Every medical act involves health risks . The choice of treatment must evaluate the relationship between therapeutic and safety effects. Can we therefore recommend something that may even pose small dangers, but for which there is little or no evidence to benefit the patient, for example the so-called " alternative medicine "? What is the acceptable level of risk compared to the "zero benefit"?
A new article in the Guardian led to an interesting debate on traditional Chinese medicine using various methods including acupuncture and herbal care. The Association of European Medical Associations has expressed concern that the World Health Organization (WHO) recognizes these therapies. Without affecting the freedom of care and therefore also the freedom to apply to therapies that have no scientific basis, the doctors have expressed fear that this can be implicitly interpreted as a recognition of efficacy .
Furthermore, although the efficiency tests are absent, the same cannot be said of the risks. In this blog I have often written about practices such as homeopathy and acupuncture and I think those who read me already know how I like it. In these cases, the apparent therapeutic effect may be explained by the placebo effect or even better by a misconception . With regard to a condition that could be resolved by itself, some people attribute healing or improvement of health to alternative therapy
A "modern" marketing strategy for selling alternative products is to offer them so-called " supplemental medicines. ". The drug is prescribed with evidence of efficacy along with "complementary medicine", and the patient believes that his recovery was somehow "accelerated". Acupuncture and homeopathy have no scientific basis. In acupuncture, the needles are placed on imaginary lines called "meridians", within which an unspecified vital energy would flow. Homeopathic medicines are mainly water or sugar .
A more detailed discussion deserves, however. the herbs used in traditional Chinese medicine or in other parts of the world. In this case, there are bioactive substances whose efficacy is real and does not depend on the placebo effect or misconception. It is estimated that 60% of all drugs are derived from natural substances because from a biochemical point of view, all living things are not so different. For example, our proteins and the proteins of a bacterium or plant consist of the same twenty amino acids, all with the same relative configuration. The Nobel Prize for Medicine 2015 was awarded to Youyou Tu a lady who published her research in second-class scientific journals, which in practice never came out of China and is a strong supporter of traditional Chinese medicine.
With this information, the reader would be inclined to believe that Chinese medicine can really work, with someone who believes that we have received the highest scientific recognition in the world. In reality, the Nobel story at Youyou Tu is definitely more complex. The prize was awarded for isolating a substance known in the West as artemisina from the annual mugwort. The extract of this plant was part of traditional Chinese medicine, but had little chance of being used because it was too toxic. Instead, the isolation of artemisin in pure form according to the scientific method has made it possible to save millions of human lives. This molecule has been shown to be effective in slowing the replication of malaria plasmodium, a disease that kills. It is estimated that the discovery of Youyou Tu saved hundreds of millions of people in the world.
After all, the process developed was very similar to that which led to the discovery of aspirin in the west. Salicylic acid present in the bark could reduce fever but had poor application due to its gastric toxicity. Instead, this substance, purified and modified by a chemical process called acetylation, has instead become the first solvent, allowing, at a time when there were no alternatives to reducing fever, to save countless lives, but not to be free from side effects. It is also a question of quality control of traditional Chinese medicines. One study has attempted to identify in the preparations of pharmaceutical substances and has found several, including codeine in a preparation presented as anti-asthmatic.
In this case the perfect crime is committed : the efficacy there is, but it depends on a drug of known effect, really not on herbs. Here we get into real scams, as the danger of taking an undeclared drug is really high. For the same acupuncture, cases (rare, but significant) of injuries to patients are also reported.
Compared to the usual objection, "even the official drug may have side effects" can be answered by observing that scientifically based medicine has effects. measurable benefits for patients, while alternative treatments do not. It is also good to remember that it is very risky to give some credibility to alternative therapies, as patients could have them use them to replace effective treatments, with really serious indirect damage.
Does it make sense to use herbs today (how effective are they) when you risk unwanted effects? The answer is that it is safer to use a single purified substance rather than administering a whole series of other compounds found in plants that are not only worthless but may have some side effects . Everyone decides what is the best way to protect their health, but science can't help alert people to potential harm. It's good to remember that anything that is worthless in the end is also harmful, and so it would be good to stay away from therapies that have no evidence of benefit to patients.