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Introduction
A few days ago, The Lancet published a multicenter randomized, placebo-controlled, double-blind clinical trial on the treatment of acute intracerebral hemorrhage with Traditional Chinese Medicine FYTF-919 (Zhongfeng Xingnao oral prescription).
There are several reasons why this article has gained significant attention:
- It is the first randomized double-blind study of herbal medicine published in The Lancet.
- The results indicated no statistical difference between the treatment group and the placebo group, showing that the stroke-resolving formula (the herbal compound FYTF-919) did not improve functional prognosis, survival rate, or quality of life for patients with moderate to severe cerebral hemorrhage.
Let’s Talk About Modern Medicine
There has been a long-standing tendency in public opinion to blur and oppose the concepts of “Traditional Chinese Medicine” (TCM) and “Western Medicine.” These two concepts are geographically based and represent unique cultural phenomena; however, many people confuse them with traditional medicine and evidence-based medicine, blurring the lines between them and infusing a lot of personal and social emotions, leading to extremism.
Separating different dimensions of labels and viewing issues rationally is the first step.
The “Western Medicine” that people often refer to has developed into evidence-based medicine, which has evolved gradually from traditional practices like herbal medicine. Evidence-based medicine is a part of modern medicine, emphasizing the optimization of decision-making through well-designed and executed research (evidence). However, it is not the end point; it is a way of thinking about problems. Evidence-based medicine evolved alongside the Renaissance, logic, and industrialization.
Conversely, “Traditional Chinese Medicine” is often perceived as traditional and experiential medicine, but China’s traditional medicine has also developed gradually. Modernization is not a binary choice but follows objective laws. Similar medical practices today can be referred to as complementary medicine, which is unconventional medical practice used alongside conventional (mainstream) medicine.
All technologies are instrumental; some are merely products of different eras.
Modernity is simply a matter of time scale; it is not necessarily good or bad. All medical technologies currently in use can actually be termed modern medicine, even those that are traditionally considered TCM. Many people believe that certain diagnostic and therapeutic techniques used by traditional Chinese doctors have not changed, yet the overall production process for herbal treatments has changed significantly with the times.
As the saying goes, “Oranges grown in the south are oranges; in the north, they are trifoliate oranges.” The same applies to medicinal materials; different origins and subtle varietal differences can greatly influence their efficacy.
Herbal material X from region A can be used in herbal prescription D, yielding good results.
However, if we substitute X from region B, other components in prescription D may require adjustments.
Moreover, modern intensive and industrialized production has blurred many regional medicinal usage habits.
In addition, within small-scale regional medical practices, the treatable diseases are relatively fixed. Through long-term practical accumulation, rich experience has formed a foundation for the effectiveness of TCM. However, with the acceleration of population mobility in contemporary society and the complexity of diseases, the limitations of experiential medicine have gradually become evident, exceeding the scope of individual learning capacity.
It is essential to acknowledge the changes in era and social environment.
Back to This Paper
Many past societal issues are already set in stone; we cannot change the past. Let’s discuss the impact of this paper.
From a developmental perspective, it is entirely normal to draw lessons from traditional herbal medicine and interpret them in new ways relevant to contemporary times.
Research on TCM compound formulas and randomized double-blind studies has always been ongoing, and with the improvement of relevant industries in China, such studies will become increasingly compliant and standardized. The results of these studies vary; for example, a study published in Nature Medicine indicates that adding Qiliqiangxin capsules (QLQX) to conventional treatment can improve clinical outcomes in patients with HFrEF. Source: The traditional Chinese medicine Qiliqiangxin in heart failure with reduced ejection fraction: a randomized, double-blind, placebo-controlled trial.
For drugs that have not yet been approved, positive results are more significant because they suggest the possibility of future approval; for drugs that are already in use, negative results are more important as they can guide future clinical decision-making.
The attention this study has garnered exceeds expectations. Rigorous research findings are beneficial for the development of China’s modern pharmaceutical industry, helping to differentiate the genuine from the false.
Change is always welcome, and true courage lies in confronting one’s own ignorance and weaknesses and being willing to change, breaking free from narrowness and limitations.