ABSTRACT

In recent years, the search for new medicines for treating life-threatening diseases such as cancer has become the center of attention in pharmaceutical research and development. As a result, many pharmaceutical companies have begun to focus on the modernization of traditional Chinese medicines (TCM). Modernization of a TCM is based on scientific evaluations of the efficacy and safety of the TCM in terms of well-established clinical endpoints for a Western indication through clinical trials on humans. However, it should be recognized that there are fundamental differences in the scientific evaluation of the efficacy and safety of a TCM as compared to a typical Western medicine (WM) even though they are for the same indication (Chow et al. 2006; Tse et al. 2006). For example, most WMs contain a single active ingredient, while most TCMs consist of a mixture of components or constituents, which may or may not be active pharmacologically. In addition, the traditional Chinese diagnostic procedure (CDP) for a TCM is quite different from that of a WM. Typically, the CDP consists of four major categories, namely, inspection, auscultation and olfaction, interrogation, and pulse taking and palpation. Basically, each category can, in fact, be thought of as an instrument (or questionnaire), consisting of a number of questions to collect different information regarding the patient’s activity/ function, disease status, and/or disease severity. For instance, the Chinese diagnosis for stroke is called Tsu Chung. The CDP for stroke consists of wind syndrome (six categories), fire-heat syndrome (nine categories), sputum syndrome (seven categories), stasis syndrome (five categories), deficiency syndrome (eight categories), and overabundant syndrome (nine categories). On the other hand, WM uses the NIH Stroke Scale (NIHSS) developed by the US National Institute of Neurologic Disorder and Stroke (NINDS) from the original scale devised at the University of Cincinnati to measure the neurological impact of stroke (Lyden et al. 1999).