[BEIJING] Modern research on traditional Chinese medicines should skip studies of the molecules involved and proceed directly to clinical trials on human subjects, argues a senior medical researcher.
Tang Jinling, a professor of epidemiology and public health at the Chinese University of Hong Kong, says many traditional remedies have already been proven safe because they have been used for generations.
He outlined his reasoning in an article published last week (18 August) in the British Medical Journal.
There is growing scientific interest in assessing whether traditional remedies represent genuinely effective cures.
Research in this field tends to follow the Western model, which first identifies the active chemicals in herbal remedies, and then tests their safety and efficiency in cells and animals.
Only after these stages have been completed are the chemicals given to people in clinical trials.
But this approach could waste a lot of time and money, says Tang. He points out that some traditional medicines may prove to be useless, wasting the preceding basic research.
Such studies are already complicated by the fact that many traditional remedies are composed of a variety of plant extracts, unlike Western medicines that usually contain a single, pharmaceutically active molecule.
Tang says research should start with the Western model's phase-II clinical trial, in which scientists assess the efficiency — rather than just the safety — of a drug in patients randomly selected to receive it.
He says that testing traditional medicines in people before identifying the remedies' chemical constituents or giving them to animals should present no ethical concerns.
"These medicines have been used for thousands of years," Tang says in the article. "Whether tested or not, they will continue to be used in places where traditional Chinese medicine is officially recognised."
Shi Renbing, a professor at the Beijing University of Chinese Medicine who studies the chemistry of traditional Chinese medicines, says Tang's proposal is very practical.Research on the molecular structure of chemicals in herbal remedies might help scientists publish academic papers, but it delays the identification and application of effective remedies in clinical settings, Shi told SciDev.Net.