Scientists Put Traditional Chinese Cures to the Test
|July 25, 2001|
Kenneth Kwong never expected to dabble in ancient Chinese medicine.
A physicist at Massachusetts General Hospital, Kwong developed a revolutionary technology, called functional MRI. It gives scientists live views of the brain in action, opening new horizons in the study of memory, language, and even the lure of cocaine.
Lately, Kwong also uses the machine to study acupuncture, a 2,500-year-old Chinese medical practice.
Traditional acupuncturists believe they are regulating the flow of a life energy called Qi through mysterious channels in the body called "meridians."
Kwong wanted a more scientific explanation. "I personally thought it was kind of a long shot, but you never know," Kwong said. He ended up discovering that acupuncture slows metabolism in an area of the brain that is active at times of anger or fear.
After years of watching patients turn in growing numbers to so-called alternative medicine, a growing number of researchers are giving herbs, acupuncture, and other ancient healing arts a much closer look.
Researchers from Boston to Beijing are testing herbal remedies and an array of other treatments long viewed by scientific medicine as mystical and unproven. The scientists hope the effort will bridge some of the disparate views about illness, the body, and the role of medicine.
The National Institutes of Health has a U.S. $92 million budget this year to study alternative remedies: gingko biloba to prevent Alzheimer's disease, yoga for insomnia, massage for lower-back pain. State universities from Maryland to California have set up research centers on the topic. Harvard this year followed suit with a $10 million institute for what it prefers to call "complementary and integrative medical therapies."
In one study at Massachusetts General's main campus in Boston, researchers are trying to cure high blood pressure with acupuncture. With 180 patients, $1.4 million in federal funding, and all the strictures of scientific research methodology, the study is investigating whether the treatment works.
Growing Consumer Demand
Collectively, researchers hope to sort out which treatments work, which are harmful, and which could lead to new insights into microbiology, physiology, and drug development.
They are also playing catch-up with the American public, which spent roughly U.S. $27 billion on alternative dietary products and medical treatments last year. Most of the treatments were paid for out of pocket and without consultation with the users' physicians, according to Dr. David Eisenberg. He heads Harvard's new center and was one of the first U.S. medical students to study in China in the 1970s.
Meanwhile, some practitioners of traditional Chinese medicine are welcoming the scrutiny as a chance to prove how much their treatments have to offer. They note that their techniques are based on thousands of years of recorded case histories and are practiced alongside conventional medicine in Chinese hospitals.
"We want to join the modern scientific world, and to convince the modern medical arena to accept this service," said Keji Chen, a leading authority on integrating Eastern and Western medicine and a professor at the Chinese Academy of Traditional Medicine in Beijing.
Yet some traditional practitioners are wary of the new attention from academic medicine, fearing that conventional doctors simply want to debunk the competition, or cash in on it.
Chinese medicine is hard to test. Scientific trials depend on standardized doses of medication; in traditional Chinese medicine, a different herbal mixture is made for every patient. Western medicine looks at discrete ailments and tries to fix them; traditional Chinese medicine tries to restore a sense of balance in one's relationships with the body, society, and nature.
And how do researchers study the placebo, or dummy-pill, effect in a trial of acupuncture, when patients know whether they've been stuck with a needle or not?
Eisenberg said there are ways to disguise the treatment. For example, there are spring-mounted needles that prick but don't go as deep as in acupuncture.
Some researchers bend over backward to insist they are sober scientists, not enthusiasts looking for data to support their beliefs.
"The purpose is not to prove that all Chinese medicine is right," said Dr. Kathleen Hui, a University of Michigan-trained microbiologist who convinced Kwong, the physicist, to look at acupuncture. "I want to show what is good, what can be improved, what should be discarded," she said.
Kwong's research using functional MRI (magnetic resonance imaging), in which 13 people were studied, showed that the parts of the brain affected by conscious sensation are less affected by acupuncture than by a normal pinprick.
What really excited the researchers, however, was that deeper areas of the brain, such as the amygdala, which regulates emotions, showed a decrease of activity during acupuncture. Heightened activity in the amygdala is associated with emotions such as anger and fear.
At Massachusetts General, acupuncture is already being used for pain relief.
Now, cardiologist Randall Zusman, Qunhao Zhang, and others are investigating its effect on blood pressure, in a study funded by the National Institutes of Health.
Zusman was initially skeptical about joining the study. "I'm a pill-pusher," he said. But he is impressed with the drop in some patients' blood pressurealthough he won't know until after the study is over whether they are getting acupuncture or a placebo, with random needle sticks.
Copyright 2001, Boston Globe
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