Scientific Credibility of Traditional Chinese Medicine

Establishing scientific credibility for Traditional Chinese Medicine (TCM) presents unique challenges when subjected to Western medical research's rigorous standards, particularly in Randomized Controlled Trials (RCTs). Within evidence-based medicine's traditional framework, classical RCTs hold high regard, complemented by methodologies like cohort studies in a comprehensive evidence hierarchy. However, the intricate and distinct nature of TCM interventions often defies complete encapsulation within classical RCTs. TCM's focus on individualized treatment based on the philosophy of differing "qi" energies (derived from yin and yang balance) complicates research, leading to an emphasis on therapeutic efficacy rather than real-world effectiveness or safety aspects.

As China prepares to export TCM globally, a growing recognition of the need for a nuanced approach has emerged. One promising strategy involves progressively standardizing key diagnostic and treatment factors influencing TCM treatment outcomes (Sun, 2021). This approach acknowledges the complexities of standardizing unique TCM aspects, such as syndrome differentiation, proposing a phased standardization process.

Notably, acupuncture and Chinese patent medicines have become focal points in the new RCT framework due to their higher standardization compared to practices involving tongue examination and customized herbal prescriptions. The escalating rate of acupuncture trials exceeds herbal medicine trials, indicating heightened scientific interest, particularly in stroke treatment globally. Across various countries, significant percentages of stroke patients have resorted to Traditional, Complementary, and Alternative Medicine (TCAM) treatments (Huang), where TCM exhibits notable improvements in symptoms and motor functions – 46% in the US, 66% in Malaysia, 36% in India, and 54% in Korea (Huang, 2021).

However, the financial implications of integrating TCM with conventional treatments raise concerns. While TCAM may reduce average conventional medication costs, combined TCM and conventional treatments for ischemic stroke patients incurred significantly higher expenses compared to using conventional medication alone. This indicates that TCM often complements rather than replaces conventional treatments, adding substantially to patients' total medical costs. Comparatively, when contrasted with physical therapy, TCM, especially in stroke rehabilitation, assumes a complementary role. Nonetheless, the added financial burden of combining TCM with conventional treatments prompts inquiries into its overall cost-effectiveness. The ongoing scientific evolution of TCM, evidenced by an increasing number of rigorous clinical trials, continues to influence its integration into modern healthcare systems, reshaping perceptions among practitioners and patients alike.

Despite research complexities, TCM has gained credibility in Western and multilateral institutions. Tu Youyou's Nobel Prize in 2005 for discovering artemisinin, which aids in malaria treatment, highlighted TCM's innovation beyond Western drugs. The recognition prompted further dissemination of TCM knowledge by the Chinese government, bolstering its global acceptance. However, critics contend that TCM, due to its dependency on herbal quality, requires stricter regulations than Western medicine. Challenges regarding herb quality, pesticide residues, and heavy metals impede global credibility, especially in Western nations.