{"id":545,"date":"2016-11-21T14:30:07","date_gmt":"2016-11-21T14:30:07","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=545"},"modified":"2016-11-21T14:57:28","modified_gmt":"2016-11-21T14:57:28","slug":"can-traditional-chinese-medicine-help-you-live-longer","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2016\/11\/21\/can-traditional-chinese-medicine-help-you-live-longer\/","title":{"rendered":"Can Traditional Chinese Medicine Help You Live Longer?"},"content":{"rendered":"

I have just returned from three months in Beijing as a visiting scholar at the National Institute for Biological Sciences<\/a>. \u00a0My host was <\/span><\/i>Meng-Qiu Dong<\/span><\/i><\/a>, who heads a lab studying aging in worms. \u00a0At the end of my stay, I took a look at longevity from the perspective of Traditional Chinese Medicine. \u00a0There is no doubt that TCM has some gems to offer longevity science, but the overall effectiveness of TCM resists quantification by the usual scientific standards <\/span><\/i>\u2013 <\/span>meaning not that it is ineffective, but that it is extraordinarily difficult to define suitable tests. \u00a0But the contrast between\u00a0TCM and modern Western approaches offers us a valuable perspective on our own practices.<\/span><\/i><\/p>\n

\n

[Disclaimer: No one in my institute thinks much about Traditional Chinese Medicine. \u00a0They are all trained in Western scientific methodology, many with PhDs from American universities, and they tend to be more conservative, more Western than Western scientists, because they are seeking recognition from American and European bio-medical journals. \u00a0They can\u2019t afford to have their reputations tainted by anything that might be labeled as unscientific.]<\/span><\/p>\n

Personal note<\/b><\/p>\n

I first became interested in China in the 1970s. \u00a0I was a Berkeley grad student, auditing Chinese I every morning at 8 before my physics classes. \u00a0I knew that I was viewing the world through lenses shaped by my own education and the culture around me; and I wondered what that world might look like from a very different perspective.<\/span><\/p>\n

The same idea applies to Chinese medicine. \u00a0Its approach and its basis of validity, its range of effects and benefits are different from Western medical science in ways that help me question assumptions that I didn\u2019t know I was making. \u00a0<\/span>\"\"<\/a>I am tempted to scour the English language literature for credible clinical trials of single ingredients isolated from traditional Chinese herbs. \u00a0I am more than \u201ctempted\u201d <\/span>\u2013 this is all I really know how to do. \u00a0And yet I know that this is an unfair and very limited snapshot of Chinese medicine \u2013 see below. \u00a0<\/span>US NIH has a <\/span>page devoted to TCM<\/span><\/a>, and concludes \u201c<\/span>For most conditions, there is not enough rigorous scientific evidence to know whether TCM methods work for the conditions for which they are used.\u201d<\/span><\/p>\n

Headliners<\/b><\/p>\n

Berberine<\/span><\/a> is derived from goldenseal=\u5c0f\u6a97\u78b1 and is a promising anti-diabetic drug, comparing favorably to metformin, though, of course there is much less data available. \u00a0Berberine <\/span>increased lifespan<\/span><\/a> in one fruitfly experiment, but has not been tested in rodents. <\/span><\/p>\n

I wrote two years ago about <\/span>Ginseng<\/span><\/a> (\u4eba\u53c2), the Chinese longevity tonic with the longest pedigree. \u00a0Multiple benefits have been documented, including modest effect on lifespan.<\/span><\/p>\n

The best-documented benefits of royal jelly (\u8702\u738b\u6d46), harvested from beehives, are for <\/span>retaining insulin sensitivity<\/span><\/a>. \u00a0There are credible reports of anti-inflammatory activity and promotion of wound healing. \u00a0Benefits are claimed for blood lipid profile. \u00a0There is <\/span>one mouse longevity study<\/span><\/a> which showed a promising 25% increase in mean LS without increase in max LS, but the control LS was suspiciously short. \u00a0Dosage was 0.05% of dry diet, equivalent to ~2 g\/day for humans. <\/span><\/p>\n

LEF\u2019s \u201c<\/span>AMPK Activator<\/span><\/a>\u201d =<\/span>Gynostemma pentaphyllum<\/span>= jiaogulan= \u7ede\u80a1\u84dd is another traditional longevity herb, found in <\/span>one trial<\/span><\/a> to lower blood sugar. \u00a0AMPK is a sigal molecule in the insulin metabolism. \u00a0Jiaogulan promotes AMPK, which can reasonably be expected to preserve insulin sensitivity. \u00a0To my knowledge, there have been no trials of jiaogulan for rodent life span, and just <\/span>one 30-year-old study<\/span><\/a> in which it was found to prolong lifespan in flies.<\/span><\/p>\n

Huperzine-A<\/span><\/a> is derived from club moss=Huperzia serrata= \u77f3\u6749, and is used for cognitive enhancement and neuroprotection. <\/span><\/p>\n

Wolfberry (Goji berry=<\/span> Lycium barbarum<\/span><\/i><\/a> = \u5b81\u590f\u67b8\u675e = ning xia gou qi) has been <\/span>studied<\/span><\/a> in connection with glycation of proteins in the skin, which contributes to skin aging.<\/span><\/p>\n

\"\"<\/p>\n

One-liners<\/b><\/p>\n

Acupuncture is effective for relieving pain and inflammation of arthritis [<\/span>review<\/span><\/a>]. \u00a0Surgery patients anesthetized with acupuncture have <\/span>shorter recovery times<\/span><\/a> and <\/span>better outcomes<\/span><\/a> than patients under chemical anesthesia. \u00a0(Western science doesn\u2019t have a clue how acupuncture works.) \u00a0Chinese herbs are effective in treating irritable bowel syndrome, and even more effective when the treatment is individualized by a TCM practitioner [<\/span>ref<\/span><\/a>]. \u00a0Ginger in the diet is linked to lower levels of inflammation [<\/span>ref<\/span><\/a>]. Tree ear fungus (\u6728\u8033=<\/span>Aricularia<\/span><\/i>) reduces risk of stroke and heart attacks from blood clots [<\/span>ref<\/span><\/a>], and oyster mushroom (\u869d\u8611) has anti-inflammatory effect and benefit for blood lipid profile [<\/span>ref<\/span><\/a>, <\/span>ref<\/span><\/a>]. \u00a0Elders who practice Tai chi (slowest and gentlest of the Chinese martial arts) are less likely to fall and less likely to suffer fractures if they do fall (<\/span>ref<\/span><\/a>). \u00a0Meditation lowers morbidity and mortality, improves measures of mental and physical health, lengthens telomeres [<\/span>my review<\/span><\/a>].<\/span><\/p>\n

Chinese and Western Medicine <\/b>\u2013<\/span> A general comparison<\/b><\/p>\n\n\n\n\n\n\n\n\n\n\n
Traditional Chinese Medicine<\/b><\/td>\nWestern Biomedical Science<\/b><\/td>\n<\/tr>\n
Legtimacy comes from thousands of years of collective experience, in oral and written traditions.<\/span><\/td>\nLegitimacy based on statistical analysis of objectively measurable responses, averaged over large populations in the last decade or two.<\/span><\/td>\n<\/tr>\n
Individualized treatment <\/span>\u2013 <\/span>different for each patient.<\/span><\/td>\nStandardized treatment; same for everyone diagnosed with a given condition.<\/span><\/td>\n<\/tr>\n
Qualitative, multi-dimensional diagnosis.<\/span><\/td>\nBinary diagnosis <\/span>\u2013 <\/span>the patient has the condition or he doesn\u2019t.<\/span><\/td>\n<\/tr>\n
Treatment aimed at restoring long-term health.<\/span><\/td>\nTreatment aimed at relieving acute condition.<\/span><\/td>\n<\/tr>\n
Combination of many herbs with dietary recommendations, acupuncture, and some prescribed behaviors that seem to us random and irrelevant.<\/span><\/td>\nOne drug for one condition.<\/span><\/td>\n<\/tr>\n
Integrated diagnosis and treatment of body and mind.<\/span><\/td>\nTreatment of each body part or system as a separate entity. <\/span><\/td>\n<\/tr>\n
Doctor-patient relationship is integrated into the treatment plan.<\/span><\/td>\nDoctor-patient relationship is treated as an artifact, the \u201cplacebo effect\u201d, noise that interferes with evaluation of the core treatment.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Those few Western scientists who pay attention to ancient medical traditions treat them as a trove of ideas for suggesting single chemicals that can be isolated and tested for efficacy, in animals and people the same way we might test any new drug. \u00a0It is hard to find funding for these tests, promising as they are, because the chemicals are not patentable. \u00a0<\/span><\/p>\n

And when such studies are funded, they don\u2019t do justice to the Gestalt of TCM. \u00a0If we find that individual molecules isolated from TCM herbs are potent healers, how much more benefit should we expect from synergy of the traditional combinations of herbs and the personalized diagnoses by healer with training and experience?<\/span><\/p>\n

For all the reasons above, TCM doesn\u2019t fit with the standard\u00a0mode of scientific evaluation. \u00a0If each patient is treated differently, how can you make statistical inference? \u00a0If the doctor-patient relationship is part of the treatment plan, how can you subject the plan to a double-blind comparison? \u00a0If we test one chemical at a time, we may miss important synergies. \u00a0And if we look just at short-term outcomes, we are blind to what is most important to the patient over the course of<\/span> his life.<\/span><\/p>\n

Fictions of Western Medical Science<\/b><\/p>\n

What can we learn about our habits of thought by immersing ourselves in another culture and looking back? \u00a0Our first reflex may be to subject TCM to standard evaluations from evidence-based medicine. \u00a0But equally important is the perspective we gain from criticizing \u00a0Western medicine fromt he vantage of TCM. \u00a0<\/span><\/p>\n

We (Western, scientific types) know that different people\u2019s reactions to disease and responses to treatments are highly idiosyncratic; yet we treat all differences as though they were random scatter in the data, and look for one-size-fits-all treatments.<\/span><\/p>\n

We know that drugs interact with one another, including both synergies antagonisms, and that these . \u00a0\u00a0All of life depends on homeostatic balance among thousands of active chemical agents, catalytic enzymes, and signal molecules. \u00a0Yet our research is based on testing one drug at a time. Building knowledge from the ground up is the only way we know how to do science. \u00a0\u00a0Less than one experiment in 100 looks for pair-wise interactions, and almost none explore the effects of a dozen or more treatments in combination. \u00a0<\/span><\/p>\n

We value predictability and reproducibility, sometimes to the neglect of miraculous effectiveness. \u00a0We imagine that the world is a predictable clockwork, of which our task is to learn the mechanism, and we are suspicious of any intervention that works only some of the time. \u00a0We disdain anecdotal evidence. \u00a0Thousands of credible stories of one-off cancer cures are discarded in the dustbin of quackery; we refuse to learn from them because other people given the same treatment were not cured.<\/span><\/p>\n

We have moved toward standardization of medical practice. \u00a0American caselaw in medical malpractice sets a disastrous incentive structure, defining malpractice as doing anything different from what the majority of other doctors are doing. \u00a0A good doctor\u2019s experience and subjective intuitions can potentially provide a treasurechest of treatment options, but in America there is a powerful legal and cultural discouragement from trying anything that is not \u201c<\/span>the <\/i><\/b>standard of care\u201d.<\/span><\/p>\n

As medical knowledge has multiplied, Western medicine has moved toward specialization. \u00a0We rely on experts who know one field, even a single disease, or even a single treatment for a single disease in great depth. \u00a0With specialization, we have lost the generalist\u2019s knowledge of interacting body systems and organs, and the art of gathering diverse symptoms and observations to infer a diagnosis has been replaced with <\/span>algorithmic medicine<\/span><\/a>. <\/span><\/p>\n

Background <\/b>\u2013<\/span> Western and Eastern Thought<\/b><\/p>\n

Western science doesn\u2019t have life completely figured out yet <\/span>\u2013<\/span> this is no surprise. \u00a0\u201cToo complex\u201d is the common refrain, but I think the problem may be deeper. \u00a0Since the 19th Century, biology has been committed to a reductionist approach. \u00a0Modern biologists are committed to a program of building an understanding of life from the bottom up, beginning with molecules.<\/span><\/p>\n

It\u2019s commonplace to say that Eastern thought is more holistic, Western more reductionist. \u00a0Many of the principles of Chinese medicine are conceived in terms that make a Western scientist snicker, and many are tempted to dismiss the whole field based on its theory. \u00a0But the other side of Chinese medicine is that it incorporates thousands of years of experience, and the treatments that have survived the centuries are the ones that work. \u00a0For example, the whole field of acupuncture was once dismissed as superstition, but now is accepted as a set of techniques that work for pain relief and sometimes for healing, but Western medicine has no way to think about its mechanism.<\/span><\/p>\n

There are MDs here who practice both TCM and Western medicine, and they have the experience and the wisdom to know which patients will respond best to one or the other approach. \u00a0There are drug stores here that carry Traditional Chinese Medicine alongside their prescription drugs, in a separate department. \u00a0<\/span><\/p>\n

A typical Chinese prescription consists of a bag full of a dozen or so herbs and roots that are boiled, and the broth imbibed once or more per day. \u00a0It’s safe to assume that tradition has combined these herbs in these combinations for a reason, but the Western analytic approach is yet quite far from a predictive\u00a0science of how they interact. \u00a0The moral is that when we encounter evidence for the effectiveness of TCM, we should resist the temptation to look for the Active Ingredient, lest we risk killing the goose that lays the golden egg. \u00a0<\/span><\/p>\n

\"\"<\/span><\/p>\n

I would like to see a study of people who have used TCM over several decades, not just to treat a particular malady but as a tonic for general health. \u00a0Compare specific health outcomes as well as morbidity and mortality for a cohort of such people with a matched cohort that has comparable diet, income and lifestyle, but does not use TCM.<\/p>\n

Optimizing the Placebo Effect<\/b><\/p>\n

Don\u2019t look down on what Western medicine calls the placebo effect. \u00a0While its power is universally acknowledged, Western institutions do nothing to try to get the most out of the doctor\/patient relationship, and in fact the Balkanization of medicine and the economic pressures that have progressively curtailed doctor\/patient interactions speak loudly of disdain for the power of \u201cbedside manner\u201d in the healing process. \u00a0The mind\/body connection may not be understood, but it is of paramount import, probably <\/span>as powerful as all of Western medicine combined<\/span><\/a>. \u00a0It is only common sense that some practitioners will be much more effective than others, and that time to foster a human relationship has potential both to restore meaning and satisfaction to the work-life of physicians, and also to turn them into more effective healers. \u00a0In contrast to Western medicine, a personal connection with the doctor is well-integrated into the culture of TCM.<\/span><\/p>\n

Random observations on Chinese health and longevity<\/b><\/p>\n

China is westernizing at a pace and <\/span>TCM is declining in popularity<\/span><\/a>, especially with the younger generation. \u00a0At the same time, TCM and acupuncture in particular are gaining adherents and practictioners in the US and Europe.<\/span><\/p>\n

Life expectancy<\/span><\/a> in China is 75 years, compared to 79 years in Taiwan (tied with USA), 85 years in Japan. \u00a0The amount that Americans spend per capita on health care is about $9,000, compared to $1,800 in Taiwan and $500 in China. \u00a0In fact, Chinese expenditure on everything put together (per capita GDP) is only $8,000.<\/span><\/p>\n

Two thirds of Chinese men smoke<\/span><\/a> (compared to <20% in the USA), but the smoking rate for women is actually lower than the US. \u00a0Only recently, the Chinese government has begun measures to reduce smoking, beginning with a ban in public buildings in 2010.<\/span><\/p>\n

I have seen people in China eat liberal quantities of rice with each meal, and yet the obesity rate among Chinese men is 0.6% compared to >30% in America. \u00a0The weight difference is something you might readily notice while walking around any Chinese city. \u00a0The traditional Chinese diet includes small bites of meat as a condiment, but with recent prosperity has come increasing meat consumption. \u00a0The \u201csweet tooth\u201d as an addictive affliction is less prevalent in China than the West. \u00a0\u201cGym rats\u201d can be found in China, but much more rarely than in the US. \u00a0People have more exercise built into their day, less time set aside for exercise as a Thing To Do. \u00a0Chinese cities have undergone explosive growth in recent decades. \u00a0Pollution in Chinese cities (Beijing is worst) is bad enough to be a major factor in mortality statistics. \u00a0<\/span><\/p>\n

…and a glimpse of the modern side of Chinese medicine<\/b><\/p>\n

\"\"<\/p>\n

This week, oncologists at Sichuan University Hospital in Chengdu <\/span>announced<\/span><\/a> that they had used CRISPR technology for the first time in a human medical application. \u00a0Immune cells were harvested from a lung cancer patient, and the cells were treated with CRISPR-Cas9 to remove the gene for a protein called <\/span>PD-1<\/span><\/a>. \u00a0The function of PD-1 is to help killer T-cells identify the body\u2019s own healthy cells and make sure that the immune system does not attack them; but some cancers have learned to evade immune attack by displaying a PD-1 target. \u00a0The Sichuan team cultured the modified T-cells and returned them to the patient, on the theory that they might renew the body\u2019s failed immune response to the cancer. \u00a0Results of the trial are not yet reported. \u00a0Principal Investigator Lu You emphasized that this is a small trial focused on safety, and ten patients will be closely monitored to look for indications that the modified immune cells have attacked the patient himself.<\/span><\/p>\n

The Bottom Line<\/b><\/p>\n

The Western, scientific approach to medicine is my paradigm and (I presume) yours; but it is not the perfect paradigm or the only paradigm. \u00a0People who dismiss the 2500-year-old wisdom of TCM as superstitious nonsense are missing a potential influx of new ideas and an opportunity for self-reflection. \u00a0It is only by getting outside our paradigm that we can see its limitations, realize that our thinking has been within a box. \u00a0<\/span><\/p>\n

Research scientists in America and Europe have to compete for grants and have to get their work accepted into one or another elite journal. \u00a0This creates incentives to stick to the kinds of biological questions that can be addressed through standard methodology, that will yield definitive answers within a few years at a cost the lab can afford. \u00a0We can hardly expect \u00a0researchers to behave otherwise. \u00a0But we might, at least, recognize that the system steers researchers to ignore approaches that involve multiple coordinated interventions, that rely on experience or expert judgment to be tailored to individuals, or that work via pathways that we do not understand. \u00a0We ought to recognize that some promising treatments for life extension and health have been excluded from investigation \u201cin the name of Science\u201d.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

I have just returned from three months in Beijing as a visiting scholar at the National Institute for Biological Sciences. \u00a0My host was Meng-Qiu Dong, who heads a lab studying aging in worms. \u00a0At the end of my stay, I took a look at longevity from the perspective of Traditional Chinese Medicine. \u00a0There is no … Read more<\/a><\/p>\n","protected":false},"author":65,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":true,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-545","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nCan Traditional Chinese Medicine Help You Live Longer? - Josh Mitteldorf<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2016\/11\/21\/can-traditional-chinese-medicine-help-you-live-longer\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Can Traditional Chinese Medicine Help You Live Longer?\" \/>\n<meta property=\"og:description\" content=\"I have just returned from three months in Beijing as a visiting scholar at the National Institute for Biological Sciences. \u00a0My host was Meng-Qiu Dong, who heads a lab studying aging in worms. \u00a0At the end of my stay, I took a look at longevity from the perspective of Traditional Chinese Medicine. \u00a0There is no ... 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