Is the “Gold Standard” of Modern Medicine Applicable to Traditional Chinese Medicine (TCM)?
Recently, The Lancet published a study on traditional Chinese medicine (TCM), specifically on a herbal formulation for stroke treatment known as “Xingnaojing.” The publication quickly became a focal point within the medical community. As a journalist who has closely followed the developments in TCM, I recognize the sensitivity and complexity of this field. Traditional medicine has long sought breakthroughs within the framework of modern scientific standards, and this study marks an important milestone in that journey.
The discussion surrounding TCM invariably raises a critical question: how can we scientifically evaluate the efficacy of traditional Chinese medicine? This issue encapsulates the conflict between traditional medicinal practices and modern scientific methodologies. The study published in The Lancet not only drew attention due to its negative trial results but also for its rigorous design involving randomized controlled trials (RCTs), which directly touches upon the core issues of evaluating TCM.
While reporting on this study, I encountered challenges in securing interviews, but ultimately spoke with several authoritative experts in both Western and Chinese medicine. These conversations revealed that the disagreements regarding the evaluation standards for TCM are far more profound than the study’s results. Although RCTs are considered the “gold standard” in modern medicine, their applicability to TCM—which emphasizes holistic approaches and personalized treatment—remains questionable. Some TCM experts pointed out that a significant challenge facing traditional medicine today is the difficulty of translating scattered clinical experiences and individual patient perceptions into quantifiable clinical data. For example, non-quantifiable indicators such as patients’ quality of life and subjective experiences may not be accurately captured by RCTs.
I conducted a one-hour video interview with Craig Anderson, one of the study’s co-authors and a leading authority in stroke research, referred to by The Lancet as a “pioneer in stroke research.” This interview was a crucial aspect of my reporting, as his candidness and expertise helped clarify the study’s intentions and underlying details. He acknowledged that the view that RCTs cannot fully encompass the characteristics of TCM has merit, but this does not imply that TCM is incompatible with RCT methodologies. The success of a study is determined not solely by its results but also by the subsequent discussions and reflections it prompts.
The validation processes of modern science and the holistic principles of TCM are not necessarily in opposition; rather, they require exploration of dialogue and compatibility. For TCM to gain recognition on the global stage, it must adhere to internationally accepted standards and undergo rigorous testing and evaluation. Utilizing RCTs to verify the efficacy of herbal medicines is an essential pathway for TCM’s international integration. However, it is equally important to consider the unique characteristics of TCM during this process, aiming to strike a balance between scientific rigor and traditional essence.
This intersection of traditional medicine and modern scientific evaluation underscores the need for innovative approaches to assessment that respect the principles of both systems. Embracing such dialogue may not only enhance the credibility of TCM but also foster greater acceptance within the global healthcare community.
