Bringing Traditional Chinese Medicine into the 21st Century

Chinese scientist Tu Youyou was awarded the Nobel Prize in Medicine on the 5th of October 2015 for her work on the anti-malaria drug artemisinin, which is based on Traditional Chinese Medicine. Dr Tu told media it was a successful example of collective exploration in Chinese medicine. 

The Traditional Chinese Medicine industry in Asia

Traditional Chinese Medicine (TCM) is used widely in Asian countries – especially among Chinese populations. China, Hong Kong, Macau, Taiwan, Malaysia, Singapore and many other non-Asian countries have a long history of practicing TCM. The total market size of TCM in China was more than US$85 billion in 2015, accounting for 31% of the total medicine industry in China. TCM is one of the fastest growing industries in China and is now worth more than the entire pharmaceutical industry. While ASEAN remains the largest importer of these products, there are now over 70 countries that have instigated laws directly related to the import, distribution and use of TCM and over 120 countries that have established dedicated TCM institutions.

Challenges in Asia

Despite TCM being widely practiced in Asia for thousands of years, its usage and efficacy are not fully accepted worldwide – in part due to a lack of systematic clinical trials or outcomes would satisfy evidence-based medicine. This is a major barrier to the acceptance of TCM in mainstream Western medicine. It is possible that the very nature of TCM treatment – holistic, complicated and personalised – makes it very difficult for researchers to study. The problem is not due to a shortage of clinical studies. There are over 400 TCM-based trials and more than 600 worldwide on the efficacy of acupuncture. The issue is the absence of published studies with good quality evidence, which undermines the credibility of TCM.

Furthermore, there is concern over the safety of herbal TCM remedies. Reports of contamination with heavy metals, drugs, or toxins are common, while the listed active ingredients can be missing entirely. It is also known that some traditional remedies used in TCM can react with prescription drugs, causing serious side effects. The herb ephedra, used to treat asthma and allergies in TCM and in diet pills in the West, has been linked to serious health complications including heart attack and stroke. Consequently, in 2004, the FDA banned the sale of ephedra-containing dietary supplements.

As TCM is still relatively new in Western countries, intellectual property is not well protected. When Chinese companies launch products in the US they are required by law to publish a full list of ingredients. This means that other companies can easily copy recipes and even register patents for these traditional remedies that have remained a closely guarded secret in China for many years. Without protection for their intellectually property Chinese firms can be reluctant to enter Western markets, creating a further barrier to innovation, modernisation and growth.

These challenges must be addressed if TCM is to become more widely accepted and understood throughout the world, and so that it can fully benefit from advancements in modern science and technology.

TCM goes digital: cloud-based applications

Traditional TCM diagnostic methods of inspection, olfaction, inquiry and pulse taking have been used for millennia and therefore do not require modern diagnostic instruments. The quality of diagnosis is often dependent on the experience of the TCM practitioner and recommended treatments may vary if a patient visits different clinics with the same complaint.

Modern technology, such as the internet and cloud-based data applications, could help overcome these inconsistencies, allowing practitioners to pool knowledge and standardise treatments. For example, tongue inspections are an important factor in any TCM diagnosis, but it is a difficult skill that takes many years of training to master. A smartphone-based diagnostic tool could allow practitioners to photograph patients’ tongues and submit them for digital analysis and cross referencing. A central system could be configured to analyse tongue images using image recognition technology and identify possible problems. The system could also allow patients to submit their images for analysis from home to avoid unnecessary visits to the clinic or for follow up checks.

A similar approach could be applied to pulse-taking. There are numerous smartphone apps available that allow users to accurately take their pulse (using the phone’s built in camera and flash to “see” blood flow). Pulse measurements could then also be submitted remotely.

TCM goes digital: big data

Big data is transforming the healthcare industry and it could have a similar, if not a more profound influence on the modernisation of TCM. Due to its personalised, holistic approach and fragmented services, a big data approach is vital if the TCM industry is to prove to medical science that its methods are effective and repeatable.

Currently, it is impossible to know whether commonly prescribed combinations of herbs are effective or if any rarely used or forgotten treatments are more successful. A big data approach could solve this issue using machine learning – artificially intelligent systems that can analyse large data sets and identify significant trends, groups or outcomes.

Over time, such systems become more “intelligent” as they acquire more data, learning the best treatment for each ailment based on solid global data rather than human knowledge and personal experience.

The system can also help to identify new drug compounds for clinical trial. Parameters can be set so that once a certain herb combination has proved effective for a significant number of patients, scientists are alerted and tests can begin. This is one of the major issues with identifying and developing prescription drugs based on TCM herbal remedies – the sheer variety of herbs and treatments make it very difficult to identify areas that warrant further investment and study. Perhaps Nobel Prize winner Tu Youyou would have discovered the anti-malaria drug artemisinin sooner is she had had access to a massive, systematic global database.

Summary

TCM has been used in China for thousands of years and its unique, holistic approach has been used to treat and cure countless individuals. Despite this, evidence-based studies proving its efficacy are rare. Today, modern technology has the power to change the status of TCM in the global market, providing vital scientific and systematic evidence of efficacy or otherwise. Cloud computing, artificial intelligence and freely accessibly patient records could revolutionise diagnosis, standardise treatments and help identify statistically valid targets for further scientific research. The big question now on everyone’s tongues is, will TCM embrace the opportunity?

About the author

The authors are alumni of the ACI-NTU Masters of Marketing and Consumer Insight – an Executive Education program targeting individuals with over 5 years’ industry experience and looking to expand their marketing and consumer insight knowledge, particularly with respect to the Asian markets. Weilin Wang is Process Integration Engineer in Globalfoundries. Emma Chen is Marketing Manager in Essentra. Li Jiuan is a Senior Sensory Scientist in Abbott Nutrition.