value of taking Cold-fX.

- Based on the third trial, led by Basu and Predy and published in the Canadian Medical Association Journal, CV Tech said “COLD-fX prevents recurrent cold and flu infections by 56 per cent, and significantly reduces the days of illness and symptom severity.” The Sun’s piece also questioned this claim.

In fact, it noted that the trial showed no major difference in the level of subjects who caught at least one cold—the primary endpoint.

Only by examining secondary results—the number of subjects who caught more than one cold—was there a clear difference, with 22.8 per cent of the placebo group infected, versus 10 per cent of the COLD-fX group.

The 12.8 per cent absolute reduction equated to a 56 per cent relative reduction. Hence the efficacy claim made above. ...

And so on. I’d say, “Caveat emptor”.

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Posted: 29 November 2007 01:46 PM   [ Ignore ]   [ # 6 ]
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Thanks for digging up that info Doug, very interesting. As I said earlier, I’ve never used the product myself, it’s simply an example of something I would like to see more of: private funding to test the efficacy of Chinese medicines. Let the results speak for themselves. Some will turn out to be bunk, while I would bet that some will be effective, I believe anything would be better than the current limbo status.

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Posted: 19 September 2012 04:16 AM   [ Ignore ]   [ # 7 ]
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Hi, I have lived in China for six years and have just tried chinese medicine for the first time.
Symptoms:
going to the bathroom several times during the night, and often during the daytime.
treatment:
After taking my pulse,chinese-style, doctor wrote out a prescription. I took the prescription to the dispensery and was told to return the next day with a large bag.
Next day I was given 21 bags, each containing 300ml of brown liquid and told to take one,heating it first, after each meal.
Result:
After 7 days I completed the course and there was no change in symptoms.
By the 10th day all the symptoms had disappeared.
After 6 months there has been no reoccurence of my problem!

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Posted: 19 September 2012 04:22 AM   [ Ignore ]   [ # 8 ]
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TomJ - 19 September 2012 04:16 AM

Hi, I have lived in China for six years and have just tried chinese medicine for the first time.
Symptoms:
going to the bathroom several times during the night, and often during the daytime.
treatment:
After taking my pulse,chinese-style, doctor wrote out a prescription. I took the prescription to the dispensery and was told to return the next day with a large bag.
Next day I was given 21 bags, each containing 300ml of brown liquid and told to take one,heating it first, after each meal.
Result:
After 7 days I completed the course and there was no change in symptoms.
By the 10th day all the symptoms had disappeared.
After 6 months there has been no reoccurence of my problem!

This is known as “anecdotal evidence” and is scientifically worthless. Most medical conditions eventually clear up on their own, which might have been the case for you. Or it might have been that the ‘brown liquid’ contained a mild antibiotic that cleared up the problem. Who knows? Without a well-designed test, or analysis of the precise components you ingested, there is no conclusion we can make.

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Posted: 19 September 2012 05:07 AM   [ Ignore ]   [ # 9 ]
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thanks for your prompt post Doug, I still have the chinese prescritpion. I will try to get it tanslated to english and then post it.
cheers.

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Posted: 19 September 2012 09:51 PM   [ Ignore ]   [ # 10 ]
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We’ve also found some Chinese medicines to be adulterated with mercury, usually in the form of reddish brown cinnabar. Be careful, it is not an uncommon additive.

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Posted: 19 September 2012 11:18 PM   [ Ignore ]   [ # 11 ]
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Good point, Asanta.  I would guess that the mercury would be toxic to the kidneys.  As such, it may have only damaged them a bit and made them less efficient, slowing down their extraction of water from the blood.  That way, one wouldn’t have to urinate nearly as often, and wouldn’t tend to drink very much water.  I’d be worried about the build-up of materials normally emptied through the urine.

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Posted: 20 September 2012 08:33 AM   [ Ignore ]   [ # 12 ]
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Thats an interesting theory Occam but while those of us who are male and over 50 tend to assume that “going to the bathroom at night” means urinating he wasn’t clear about that. He could have been having frequent bowel movements.

The other thing that would make this theory less likely is that decreased urinary output is usually not something you see with mild loss of kidney function. Its usually a sign of end stage kidney failure and such a person would become deathly ill very quickly at that point. Increased urinary output in an otherwise well person is usually more of a bladder outflow issue ( ie. you don’t empty fully so you fill up more quickly and have to go more often). There are meds that can alleviate some of this and its not entirely improbable that by pure dumb luck the Chinese herbalists may have stumbled upon something. Its also possible as you and asanta have both correctly pointed out that the very same substance may have harmful or dangerous side effects that have yet to become apparent.

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Posted: 20 September 2012 04:41 PM   [ Ignore ]   [ # 13 ]
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By the 10th day all the symptoms had disappeared.
After 6 months there has been no reoccurence of my problem!

First, what was this stuff and how could you possibly get a corrolation of cause and effect without a controlled study?

Second, you are aware that there are a lot of illnesses which run their course and go away no matter what you do or take…including doing nothing and taking nothing…right?

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Posted: 20 September 2012 05:24 PM   [ Ignore ]   [ # 14 ]
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Quoting Macgyver:

He could have been having frequent bowel movements.

  Whoops.  Very good point, Mac.  When I went back and read it, that’s a clear possibility.  I jumped to a conclusion that could easily have been incorrect.  red face

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Posted: 22 September 2012 12:33 AM   [ Ignore ]   [ # 15 ]
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macgyver - 20 September 2012 08:33 AM

Thats an interesting theory Occam but while those of us who are male and over 50 tend to assume that “going to the bathroom at night” means urinating he wasn’t clear about that. He could have been having frequent bowel movements.

The other thing that would make this theory less likely is that decreased urinary output is usually not something you see with mild loss of kidney function. Its usually a sign of end stage kidney failure and such a person would become deathly ill very quickly at that point. Increased urinary output in an otherwise well person is usually more of a bladder outflow issue ( ie. you don’t empty fully so you fill up more quickly and have to go more often). There are meds that can alleviate some of this and its not entirely improbable that by pure dumb luck the Chinese herbalists may have stumbled upon something. Its also possible as you and asanta have both correctly pointed out that the very same substance may have harmful or dangerous side effects that have yet to become apparent.

Yep! What he (Macgyver)said!  wink  You can have high output kidney failure and low output kidney failure.

At the point of low output failure, you would develop a uremic frost on the skin as your body attempts to excrete waste in any way it can, as you become very obviously and seriously ill. You can also have SIADH (Syndrome of Inappropriate Anti Diuretic Hormone Secretion) where your body holds onto fluids for various reasons, the most common being after surgery. If not quickly recognized by the stellar nursing staff, you can quickly go into fluid overload, causing you electrolyte levels to plummet because you are holding on to free water. The most disastrous is the drop in sodium which can lead to cerebral edema and seizures.

High output failure isn’t much better. You could have difficulties replacing both the fluids and electrolytes lost in the urine. The most common condition with this is a somewhat rare condition called Diabetes Insipidus, which is a VERY highput problem. It is treated with Vasopressin also called ADH.  I also once cared for a patient with Bartter Syndrome (inherited and VERY rare) a potassium wasting kidney disease, where we were putting 120 to 160meq of KCL/liter in his IV fluid, which would be lethal for anyone else. We had to get special clearance for the fluids!  People with Type 1 diabetes can go into a ketotic state where they are passing a copious amount of urine, and have an unquenchable thirst as their bodies try to get rid of the excess sugar and tries to find fuel for the bodies cells without the presence of insulin.

The point being that both high output urine and low output urine situations are fraught with serious medical complications and need to be attended to.

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