03 June 2010
Breathing easy
Professor Charlie Xue amid his storehouse of herbs.
The research blends Eastern tradition with Western science.
Chinese medicine uses almost 600 herbs.
Herbs are often combined to make particular formulations.
Thanks to stringent cigarette advertising regulations and high-profile quit campaigns, Australia’s adult smoking rate fell from 34 per cent in 1980 to 19 per cent in 2007. Yet the fallout continues.
According to QUIT Victoria, smoking is Australia’s leading preventable cause of death and disease, costing about $30 billion each year.
"Among its many other ill-effects, smoking is responsible for most cases of Chronic Obstructive Pulmonary Disease (COPD), an umbrella term referring to emphysema and chronic bronchitis," says Professor Charlie Xue, Director of the Traditional and Complementary Medicine Research Program at RMIT’s Health Innovations Research Institute.
In people with COPD, lung tissue is progressively and irreversibly damaged. This leads to shortness of breath, fatigue, inability to perform day-to-day tasks and, eventually, death.
Access Economics estimates that about 1.2 million Australians had moderate to severe COPD in 2008. Almost half were of working age, creating considerable ramifications for earnings and productivity.
In China, the situation is even more serious. As a developing nation, its regulatory system hasn’t yet caught up with countries like our own.
"It is estimated that almost two-thirds of men in China smoke," says Xue. "And, because COPD can take years to manifest, it’s reasonable to assume that the condition will become increasingly common in China for some time to come."
According to Xue, Western medication provides only temporary and symptomatic relief from COPD. What’s more, the medication can have significant side-effects.
But hope may be on the horizon - thanks to a collaborative study between RMIT and the Guangdong Provincial Academy of Chinese Medical Sciences in southern China into the potential use of traditional Chinese herbs for treating COPD.
"Traditional Chinese Medicine (TCM) is a complete healthcare system with a 2,500-year history," says Xue.
"Unlike Western medicine, which focuses on identifying and treating conditions affecting individual body systems and organs, TCM looks at the overall relationships between body systems and organs."
TCM works on the premise that an imbalance in these relationships can affect the body’s energy, structure and/or function - making it more susceptible to disease.
To restore the balance, TCM uses treatments like acupuncture, herbs, dietary modification and stress management.
Several years ago, Xue and senior respiratory physicians at Melbourne’s Box Hill Hospital began discussing the possibility of trialling a Chinese herb to treat COPD patients.
"Choosing which herb to study was no mean feat, since TCM uses almost 600 herbs, and often combines several to make a particular formulation," says Xue.
To complicate matters, his research team had to find a formulation with strong pre-existing evidence of quality, efficacy and safety. They also had to identify one that TCM practitioners can use in everyday practice.
Ginseng was the only herb that met both criteria.
"Historically, ginseng has been used in TCM to improve lung, digestive and immune functions, and to increase general wellbeing," says Xue.
"We want to determine whether, and to what degree, ginseng can improve lung function and quality of life for COPD patients."
Xue will lead two studies to answer these questions.
The first is a three-year trial beginning this month, recruiting 168 patients from Box Hill and Austin hospitals. $560,000 in funding will come from the National Health and Medical Research Council, with $30,000 from the National Institute of Complementary Medicine.
As an Adjunct Professor with the Guangdong Academy, Xue discussed the Melbourne ginseng study with his colleagues in China.
"They were interested in expanding our work to trial the effectiveness of ginseng in combination with two other Chinese herbs," he says.
These herbs can’t yet be named because the formulation is subject to further pre-clinical evaluation.
Funded by $1.05 million from the Guangdong Academy, this three-to-four-year study is expected to begin in mid-2011, with about 200 participants from hospitals in southern China and Melbourne.
The two studies will enable researchers to compare the effectiveness of the three-herb formulation with ginseng on its own, based on data from randomised controlled trials.
They will also determine whether the formulations could help reduce dependence on pharmaceutical medication.
For Xue and his team, the project is an opportunity to combine the best of Eastern and Western research methodology to tackle a major international health problem.
"We in the West may tend to think that Eastern researchers have a lot to learn from us, but I believe we have a lot to learn from each other," says Xue. "It goes both ways."
All photos: Carla Gottgens.
