Drugs Cross Talk in Traditional Chinese Medicine (T.C.M.) and Modern Medicine (M.M.)- Is It a Strategy Or a Ban for Patients ?

Drugs Cross Talk in Traditional Chinese Medicine (T.C.M.) and Modern Medicine (M.M.)- Is it a strategy or a ban for patients ? 

   How hard for general patient to be patiently wait to turn around while being really sickness. In order to relieve discomfortable situation quickly for themselves, they almost see the doctors, one majored in M.M, the other is in T.C.M. in one day.

Also,the patient went to see the Chinese medicine doctor in the morning and then had taken two packages of medicines, because he/she couldn’t wait the improvement that is inferior anticipated slowly, evening acquiring to the doctor practicing modern medicine to prescribe. On the side of the computer segment in the same hospital, may know the patient was administered multiple prescriptions, one in the traditional Chinese medicine and the other in modern medicine project, both of them happened in one day. But there would be more possibly events, patients voluntarily consult to doctors, taken remedy respectively in different clinics, patients would brings a bag of traditional Chinese medicine, and another bag of modern medicine back.

In Taiwan, it is very popular equipped outpatient service with T.C.M. in modern medicine hospital, only for excepted to National Taiwan University Hospital(NTUH) and National Cheng Kung University Hospital (NCKU). Patients, which diagnosing and treating by T.C.M. and drinking traditional Chinese medicine,present to feel certain degree of satisfaction, and believe its  curative effect, the population is not inferior the part of taking M.M. population.

A symposium was launched for Pharmaceutical Clinical Profession and Security Management in Traditional Chinese Medicine in National Research Institute of Chinese medicine on 24 July 2011. The topic was focused on if patients are treated with dual remedies by T.C.M. and M.M., it would derivate the problem that Drugs cross talk in T.C.M. and M.M., is this a strategy or a ban for patients? Perhaps is the medical new hope. Under the M.M. trade of Taiwan medical service environment, a person, who treated by M.M., would be stipulated to cut off the administration of T.C.M. Involuntarily. In addition, the media exaggerates “the medication of T.C.M. mix with the active chemicals is illegal” excessively, leading the populace regard the traditional Chinese medicine as the non-mainstream medicine, dared to drink does not dare to present.There are the merit and possibly unknown effect among the correlation of medication. The researches of drugs interaction in M.M. were abundant, and the clinical caution system was also complete. Compared to T.C.M., all of these information were really insufficient, the discussion of varied reports were almost in adverse reaction aspect. Take all above factors to consideration; the major reason lead T.C.M. being inferior to regard is that seldom evidence provided support the success of clinical trial. As mentioned in this seminar, the international journal, like as herbal-drug interaction, drug-herb interaction and so on. Both of them were not exactly being means to interpret for the interaction of T.C.M. with M.M. The word of Herb-Medicine was not simply represented as T.C.M., in relatively, Herb-Medicine could definite as botanical application in the worldwide medication. The following were several examples for the Herb interaction with Drugs of M.M. 


1. 1.1.St. John’s Wort —Cyclosporin ,Digoxin, Sertraline
2. 2.2.Leaves of Ginkgo biloba—Warfarin, Ibuprofen, Aspirin
3. 3.3.Panax ginseng—Warfarin, Digoxin, Hypoglycemias
4. 4.4.Ephedra—Isoniazid, MAO inhibitor
5. 5.5.Salvia—Warfarin, Aspirin, Phenobarbital
6. 6.6.Liquorice—Corticosteroids, Diuretics

   The high risk category of druds are like as Adrenergic agents, Cardiovascular agents, Diuretics, Anticoagulants, Hypoglycemic agents and so on.

Turn Risk to Chance

1. I.I.Like as example, “ma-huang (In Traditional Chinese words as麻黃)”, is Ephedra species plant being used to treat disease cautiously for whom were hypertension, epilepsy, diabetes, thyroid gland sickness, for the reason of components, ephedrine, pseudoephedrine, norephedrine. Moreover, past reports from international journal said that Ephedra were not good for people caused of high risk in sympathetic nervous system. Contrast to above opinions, in T.C.M. wouldn’t take single component to treat disease differentiated from European/American Medical principle, the alternative method was to coordinate multiple constitutes toxic by sorting to four grades as Jun , Chen , Zuo, Shi, from major to minor by tuning dose based on the T.C.M. prescribed principle in treated complex formulation. Therefore, the varied researched results in international journals were all not applicable to judge the effect of Ephedra in T.C.M
2. II.II.In anticoagulant, Warfarin, while the dose used insufficiency would produce thrombus, and the other side, the excessive amount result to exceptionally bleed, all of these lead the safe dose is very narrow. If coming to a chance, we take this medication to be composed of warfarin and activating blood and dissolving stasis formulations from T.C.M., it possibly to extend the bleeding time alternatively. By this way, it would bring the merits as the following.
   1. i.i.Reduces the dose, the frequency of Warfarin by accompanied T.C.M. formulations to achieve the better therapy quality.
      1. ii.ii.The dose reduced from warfarin will also relieve the side effect induced, and decline the cost for therapy at the same time.

   The anticipation for the future is that we should enforce continuous education for professional in medicine, pharmacy, nursy; and support more researches in Pharmacokinetic with pharmacodynamic to discover more advantages in integrated medication for T.C.M. and M.M. applied in treatment. In order to carry out more better medical quality and bring more reasonable healthy cost, we really should to introduce T.C.M. treatment into health insurance expense included. As hard as we could do, the cross talk correlations in aspect of Healthy product (like as Monascus purpureus and natto related food, deep sea fish oil and etc.), T.C.M., M.M. are also important to explore in advanced for public well.