The age of evidence based research in CAM (Complimentary and Alternative Medicine)..does it exist?

I frequently get asked does herbal medicine work? In my 14 years of experience I will say yes, not for ALL conditions but it certainly helps improve the general wellbeing of a person and enhances the bodies own innate healing mechanism so that no matter what underlying condition/s they have, their signs and symptoms generally improve . As much as it is important that the traditional use of these herbs are maintained and respected, there is currently A LOT of evidence based research also conducted in herbal medicine, it's just that no one ever sees it. However, having evidence based research knowledge in herbal medicine and acupuncture also brings about it's own challenges to the practitioner in contemporary society today.

The quality of the research done is not always guaranteed, the research methodologies employed can also be questioned and so can the very question being asked. A lot of the current research done in complementary medicine is done using a biomedical framework or biomedical research model so that the outcome doesn't always reflect the results in complementary medicine practice. Or it is conducted by people that don't have sufficient knowledge in that particular area of medicine. An example of this is research where randomised controlled trials are conducted on people with tennis elbow using acupuncture whom are given the same set of acupuncture points and then compared to sham acupuncture.

The problem here is that we, as Chinese medicine practitioners, DO NOT prescribe the SAME acupuncture points on people with "tennis elbow". We assess the individual on the basis of a Chinese medicine diagnosis, which incorporates so called "patterns of differentiation" and so forth, in order to determine what that particular individual needs in order to help them with their "tennis elbow", which, once again, is a biomedical diagnosis, another issue in our profession, as we don't diagnose in a biomedical fashion, we deal with signs and symptoms as they present and form a pattern and have our own diagnostic language based on language that was around thousands of years ago, which still is applied very effectively to people today. Diseases may have changed but not people and not natural occurring phenomena.

Sometimes you will hear GP's conducting research using Chinese herbal medicines in trials for a condition. This imposes a big problem in the research. GP's can diagnose and treat in Western medicine, however they do not know how to diagnose and treat in Chinese medicine, so how do they know what particular herbs need to be put together for that individual for his or her condition? This is where research in complementary medicine is not necessarily doing the profession any favours. The result or outcome of the research is deemed to fail and that's when they will say..well, acupuncture or herbs doesn't work. This will be an issue that will indeed challenge the profession.

If you log into the main research databases such as PubMed or Cochrane Reviews or even Google Scholar, there are thousands and thousands of papers on herbal medicine research. Most of it is done using the reductionist biomedical approach, however it still of value and it can have it's place in practice. This is where we as herbalists can get knowledge for herb-drug interactions and how active constituents (a particular ingredient) in Tumeric (Curcuma longa) such as curcumin, works on the body's biochemical pathways. Tumeric is popular at the moment as it works on a principle in pharmacology called network pharmacology, that is, it influences various and many biochemical pathways in the body giving it is anti oxidant, anti inflammatory, anti tumour possessing properties.

There is a lot of information and research done on herbs such as St John's wort (Hypericum perforatum) too, and as a herbalist, we know what forms, dosages and extraction methods of St John's Wort interact with other medications such as the contraceptive pill or anti depressant medications. This is the level of knowledge an educated herbalist also possesses. Otherwise depending on the level of interference, it can render that medication to not work as effectively, so you can imagine the consequences of that happening with medications such as the contraceptive pill.

Mind you, the therapeutic effect, i.e., concentration of practitioner only herbs are different from those OTC (over the counter) and so is the dosage. However make sure you comply with the dosage as that can bring unwanted adverse effects and/or unsavoury interactions with medications! Some people believe that because herbs are natural, they are fine to take in what ever quantity, not the case at all with herbal medicine. When in doubt, book in for a consultation with a well trained herbalist, that's why we have done the years of study.