For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical Group, Raffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.
Refer to the first part of this interview here.
Herbal Medicine & its Compounds & Prescription
Herbs such as Flos Lonicerae (Jingyinhua), Herba menthae (Bohe), Cortex Moutan (danpi), Rhizoma Atractylodis (Cangzhu) and Cortex Phellodendri (hungbai) are herbs commonly prescribed by TCM physicians for eczema. They have anti-allergic, anti-inflammatory and reducing itchiness effects.
MarcieMom: Physician Lau, could you explain to us what compounds are made up in the herbs that you commonly prescribe to eczema children? (Compounds meaning containing which Vitamin or which carotenoid)
Physician Lau: These compounds are extensive and it is not possible to list them all down.
Marcie Mom: I searched for studies on TCM and effects on atopic dermatitis and it appear that studies which indicate positive results (meaning lower severity of eczema or less reliance on cortisteroids) have relatively small sample size (see here and here). In this review article, the authors from The Chinese University of Hong Kong, Pediatrics and Institute of Chinese Medicine departments, concluded that the “beneficial effects of Chinese medicine on children with atopic dermatitis have not been consistently demonstrated”. I would think this is due to limited studies, both in number of studies and the sample size of studies, which led to inconclusive results and the ambivalence of non-TCM practitioners to recommend their patients to explore TCM.
MarcieMom: Physician Lau, do you know of any conclusive large-scale study of TCM on eczema?
Physician Lau: Not that I know of.
I also read that the TCM prescription is individualized and not standardized across eczema patients. Why is it not possible to be standardized? Would prescribing the common herbs for eczema and in a standard dosage makes it easier for studies to be conducted and also for greater transparency in TCM medicine?
Physician Lau: Each patient requires different attention and treatment and TCM does that. It customizes the treatment for the patient so patient can recover speedily.
MarcieMom: Related to the above, the individualized treatment characteristic of TCM makes it scarier for parents, what if their TCM physician prescribes the wrong potency or frequency? I’m thinking about western steroid creams, a mom would easily google the strength of the steroid and know if it ought not be used daily. Can you advise (1) what questions a parents should ask their TCM physician about the medicines given to their child and (2) what are the common dosage and length of taking these meds?
Physician Lau: Each consultation differs from patient to patient so there is no common dosage or length of taking these medications. The most frequently asked question is “are they safe?” Yes, they are safe and there are no known side effects.
MarcieMom: I read quite a few studies preparing for this interview and found that all of them measure the toxicity level in kidney and liver (and most conclude no toxicity effect). Why is this mentioned in the studies of TCM? Is there a risk of toxicity because the compounds in the herbal medicine are too potent?
Physician Lau: In fact, all medications including western medicine measures the toxicity level in the kidney and liver as these are important and immediate organs that has reactions to the medicine. All medication concoctions follow this benchmark.
MarcieMom: Thank you Physician Lau for the reply. Next week, we’d explore herbal bath and cream treatment options.
4 replies on “TCM Series – Understanding Eczema from TCM’s Perspective”
Hi Marcie Mom, great questions, although the answers remain frustratingly vague. No fault of yours, since the benefits of TCM are quite hard to quantify. Personally, I have been going to Thomson TCM at I12 Katong for regular acupuncture. My focus is not to cure my eczema, but I have found that the acupuncture helps me sleep better, and reduces the itching at night. The physician also gives me a herbal medication that I take every night.
On a separate note, I have found it difficult to know the actual “specialty” of a TCM, since each has their own area of expertise e.g. stroke, fertility, etc. I have been trying to put together a (hopefully) useful directory of eczema-specific TCM physicians at http://finder.skinshare.sg. It’s very bare at the moment, so I hope your readers can pop by to share their experiences with TCM.
Thanks for dropping by Bee, and good to know that TCM has helped with your sleep and itch, take care!
Thanks for dropping by my blog and always leaving constructive comments 🙂 I agree, I remain skeptical myself, esp. when there seems a lack of movement on TCM part to consolidate their efforts to promote further clarity and conduct larger scale studies…
Those are some great questions, Mei. Others I might ask would be: 1) how does a TCM practitioner personalize the treatment to a patient? i.e. on what basis does he or she prescribe a certain mix and amount of herbs? 2) with the large number of herbs and compounds they contain, is there not a greater risk of drug interactions–either “harmful” or “beneficial”–in TCM than in Western pharmacy? 3) with herbs coming from myriad different sources how can a practitioner be sure of the amount of drug contained in a sample, and hence how much to prescribe?
Until we do have some large-scale studies that show efficacy, I will be skeptical. And for such studies it is essential to standardize the amounts and frequency etc. and include a large placebo control group.