From bark and roots to pills and capsules

Traditional Chinese medicine is going modern

As myth would have it, traditional Chinese medicine can be traced back 5,000 years to Shen Nong Shi, who sampled hundreds of herbs for medicinal use. The formal history of TCM, however, began about 2,500 years ago with the Yellow Emperor's Classic of Internal Medicine, the first written account of its practice.

TCM views a patient's condition as a reflection of the interaction of five elements of nature: wood, fire, earth, metal and water. The goal is to use raw materials, principally herbs, to treat disease. Patients are treated holistically, with prescriptions tailored to an individual's condition.

Historically, the formulation of TCMs incorporated as many as 10,000 ingredients, 90 percent extracted from herbs and 10 percent from animal byproducts and minerals.

Today, practitioners of TCM regularly use around 300 ingredients in their widely available formulations. Any given formulation requires four to eight ingredients on average.

The principle used for combining ingredients has its origins in the framework of imperial ministerial-assistant-servant, which was documented 5,000 years ago in the Shen Nong Herbal Encyclopedia.

The framework calls for an imperial herb, the chief herb or main ingredient of a formula; the ministerial herb, ancillary to the imperial herb, which augments and promotes the action of the main ingredient; the assistant herb, which reduces side effects of the imperial herb; and the servant herb, which harmonizes or coordinates the actions of the other herbs.

Chinese consumers generally perceive TCM as more effective for disease and chronic illness prevention, while they view Western medicine as more effective for acute and serious illnesses.

According to Bruce Liu, partner and co-head of the Pharma & Healthcare practice at Roland Berger Strategy Consultants, TCM's globlization faces a challenge from within as traditional TCMs are typically a mixture of diverse compounds. Among other things, this makes it difficult to explain how they work and to standardize the dosage.

Zang Jingwu, senior vice-president and head of GSK R&D China, agrees. "It's often hard to market TCM in many other countries because of the difficulties of explaining its working mechanisms and extracting its effective ingredients," he says.

Another major difference between TCM and Western medicine is that, until recently, TCM relied on patient experience, not clinical trials, for proof of effectiveness. Therefore, to win international customers' hearts, TCM must find ways to comply with the data-based operating systems in existence around the world.

Zang says that his company will transform TCM from experience-based practice to evidence-based medicine through innovation and differentiation. "What we will do is to transform the TCM mechanism into clinical data and evidence through Western methods," he adds.

Nowadays, many new measures are used in developing TCM products, including the extraction of the effective ingredients from a TCM to form a new compound drug.

"We don't do it like that, and we still abide by the concept of TCM," Zang says. "We will test the effective ingredients of TCM, and see how they work and form through innovative means."

Though old prescriptions have been passed from generation to generation through words and documents, it is indeed important to foster a legal and scientific patent protection system in modern society, as internationally identified recognition is a crucial step in TCM's global face.

Take Tasly's TCM for example: its Fufang Danshen Diwan, which works to improve circulation and kill pain, has patent protection for its ratio of raw materials and special processing techniques.

According to Tasly Pharmaceutical International, it is significant for certain kinds of its TCM to get approval from authoritarian agents like the US Food and Drug Administration. Through this, TCM can establish a reputation of being scientific and effective.

Contact the writers at jixiang@chinadaily.com.cn, liujie@chinadaily.com.cn and wanghongyi@chinadaily.com.cn

(China Daily 03/29/2013 page11)