Due to the complex nature of TCM, the fact that it does not fit easily into the Western scientific research model and the potential for corruption of the scientific method, it is wise to treat research into TCM as giving a general compass direction for a tiny part of an unmapped continent, rather than universal truth.

Evidence-based Medicine and Traditional Chinese Medicine

The term ‘evidence-based medicine’ is bandied around a great deal today. It’s one of those terms that sounds important and impressive.  A bit like the word ‘Science’. Easy, clean, black-and-white.  Either there’s evidence for something working or there’s not, right?

Take a magnifying glass to the term, however, and things can get a little shaky.

First, the term ‘evidence-based medicine’ applied to a therapeutic modality can sometimes mislead people into thinking a treatment is guaranteed to work, when it simply means that it draws on evidence that has a significant clinical effect for some (not all) people.

On the other hand, ‘insufficient evidence’ can make it sound like something doesn’t work, when it could simply mean that so far nobody has conducted decent studies for that particular problem.

In fact the term ‘evidence-based medicine’ is not just about scientific research.  It’s better understood as describing an approach that has three prongs, of which good quality research is only one.  There are two other important factors: Clinical Expertise (what the practitioner knows) and Patient Values (what the patient wants).  In order for a balanced evidence-based medicine approach, these two factors need to be given equal weight with scientific research.

It’s also important to understand that the world of scientific research is fraught with difficulties. According to the International Science Council, about 70% of research globally is funded by the private sector.  This means there is usually a business/financial imperative that has led to the decision to fund a particular study – and there is inevitably pressure felt by scientists to produce favourable results in order to secure ongoing work.

To complicate things, universities are often funded by industry interests, and in some cases even privately owned.  Governments, too, have funding from private industry which can influence research objectives.

This is not to say that the scientific method is dead, but only that there is a great deal of pushing and pulling going on, which not only affects what is researched, but how.  There are multitudes of ways to pummel scientific research into producing favourable results, starting with how the question is framed and what data is included.

In recent years, editors of two different prestigious medical journals have spoken out about corruption in scientific research. Richard Horton, editor of the Lancet, wrote the following in 2015:

“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. As one participant put it, “poor methods get results”. (1)

About a year later, Fiona Godlee, the editor of the British Medical Journal from 2005 – 2021, had the following to say in respect of forces at play in science and medicine:

“I think we have to call it what it is. It is a corruption of the scientific process.” (2)

Traditional Chinese Medicine is a complicated research subject

TCM is based on an entirely different system of medicine that does not easily match up with the Western medical research paradigm.

Rather than treating disease states as defined by Western medicine, the skilled practitioner uses techniques honed from years of education and practice to detect and treat ‘patterns of disharmony’ within the client. Every single client has a unique configuration and intensity of these patterns, and they will be treated with different herbs and acupuncture points depending on the diagnostic skill, personal preferences, education and experience of the individual practitioner.  In other words, you cannot easily separate out any one herb or acupuncture point of TCM and study just that part to see if it has a clinically significant effect, because it’s often the synergistic action of the combination of elements that is doing the work.

Scientific medical research works best when researching the effect of a single substance on a single aspect of a condition, removing all variables.  This works well (theoretically) when studying a single chemical intervention such as a pharmaceutical drug.  However, in the case of TCM this modus operandi necessarily results in learning only a miniscule piece of a large and complex puzzle, which, when inserted back into the real world, may suffer in terms of relevance.  TCM keeps its roots firmly in the real world, where a whole person is treated by another whole person.  Variables are embraced as part of the picture, because the focus is on treating the individual, not on treating a disease state using standardised protocols.

TCM may not be able to be measured easily, but it holds the accumulated knowledge and experience of generations of practitioners, and has stood the test of time.  The synergistic, individualised approach is the key to its success – success in this context meaning that the TCM system of medicine has been used continuously for at least 3000 years.

Due to the complex nature of TCM, the fact that it does not fit easily into the Western scientific research model and the potential for corruption of the scientific method, it is wise to treat research into TCM as giving a general compass direction for a tiny part of an unmapped continent, rather than universal truth.

The very best way to know if acupuncture and Chinese herbal medicine will work for you is to find a qualified practitioner, and then simply try it and see.

(1) Horton, Richard. The Lancet, ‘Offline: What is medicine’s 5 sigma?’ VOLUME 385, ISSUE 9976, P1380, APRIL 11, 2015

(2) Crowe, Kelly. CBC News, ‘BMJ editor Fiona Godlee takes on corruption in science’  Apr 19, 2016