Recently, a paper on the relationship between hepatocellular carcinoma and aristolochic acid was published in the International Medical Journal Science Translation Medicine, which concluded that there was a correlation between the occurrence of Asian hepatocellular carcinoma and aristolochic acid. Around this article, some comments and interpretations circulated in the circle of network friends, and some media even proposed to deny the value of Traditional Chinese Medicine(TCM).
In fact, the toxicity of aristolochic acid is not news. It has been clear that this component can cause kidney damage more than a decade ago. In the 2010 edition of the Chinese Pharmacopoeia, for herbs like Aristolochia, herba aristolochiae and Asarum, which contained Aristolochic acid that could cause kidney damage and other adverse reactions are added in the instructions.
And the warnings that “Children, the elderly, and pregnant women, infants and those with renal insufficiency should use these medicine cautiously” were added in Attention Items, too. In the content determination, it is clearly marked that aristolochic acid I must not exceed 0.001%.
We believe that scientific research is a useful exploration of the real world. We should not over-interpret scientific research data and achievements, but also pay attention to the research inferences put forward by scientific research.
Adverse drug reactions (ADRs) are inherent characteristics of drugs, and it may occur either in traditional Chinese medicine or in modern medicine. Safety is the primary principle of drug application in clinical practice. With the deepening of drug research, we need to implement certain norms to seek benefits and avoid disadvantages.
TCM is a kind of natural medicine with hundreds of chemical constituents, and the characteristics of TCM compound drug use increase the complexity of TCM chemical research. Like the clinical use of all the drugs, including chemical medications, the use of TCM needs the attention and standardization of researchers all over the world. Only in this way can we genuinely utilize modern scientific and technological achievements, inherit and develop TCM, and make it serve human health better.
The application of traditional Chinese medicine has certain norms and rules, which should be followed in clinical use.
Standardized harvesting time
At different stages of growth and development, the accumulation of chemical constituents in plants is different. For example, Ginseng has the highest content of total ginsenosides when it is harvested in 6 to 7 years, Honeysuckle, Sophora japonica, and Flos Magnoliae pick buds should be harvested when buds are ready to blossom. And Safflower is suitable to be selected when corolla changes from yellow to orange-red.
Standardized drug varieties
It is reported that Bupleurum macrophylla has been used as Bupleurum in Northeast China, its root and stem are toxic, which can lead to nausea and vomiting, paroxysmal convulsions, angular arch reflex, and other adverse reactions.
Standardized medicinal part
Through long-term clinical practice, TCM has selected certain medicinal parts. Different medicinal parts not only have different pharmacodynamics but also may have some toxic and side effects.
Before Chinese herbal medicines become Chinese Herbal Pieces for clinical use, they must be processed according to certain rules, so as to play the role of cleanliness, synergy, and detoxification.
TCM refers to natural medicines and their processed substitutes, which are guided by TCM theory and have a unique theoretical system and application form, and can be used to prevent and treat diseases and have the function of rehabilitation and health care. The use must be treated according to syndrome differentiation.
Herbal medicine should be decocted in accordance with a certain temperature and time. It has been found that long-time decoction can degrade toxic diester alkaloids into non-toxic monoester alkaloids, thus greatly reducing their toxicity.
Standardized dosage and course of treatment
Chinese herbal medicine is a kind of medicine, with its established dose and course of use. One of the reasons why the safety incidents of TCM are frequently reported abroad is the result of the long-term use as a dietary supplement regardless of the course of treatment.
In fact, Chinese medicine can not be used as a dietary supplement arbitrarily. For example, our Diuretic and Anti-inflammatory Pill and Fuyan Pill, the dosage is clearly prescribed.
Scientific research is a useful exploration to promote social development. We should not only rationally interpret scientific research achievements but also face up to the shortcomings of traditional Chinese medicine. Any ignorance of scientific research and overcorrection is not a proper attitude. Only by making full use of modern science and technology, and constantly standardizing the use of TCM, can we truly inherit and develop it, so that it can better serve human health!