Michael H' Dong

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Chinese Herbal Medicines The Good, the Bad, and
the Ugly
Michael H. Dong MPH, DrPA, PhD with Jennifer I.
Dong
readings
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(No Transcript)
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Learning Objectives 1. To understand how Chinese
herbal medicines (CHM) are used worldwide. 2. To
familiarize the students with some of the
negative aspects of CHM. 3. To learn the
additional beneficial effects of CHM. 4. To gain
insight into the controversies surrounding the
use of CHM.
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Performance Objectives 1. Be able to characterize
the basics of Chinese herbal medicines
(CHM). 2. Be able to identify some of the adverse
cases associated with the use of CHM. 3. Know the
basic properties of the major class of Chinese
herbs. 4. Know the factors that continue to make
CHM unacceptable to many people. 5. Know how to
use some of the resources for advancing CHM.
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Contents of Lecture 1. A brief introduction of
how Chinese herbal medicines (CHM) are used
worldwide. 2. Toxicological or side effects of
CHM. 3. Beneficial effects on health prevention
and health maintenance. 4. Controversies over the
use of CHM. 5. Resources for advancing CHM.
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• Traditional Chinese Medicine
• Has been practiced for many centuries.
• Uses holistic concepts and elements of natural
  energies to restore body homeo-stasis and hence
  to treat the disease.
• Relies principally on acupuncture and herbal
  drugs to restore patients health.
• Chinese herbs include plant, animal, and mineral
  substances.
• Recently has increasingly found its way into
  Western medicine.

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• Use of Chinese Herbal Medicines (CHM) in the USA
• Use of CHM has soared in the USA since the
  passage of a law in 1994.
• Many CHM are now treated as dietary supplements,
  thus not subject to any stringent health
  regulation.
• Millions of Americans are now taking Chinese
  herbal products.
• Not enough Congressional support to overturn
  current regulations on CHM.

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• Use of Chinese Herbs in Europe and Australia
• Europe takes half of the global market for herbal
  medicines (HM) in 1996.
• Use in Europe largely based on rule of historical
  use as evidence of herb safety.
• European governments are more pro- active in
  regulating the use of HM.
• Australia requires registration of practitioners
  as a means to regulate the dispensing of Chinese
  herbs.

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• Use of Chinese Herbs in Hong Kong and China
• Hong Kong has enacted an ordinance and
  established a council to regulate the use of
  Chinese medicines.
• China revised the Pharmaceutical (Administration)
  Law requiring drug manufacturers to obtain good
  manufacturing practice certification.
• Chinas law exempts Chinese herbs from following
  the new standards.

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• Ways in Which Chinese Herbs Are Used
• Countless numbers of remedies have been prepared
  from a small fraction of approximately 6,000
  Chinese herbs.
• Used to treat the whole body with a focus on one
  or more body organs, but based primarily on
  holistic concepts.
• Herbal formulas are used to mitigate the toxic
  effects of some herbs.

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• Negative Aspects of Chinese Herbs (I)
• Poisonings from misuse of Chinese herbs do occur
  from time to time.
• Misuse can also lead to acute or long-term
  adverse effects.
• Chinese herbal products can be contaminated with
  heavy metals.
• Extensive clinical trials on (long-term) side
  effects are not well documented.

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• Negative Aspects of Chinese Herbs (II)
• Drug adulterations or drug interactions are found
  in some Chinese herbal medicines (CHM).
• Misleading labels can also be problems with CHM
  sold over the counter.
• Unapproved ingredients and heavy metals can be
  introduced during the formulation or cultivation
  of herbs.

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• Negative Aspects of Chinese Herbs (III)
• More than 50 cases of kidney damage have been
  linked to Chinese herbs added to slimming
  capsules.
• Several cases of liver problems have been linked
  to Chinese herbs used for skin conditions.
• Acute hepatitis has been linked to some Chinese
  herbal products used for eczema or psoriasis.

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• Negative Aspects of Chinese Herbs (IV)
• Some Chinese herbs are found to have caused
  cardiac adverse reactions and pneumonitis.
• At least one herb was considered to be
  carcinogenic another one was reported to
  increase risk of bleeding when used concomitantly
  with the drug warfarin.
• Some others are known to cause allergic reactions.

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• Positive Aspects of Chinese Herbs (I)
• Many Chinese herbs contain a variety of vitamins
  or minerals and hence can be used as dietary
  supplements.
• Those herbs that are antioxidants can alleviate
  or prevent various disorders.
• Herbs cooked with food are highly digestible,
  assimilable, extremely nutritious, and sometimes
  delicious.

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• Positive Aspects of Chinese Herbs (II)
• A majority of Chinese herbs are famous for
  providing body strength and energy.
• These tonic herbs are super-nutrients with an
  ability to enhance body functions.
• They have anti-aging functions with no known
  adverse effects when used properly and are
  easily digestible.

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• Positive Aspects of Chinese Herbs (III)
• As an example, ginseng is a classic tonic herb
  used to enhance endurance.
• The plant contains chemicals capable of
  nourishing and regulating the nervous and
  endocrine (hormonal) systems.
• Ginseng may arouse sexual desire, even though
  long-term use of this plant could lead to some
  adverse effects.

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• Positive Aspects of Chinese Herbs (IV)
• Tang kuei is another classic tonic herb used for
  centuries to build blood.
• The herb can be used to alleviate pre-menstrual
  symptoms, muscular aches, and bowel movements.
• A number of Chinese athletes regularly consume
  tonic herbs to supplement their stringent
  training regimen.

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• The Ugly Side of Chinese Herbs (I)
• Some herbs have an unpleasant smell and a very
  bitter taste.
• Stories are rarely reported on positive
  experiences with use of Chinese herbal medicines
  (CHM).
• Disbelievers of traditional Chinese medicine are
  skeptical about the merits of CHM and have no
  room for therapy based on holistic concepts.

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• The Ugly Side of Chinese Herbs (II)
• There are controversies over the use of some
  Chinese herbs, adding greater discomfort for
  disbelievers.
• As an example, ginseng is said to have many faces
  regarding its effects.
• Adequate standards and processes are not in place
  to guarantee the claimed effects and quality of
  Chinese herbs.

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• Institutes for Advancing Chinese Herbal Medicine
  (I)
• Over a hundred of traditional Chinese medicine
  (TCM) institutes are located worldwide, with gt
  50 in the USA.
• Chinese herbal medicine (CHM) is a key branch of
  TCM students thus may receive CHM training in
  these institutes.
• These institutes often take a leadership role in
  advancing CHM through joint programs and
  scientific conferences.

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• Institutes for Advancing Chinese Herbal Medicine
  (II)
• Institutes located in Asia are fewer than 50,
  with expectedly the majority in China.
• One institute in Beijing has compiled the
  English-Chinese Textbook Series in traditional
  Chinese medicine (TCM).
• The university in Shanghai is one of the leading
  institutions in the world for TCM.
• The university in Nanjing is known as the
  birthplace of the earliest TCM scholars.

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• Institutes for Advancing Chinese Herbal Medicine
  (III)
• In Hong Kong, research into the effects of
  Chinese herbs is an ongoing activity at several
  local universities.
• Some of these local universities also offer
  degree programs in Chinese medicine.
• These educational and research programs all point
  to the direction that Chinese medicine should be
  used as an alternative or a supplement to Western
  medicine.