Suggestions on Scientific Research in Chinese Medicine
It is well known that the science of Chinese medicine arose from practice. It was the millennia and billions of clinical encounters that gave birth to TCM theory, gave it form, and let it develop. "Where the signs begin, the Way is born" — apart from clinical practice, there is no such thing as TCM scientific research. The science of Chinese medicine is built on the mutual interactions of the modes of motion within Nature, society, and the life process; this kind of process exists only in the living person — it cannot be replaced by animal experiments, and it cannot be learned by dissecting cadavers. Only the clinical study of the active dynamic process of a person's life can enter this domain.
The science of Chinese medicine is a system of science wholly different from Western medicine. Western medicine has its own research methods and channels; Chinese medicine has its own; one cannot be forced to obey the other. Only by following the lawful patterns of that science itself can the discipline's research be furthered. In fact, Chinese medicine has never stopped doing clinical research: every patient seen, every prescription written, is a piece of research practice. The doctor who has gone through countless such experiences becomes a recognized senior specialist. This in fact tells us that the deepening of TCM research, and the advance of TCM science, follow the path of clinical research. This is the necessary path of TCM scientific research — the path one must take.
By today, Chinese medicine has produced a great body of welcome research results, especially in treating difficult, intractable, terminal, and stubborn conditions. But today many successful examples are routinely dismissed as "without basis," "without measurement," and so on — treated as "unscientific" and quietly negated, strangled. This puts a question to us: how can TCM clinical research be evaluated, what can be made to count? Compared to so-called "standard," "regulated" clinical research, TCM clinical research does have great specificity:
1. TCM treatment follows the principle of discerning the pattern, seeking the cause; weighing the cause, working out the treatment. It stresses individuality; though there are relatively stable methods, doctrines, and prescriptions, all must vary with person, time, place, and disease. To force standardization, or to chase the Western-medical sense of "precision," moves far from the TCM principle of pattern-discernment-and-treatment.
2. The reproducibility of TCM clinical research results is also not the same concept as the Western-medical one. It is not mechanical, not fixed and unchanging. "Out of the blurred, the precise is born" — to dismiss the TCM distinctive as "blurred" is in fact wrong.
3. TCM clinical research can be assessed in terms of statistics — clear ratios of marked effect, effect, and no effect can be given. But it is still hard to reach the "precise, regulated" results demanded by Western medicine; on this axis, one should not demand too much of TCM.
4. Because of long-standing biases in medical orientation, the difficult cases TCM takes on have often missed the best treatment window. TCM in principle stands by "treat what has not yet become illness"; in fact, only when Western medicine is out of options do people remember Chinese medicine. To compare outcomes only on critical patients is hard to control for.
5. As for "the one special skill," "secret family recipes," and "ethnic medicine," and the clinical work that grew from them — restricted by level, title, region, and other limits, these are even harder to summarize, validate, and develop. This stock of wealth is left almost untouched, allowed to live and die on its own. It is a real pity.
How should we adapt to the specifics of TCM clinical scientific research, and adopt approaches that fit it, so the work can move forward normally? We have the following suggestions:
1. Establish an academic-expert committee made up of authoritative TCM specialists, responsible for qualification review, clinical research guidance, the setting of evaluation standards, and the evaluation of research outcomes. The committee must, from start to finish, take TCM scientific theory as its guide and basis.
2. Promote TCM clinical research within TCM research institutions and clinical medical institutions, with the chief target being difficult, intractable, terminal, and stubborn conditions; provide facilitation for setting up such projects.
3. Build cooperative relationships with Western-medical general and specialty hospitals willing to facilitate TCM research. In exchange for shared research outcomes, ask them to recommend and publicize, to supply medical records, and to provide staged checks and outcome evaluations — giving TCM research enough cases and giving the records more authority and reach.
4. For demonstrably effective cases drawn from "the one special skill," "secret recipes," and ethnic medicines: once the expert committee has confirmed the qualification, exempt from title, region, and educational restrictions, and admit these as special cases for clinical scientific research. Assign professionals or researchers to help organize the medical records, and sign agreements with the originating clinic or hospital for shared outcomes.
5. The State should allocate part of the funding; localities and research institutions should raise the rest to push the work forward. When TCM research outcomes generate not only social benefit but economic benefit, part of the tax or fund proceeds should be plowed back into this work — so it has lasting economic support.
TCM clinical research carries enormous scientific value, enormous cultural value, and enormous economic value too. When TCM clinical research overcomes the difficult, intractable, terminal, and stubborn conditions that gravely threaten modern life, it will have not only cleared the name of TCM science and paved its road into the world — it will have brought honor and credit to the Chinese nation.
The advance of TCM science will surely turn into productive force, contributing immeasurably to economic development and to the strengthening of the country.