[Traditional Chinese medicine (TCM)-what is myth and what is the state of evidence today?]

Traditional Chinese medicine (TCM) is the most comprehensive and widely practiced system of medicine in the world.Originally, TCM appeared in our Western context as an unfathomable mythological doctrine. Once the linguistic barriers had been overcome, it became possible to understand and apply the terminological and physiological concepts, the method of diagnosis, and the clinical findings.Since the NIH consensus conference in 1998, our understanding of TCM has been the subject of methodologically robust studies. We now have evidence of the efficacy and effectiveness of acupuncture beyond its use in pain therapy and allergy treatment. Thanks to fMRI studies, among others, we also have a better understanding of the mechanisms underlying acupuncture.Meta-analyses and studies also confirm the efficacy of Chinese medicinal drugs and remedies in some fields, yet there is still extensive need for further research. But opportunities are also emerging for new medicines and prescriptions for (accompanying) treatments of infections, autoimmune diseases, cancer, metabolic illnesses, dermatological disorders, and gastrointestinal diseases.To enable further evaluation of TCM, but also to ensure an integrative, critical application in the practice of TCM, it is vital for doctors to have thorough training. Further institutionalisation is necessary to provide orientation and patient safety.The days of regarding TCM as some kind of mysticism are indeed long over and it can offer real opportunities for better patient care. In many fields, there is increasing evidence of TCM's effectiveness, yet further comprehensive research is essential. This should be encouraged unconditionally.

[Traditional Chinese Pharmacotherapy in Patients with Chronic Rhinosinusitis - an Observational Trial Considering the Origin of Medicinal Drugs]

BACKGROUND

The use of Chinese medicinal drugs is becoming more common in Germany. However, the import from China results in aggravated quality controls and potentially jeopardized therapeutic safety. Therefore, in 1999 the Bavarian Department for Agriculture has initiated an interdisciplinary research project to cultivate and analyze important Chinese herbal plants. Currently 16 Bavarian-produced Chinese drugs are in use and distributed to patients by pharmacies. Despite a comparable quality of Bavarian pharmaceutical products, there are concerns remaining as the Bavarian medical drugs have been used for treatment purposes on patients since 2006, without their effect having been compared to the Chinese products. Therefore we performed an observational trial using a parallel group design on patients with chronic rhinosinusitis.

METHODS

The duration of the trial was 4 weeks. After a 4-week follow-up, the patients were interviewed via telephone. During the trial the patients were given 2 × 50 ml of a decoction of Chinese medicinal herbs, either (a) from Bavarian controlled cultivation (Bavaria group) or (b) from Chinese production (China group). The therapeutic success was evaluated using numerical rating scales.

RESULTS

In total, 64 patients completed the observational trial (31 Bavaria group, 33 China group). Both groups showed significant improvements in the main symptom scores of chronic rhinosinusitis as well as in secondary symptoms, such as the overall state of health or the tendency to catch a cold. There were no significant differences between the groups concerning the main symptoms scores. Overall the herbal decoctions had no severe side effects.

CONCLUSION

This observational trial shows that Chinese herbal drugs from Bavarian cultivation are as effective as medicinal herbs imported from China, but the effects of concomitant therapies must be considered as well. The symptom score improvements during the treatment period were obvious and should stimulate further investigation on the efficacy of this herbal formula in the treatment of chronic rhinosinusitis.