Traditional Chinese writing harms its users

Traditional Chinese Medicine: Remedies with Limited Effects

The designated health minister comes from the field: Wolfgang Mückstein is a general practitioner and medical director of a group practice in the sixth district of Vienna. In addition to his medical studies, Mückstein also mentions additional training in his curriculum vitae: namely a bachelor’s degree in traditional Chinese medicine (TCM), which he completed from 2003 to 2005 and immediately after his medical degree. And under the heading "Additional qualifications" on his homepage, in addition to substitution therapy, you can also find TCM.

This promptly attracted a lot of attention and questions, especially on social media. Does additional TCM training indicate a "more holistic" picture of health and illness than that which so-called conventional medicine has? Or is the TCM bachelor's degree a sign that Mückstein - like other greens - has a weakness for alternative medical approaches that are in truth nothing more than pseudoscience? What about the general acceptance and evidence of this ancient Chinese teaching?

Different healing methods

First of all, it should be clarified what actually falls under TCM - which is not that easy. The term summarizes various healing methods from China that originated more than 2,000 years ago, which also makes a uniform assessment difficult. These include acupuncture, Qigong (breathing and movement exercises), Tuina (manual therapy), Chinese drug therapy and "dietetics", which classifies foods according to their effects. The treatment methods were not systematically developed, but passed on as experience reports.

The basic concepts of TCM include the life force Qi, which according to this teaching flows through so-called meridians (a type of energy lines), as well as the pair of opposites Yin and Yang. These basic elements, however, elude concrete observation according to empirical standards.

Diseases are seen as the result of a disturbed balance between these opposites. The aim of a TCM treatment is therefore to restore the lost balance of forces in the body and to reconcile Yin and Yang. In acupuncture, for example, needles are stuck into the skin in order to divert the flow of Qi at certain points on the meridians and thus restore health.

Several training offers

Like other alternative medical methods, TCM has enjoyed great popularity in Austria for several years. Accordingly, there are also some training opportunities: From 2004 to 2009, it was possible to enroll at the TCM Private University in Vienna for bachelor's and master's degrees. 55 students completed their studies, 23 students completed a university course. After that, the accreditation expired.

Several institutions in Austria are currently offering courses on Chinese diagnostics and medicinal therapy that correspond to the curriculum of the Austrian Medical Association. The Medical University of Vienna, for example, has a five-semester extra-occupational university course for the basics and practice of TCM in its program, cost: almost 20,000 euros.

The Med-Uni Vienna is currently evaluating "whether the course it offers meets the technical and content requirements of the university and the expectations of the participants," says STANDARD inquiries. In principle, the Med-Uni Vienna assured that it was "committed to the principle of evidence-based medicine".

Inconsistent study situation

But how evidence-based are the healing methods of TCM? One problem is that the study situation is quite inconsistent, as one of the professors at Med-Uni Vienna, the public health expert Andreas Sönnichsen, says. One example is acupuncture, one of the central healing concepts of TCM. There are a number of studies that have documented the positive effects of the targeted needle sticks. But even "sham acupuncture", in which the needles were not placed on the meridians or were not pierced deep enough, had a positive effect.

"While Qigong exercise therapy can have effects similar to yoga, for example, and active ingredients can certainly be found in Chinese herbal medicine, acupuncture is most likely limited to the placebo effect," summarizes the physician Natalie Grams in her book "What really helps. Compass." through the world of gentle medicine ". Grams wrote her dissertation on the safety of TCM medicinal herbs, then ran a homeopathy practice before she "dropped out" and made education about alternative healing methods her vocation.

Sönnichsen, on the other hand, who headed the elective "Complementary Medicine: Esotericism and Evidence" at the Med-Uni Vienna, points out that the study design of many studies on the effectiveness of TCM usually does not meet the scientific quality criteria. There would be distortions due to patient selection, lack of blinding and patient groups that are too small.

Little scientific evidence

"If you take that into account, there is not much left of the scientific evidence for the effectiveness of TCM," says Sönnichsen, who attracted attention during the Corona crisis with some controversial statements about the protection of masks, for example.

Supporters and advocates of TCM naturally see it differently: "Double-blind studies are not the appropriate research instrument for a holistic view, individual diagnostics and therapy," said TCM doctor Verena Baustädter, who also heads the Wiener Schule für TCM, 2019 in STANDARD .

While "Western" clinical research is looking for individual active ingredients that specifically target a specific symptom, TCM remedies are often a mixture of a dozen or more ingredients with mechanisms that cannot be reduced to a single factor. In addition, TCM has the whole body in view and tries to find individual treatment methods.

Recognition from Geneva and Stockholm

Of course, TCM was recently recognized by the Nobel Prize Committee in Stockholm and the World Health Organization: In 2015, the Chinese pharmacologist Tu Youyou won the Nobel Prize for Medicine for the discovery of the active ingredient artemisinin, which can cure malaria. Tu Youyou had obtained the remedy from the extract of Chinese medicinal plants according to the instructions of a 1,600 year old script. Artemisinin is "a gift from traditional Chinese medicine to the people of the world," said Tu Youyou.

The WHO, in turn, included TCM 2019 in its influential medical compendium (even if only as a form of diagnosis) after many years of efforts by TCM supporters and Chinese lobbying, which promptly led to severe criticism from science. An editorial in the leading science magazine "Nature" was particularly harsh, introducing, among other things, the production of donkey skin gelatine, a popular TCM remedy with annual sales of almost two billion euros.

The closing line of the comment in "Nature": "WHO's association with treatments that have not been properly tested and may even be harmful is unacceptable to the body that has the greatest responsibility and power to protect human health." (Eja Kapeller, Klaus Taschwer, Julia Palmai, April 17, 2021)

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