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Sunday, November 16, 2014

Update on the Pulse Diagnosis for Pregnancy



Skeptics have challenged TCM practitioners to prove their claims
"I will stop calling traditional Chinese medicine (TCM) a pseudoscience if any TCM practitioner can accurately detect pregnancy simply by taking their pulse, as their ancient system claims they can," promised Ning Fanggang, an outspoken critic of TCM.
Ning, a doctor at the Beijing Jishuitan Hospital's burns unit and Sina Weibo celebrity that goes by the online handle of "A Bao," posed a challenge to senior TCM practitioners working at China's top ranked "first level" hospitals on September 13, offering 50,000 yuan ($8,162) to any TCM practitioner who could show this technique to be effective. He later doubled the prize to 100,000 yuan.
Ning said that he would organize an experiment and recruit a group of pregnant and non-pregnant women. If any TCM doctor could correctly judge the women's pregnancy status 80 percent of the time, just by feeling their pulse, they would win the cash prize.
Pulse-taking is a key diagnostic method in TCM, and has been used since antiquity to diagnose whether a woman was pregnant or not, Huang Xin, a TCM practitioner at a Guangdong-based TCM hospital who applied to participate in the experiment but was turned down as his institution is of the "second level," told the Global Times.
The chance of an experienced TCM doctor detecting a pregnancy is about 80 to 90 percent, Chen Siqing, a Jiangsu-based TCM practitioner, was quoted as saying by the Modern Express newspaper.
"This method has been used to diagnose pregnancy since ancient times with relatively high degree of accuracy. The pulse during the gestation period is indeed different," Wang Qi, an obstetrician at the Beijing Obstetrics and Gynecology Hospital, told the Global Times.
But some have questioned the accuracy of this method since the pulse of overweight people can be similar to that of expectant mothers'.
Although the challenge was dismissed by the State Administration of Traditional Chinese Medicine (SATCM) as being "meaningless" since Western medicine and TCM are two different diagnositic systems, it has once again triggered heated public debate about the effectiveness of TCM.
Symbolic challenge
Wang Zhi'an, an investigative reporter that works for China Central Television, helped Ning organize the experiment and issued the details of the experiment, which was designed by the Beijing Renown Pharmaceutical Technology Company, on November 4. The test would see the TCM practitioners taking the pulse of 32 female volunteers while they were separated by a curtain.
"Ning has seen several cases where patients with burns were unable to be properly cured because they used folk remedies prescribed by TCM doctors instead of going to a Western medicine hospital," Wang told the Global Times.
"Individual experiments, of course, cannot reach a reliable conclusion [that TCM is pseudoscience]. The experiment is more of a symbolic challenge to urge TCM practitioners to prove their claims in the future," Wang said.
As of November 9, no registered TCM practitioners have applied to take part in the experiment, however, many self-proclaimed TCM experts [speaking on] health-related shows, quacks who claim to be able to cure leukemia in 45 days, and acupuncturists who assert that they can cure various cancers have applied, Wang wrote on his Sina Weibo.
Yang Zhen, an associate professor at the Beijing University of Chinese Medicine, was the only qualified doctor who had accepted the challenge, but he later dropped out on November 6. Yang told the Global Times that many TCM doctors have contacted Wang about the participating in the experiment.
Yang explained his dropping out by saying that a sample of 32 subjects is not large enough to draw any scientific conclusions, given that Wang and Ning are attempting to prove that TCM is unscientific. He denied that he had been put under pressure by medical authorities and his school not to participate.
Skeptic of unproven claims
Experts say the exaggeration of TCM's effectiveness, a lack of hard evidence and the subjectivity of TCM practitioners contribute to the widespread perception that TCM is ineffective.
An article entitled "Hoax: acupuncture-assisted anesthesia" was widely circulated online in 2013, and searching for the article on baidu.com returns about 39,900,000 hits.
Fang Zhouzi, a famous science writer with a doctorate in biochemistry and skeptic, used his knowledge of human anatomy in 2007 to prove the nonexistence of the main and collateral channels distributed through the body that are a key part of the TCM system.
Pien Tze Huang, a type of traditional medicine which TCM practitioners claim can effectively treat hyperpyrexia and is used to treat Dengue fever in Indonesia, was recommended by the SATCM to assist the fight against the Ebola virus, the Fujian-based Minnan Daily reported. But the medicine was declined by Ebola-hit countries in West Africa as it contains endangered animals and plants, a pharmaceutical company in Fujian Province told the Guangzhou Daily on October 14.
"While TCM is unable to cure diseases like hyperlipidemia or Ebola, for illnesses such as a coughs, diarrhea and lung abscesses, it works," Huang said.
Shi Ming, an experienced doctor at a Shanghai TCM Hospital, echoed Huang, saying that TCM can help treat functional diseases, like insomnia, that Western medicine is not always able to tackle.
Western medicine and TCM can complement each other, said Wang Qi, the Western medical professional.
"The ultimate goal is to cure the sickness, no matter what treatment is used," she said, adding that many ailments, such as the preeclampsia that most pregnant women suffer from, can be treated with TCM as a complimentary medicine.
"Besides, no concrete standards have been established to evaluate [TCM's] effectiveness. Most diagnoses given by TCM practitioners are based on their experiences," Yu Xiangdong, a doctor of internal medicine at Huangshi Center Hospital, told the Global Times.
Yu raised the example of an experiment conducted by the Shanghai University of Traditional Chinese Medicine in 2009. Sixteen experienced TCM doctors followed TCM's four diagnostic methods to attempt to diagnose one patient's ailment. But their observations of the patient's tongue color, overall complexion and pulse wildly varied, with some even being drastically different. "In Western medicine, double-blind, placebo-controlled clinical trials are conducted to prove whether medicines or therapies are effective, whereas the effects of TCM are judged only by the patients' recovery," said Yu.

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