Xu Nenggui: How does the evidence-based research of traditional Chinese medicine represented by acupuncture affect world medicine?
China News Service, Guangzhou, May 2 Title: Xu Nenggui: How does the evidence-based research of traditional Chinese medicine represented by acupuncture affect world medicine?
China News Service reporter Xu Qingqing
1400 years ago, acupuncture was spread abroad as a typical representative of traditional Chinese medicine. Today, acupuncture is widely used in the West as an important part of complementary alternative medicine, and evidence-based research on acupuncture is booming, with clinical evidence emerging. However, due to the lack of scientific analysis and recommendation of these evidences, effective acupuncture treatment measures cannot be translated and applied internationally in a timely manner.
A study recently completed by the team of Professor Xu Nenggui of Guangzhou University of Chinese Medicine has improved the clinical evidence on acupuncture therapy in Theistemonikos, the most comprehensive and optimal clinical evidence database in the world, constructed the acupuncture clinical evidence matrix for the first time and formulated the world's first acupuncture clinical evidence map. This study also solves the problem of unclear classification of the dominant and potential diseases of acupuncture, and clarifies the therapeutic effect and evidence intensity of acupuncture in the above diseases through rigorous and scientific analysis methods.
What are the specific advantages and potential diseases of acupuncture treatment? From the perspective of evidence-based research on acupuncture, what is the significance of clinical evidence research on traditional Chinese medicine to promote traditional Chinese medicine and promote the health of all human beings? Professor Xu Nenggui, chief scientist of China's "973 Project", vice president of the Chinese Acupuncture Society, and director of the South China Acupuncture Research Center, recently accepted an exclusive interview with China News Agency's "East and West Question" to make an in-depth interpretation.
The interview transcript is summarized below:
China News Service: Why did the research team take the clinical evidence of acupuncture therapy as the research direction? Why is clinical evidence important for acupuncture treatment?
Xu Nenggui: The main research directions of our research team are divided into three major directions: seeking clinical evidence, exploring basic mechanisms and industrial transformation. Clinical evidence refers to the collection of data from clinical practice, collation and analysis of evidence, so as to guide clinical practice.
As a bottleneck restricting the development of acupuncture in traditional Chinese medicine, the problem of verifying the efficacy of acupuncture needs to be solved urgently. High-quality clinical evidence can not only make acupuncture more convincing and increase the self-confidence of our acupuncturists, but also affect non-acupuncture professionals or Western doctors in Chinese medicine, making them realize that these diseases can also be treated with acupuncture. Therefore, if acupuncture really wants to be recognized and further promoted by international mainstream medicine, it is necessary to carry out a sufficient number of strict randomized controlled trials and evidence-based efficacy analysis.
Doctors at the Nanyang Traditional Chinese Medicine Hospital in Henan Province give patients traditional acupuncture treatment for their legs. Photo by Gao Song, China News Service
China News Service: The team's research was sorted out according to the large, medium and small effects of acupuncture treatment, as well as high, medium and low quality evidence, and formed a classification recommendation for the dominant diseases in acupuncture treatment and the potential for acupuncture treatment. Can you tell us more about the advantages and potential diseases of acupuncture treatment?
Xu Nenggui: In this study, our team included a total of 77 diseases involved in 12 disease areas, and the study data included 205 outcome indicators from 1402 randomized controlled trials. A total of 8 acupuncture evidences of medium and high quality and large and medium effect suggested that the clinical application of these areas was strongly recommended and translated, specifically post-stroke aphasia, neck and shoulder pain, myofascial pain, fibromyalgia, nonspecific low back pain, early vascular dementia, postpartum lactation in women, and allergic rhinitis. These are acupuncture in the clinic does have a curative effect, independent use can alleviate the improvement of the disease to a certain extent.
There are 90 low-quality evidences of large to medium effects suggest that these areas are potentially dominant diseases of acupuncture and should receive more research input and support to further clarify acupuncture therapy. There are a large number here, and a few of the more common diseases are listed: insomnia, migraine, opioid addiction, simple obesity, postoperative intestinal obstruction, dysmenorrhea, stroke sequelae, etc. The clinical effect of these diseases is better, but the current high-quality clinical studies are few and the evidence is insufficient, and it is recommended to be used clinically as the main adjuvant therapy.
The clinical evidence map drawn by the team summarizes the current status of acupuncture clinical practice, finds and demonstrates the problems existing in the current clinical research of acupuncture, and proposes suggestions for improvement, which will greatly improve the evidence-based process and efficiency of acupuncture clinical practice, policy decision-making and scientific research investment.
The father and son, who weighed a total of more than 700 kilograms, received acupuncture slimming treatment in Changchun. Photo by Zhang Yao, a reporter from China News Service
China News Service: What are the more specific impacts of the team's research on the international promotion and application of acupuncture and the further internationalization of traditional Chinese medicine?
Xu Nenggui: The inheritance and dissemination of acupuncture requires more modern and concrete evidence. At present, with the increasing clinical application of acupuncture and basic biological research, although there is a lot of evidence, this evidence has not been fully analyzed and applied.
In our analysis, we assessed the quantity and quality of systematic reviews of acupuncture and explored the underutilization of beneficial acupuncture therapies that have been demonstrated in clinical practice and health policy. Nearly 90 potentially dominant diseases of acupuncture were also identified, pointing the opposite for future acupuncture research.
In view of the current situation of acupuncture research, our team suggests that future acupuncture clinical research should create an evidence-based decision-making atmosphere, promote the generation and implementation of evidence through multi-stakeholder coordination efforts, and use digital repositories and artificial intelligence technologies to promote the exchange and sharing of evidence. This will greatly improve the evidence-based process and efficiency of acupuncture clinical practice, policy decision-making, and scientific research investment.
China News Service: What benefits can evidence-based research bring to traditional Chinese medicine therapy? In the long-term exchange of Chinese and Western medicine culture, what other beneficial effects has Western medicine had on Chinese medicine?
Xu Nenggui: Evidence-based medicine is a medical diagnosis and treatment method that emphasizes the application of research (evidence) of sound design and execution to optimize decision-making. Although this method originated in modern medicine, it has no attributes as a tool. If TCM research is to be modernized and go global, it is necessary to come up with evidence that is recognized inside and outside the industry. At the same time, in this process, the evidence complements clinical practice, which produces excellent evidence to demonstrate the effects of acupuncture therapy, which further promotes the wider use of acupuncture therapy.
Influenced and promoted by the Western medicine service model, Chinese medicine services in the past 50 years, the service model has also undergone great changes, the construction of traditional Chinese medicine hospitals at all levels in various parts of China, most of the Traditional Chinese medicine practitioners have entered the practice of traditional Chinese medicine medical institutions at all levels, they have also formed a situation of extensive and close cooperation like Western medicine, which can use its strengths and make up for its shortcomings.
Foreigners study traditional Chinese medicine at Shanxi College of Traditional Chinese Medicine. Photo by China News Service reporter Wei Liang
At the same time, the surgical treatment methods of Western medicine are also widely carried out and applied in Traditional Chinese Medicine, which makes Chinese Medicine break through the original treatment limitations and open up a wider range of treatment fields. In addition, in the medical research of traditional Chinese medicine, Chinese medicine has introduced and adopted many scientific research methods and scientific research methods similar to Western medicine, which makes Chinese medicine more scientific, objective and practical operability to a certain extent.
Perhaps when it comes to Chinese and Western medicine, some people will have antagonistic emotions, but "no matter whether the black cat is a white cat, catching a mouse is a good cat", clinicians ultimately pay attention to alleviating the pain of patients and curing diseases. We modern Chinese medicine practitioners should work harder to remove its dross, inherit the essence, give full play to the respective strengths of Chinese and Western medicine, and ultimately improve the clinical treatment effect and protect the health of the people.
China News Service reporter: Where are the advantages and unique charm of traditional Chinese medicine? What are the impacts and beneficial promotions to Western medicine?
Xu Nenggui: Chinese medicine is an original medical system that the Chinese nation has gradually formed and continuously enriched and developed in the practice of production and life for thousands of years and the struggle against diseases, with high practical value and rich scientific content, it is not only China's excellent cultural heritage, but also the world's excellent cultural heritage. Over the years, Chinese medicine represented by acupuncture has long been famous all over the world.
From a practical point of view, Chinese medicine represented by artemisinin has gone to the world and benefited the world, saving thousands of lives every year, so artemisinin has also been praised by the Western media as "the greatest medical innovation in the second half of the 20th century". From an ideological point of view, in recent years, the concept of individualized treatment and disease prevention gradually proposed by Western medicine is closely related to the traditional Chinese medicine culture such as the "overall concept of dynamic balance, the individualized treatment of dialectical treatment, and the concept of treating diseases before they occur".
Chinese medicine practitioners in Nanjing Jiangning Traditional Chinese Medicine Hospital dispense Chinese medicine granules in the Chinese medicine pharmacy. China News Service reporter Yang Bo photographed
China News Service: If Chinese medicine is to be universally accepted by all countries, what are the obstacles at present? In addition to strengthening evidence-based research, what needs to be improved?
Xu Nenggui: In general, the main problems affecting the clinical application and globalization of Traditional Chinese medicine therapy are whether there is a curative effect and how to produce it, which corresponds to clinical research and basic research. At present, the first thing we have to solve is the efficacy of traditional Chinese medicine.
In addition, the exploration of the mechanism of traditional Chinese medicine is also very important. The rapid development of modern science and technology has provided a possibility for the innovation of the research on the efficacy mechanism of traditional Chinese medicine, and new ideas, new methods and new technologies in the field of modern life science should be introduced in a timely manner, laying a solid foundation for revealing the essence of the role of traditional Chinese medicine and the mysteries of the human body from the perspective of modern science.
Chinese medicine people should choose an open mind, reasonably inherit and improve the original Chinese medicine theory, and fully absorb the new knowledge, new views and new ideas of modern science, so that Chinese medicine can be better developed and innovated, and ultimately better play its role in clinical guidance. (End)
Respondent Profiles:
Xu Nenggui, vice president of the Chinese Acupuncture Society and director of the South China Acupuncture Research Center. China News Service reporter Chen Chuhong photographed
Xu Nenggui, doctoral supervisor, former vice president of Guangzhou University of Traditional Chinese Medicine, leader of the first-level discipline of traditional Chinese medicine in the national key discipline, chief scientist of the National 973 Program Project. He is the winner of the first Qihuang Scholar, a national leader in traditional Chinese medicine, an expert who enjoys special allowances from the State Council, the vice president of the Chinese Acupuncture Society, and the chairman of the Science and Technology Committee of the World Acupuncture Federation. For the first time, a staging treatment plan for ischemic stroke hemiplegia was created with the "Tongdu Tonshen Acupuncture Method" as the main body, and the disability rate of ischemic stroke hemiplegia was reduced from 40% to 17.9% in international regulation.