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Medtem ko mešanje alternativne in splošne medicine pridobiva na svetovnem oprijemu, se prav tako pojavlja čedalje več študij o koristih hkratnega sprejemanja vzhodne in zahodne filozofije. Nedavna študija, ki je bila objavljena v reviji PLOS ONE, je odkrila, da je zdravilo konvencionalne medicine, zaužito skupaj z zelišči tradicionalne kitajske medicine, vidneje učinkovitejše pri zdravljenju diabetesa tipa 2.
Študija, narejena s strani raziskovalcev Univerze v Pekingu in Univerze v Queenslandu v Avstraliji, je vključevala 800 celinskih pacientov s slabo nadzorovano sladkorno boleznijo tipa 2, ki je vodila do komplikacij, vključujoč slepoto, amputacije in prezgodnja smrt.
Pacientom je bila naključno dodeljeno samo protidiabetično zdravilo glibenklamid ali ‘tableta xiaoke’, spojina kitajskih zelišč in glibenklamida.
Po 48 tednih zdravljenja so bili pri pacientih, ki so se zdravili s tableto, za razliko od druge skupine bolj opazna vidna zmanjšanja tveganja za hipoglikemijo (izjemno nizka raven krvnega sladkorja) in podobni napredki pri nadzoru ravni krvnega sladkorja.
Profesor Ji Linong, glavni pobudnik in direktor oddelka za endokrinologijo in metabolizem na Peking University People's Hospital, verjame, da rezultati prispevajo klinično podporo o verodostojnosti učinkovitosti tablete.
“Tradicionalna kitajska medicina (TKM) je široko rabljena za zdravljenje diabetesa tipa 2, ne samo na Kitajskem, ampak tudi drugje po svetu,” pravi Ji.
“Vendar je vloga TKM in ostalih zeliščnih zdravil pri nadzorovanju bolezni še vedno ne povsem uveljavljena. Pomanjkanje znanstvenega razumevanja je povzročilo skepticizem in kriticizem o TKM; pogosto zaradi nizke kakovosti metodologije pri izvedbah poskusov.”
Upa, da bodo nedavni dokazi o učinkovitosti TKM pri obravnavanju diabetesa prispevali k zmanjševanju zakoreninjene nepravičnosti do revnih ljudi in njihovemu dostopu do učinkovite oskrbe, “ saj je več kot 80 % ljudi v razvijajočih se državah odvisnih od zeliščarstva zaradi osnovnih potreb po zdravstveni oskrbi.
Glede na Mednarodno zvezo diabetesa živi osemdeset odstotkov svetovnega prebivalstva z diabetesom v državah z nizkim ali srednje visokim finančnim prilivom. V Hong Kongu je tako, da ima ali bo imel 1 izmed 10 oz. 700 000 ljudi diabetes tipa 2. Glede na l. 2030 naj bi se ta številka še več kot podvojila.
Diabetes je v TKM poznan kot xiaoke, ker v kroničnih primerih pacienti ponavadi manifestirajo shiranost (v kitajščini xiao) in žejo (ke). Ostale bolezni s temi simptomi se lahko prav tako poimenujejo s terminom xiaoke.
Tableta Xiaoke vsebuje 0,25 mikrogramov gilbenklamida poleg zelišč Radix puerariae (korenina Pueraria), Radix astragali (korenina Astragalus), Radix rehmanniae (korenina Rehmannia), Radix trichosanthis (korenina Trichosanthis), koruzni laski, posušeni sadni plodovi kitajske šisandre in kitajski jam.
Li verjame, da so čedalje obširnejši dokazi, da prvi dve izmed naštetih zelišč lahko spodbudita odziv, neposredno ali posredno, v dveh možganskih območjih, za kateri je znano, da sta vključeni v zaznavanju koncentracije glukoze. Diabetes tipa 2 je v glavnem preprečljivo metabolično stanje, ki ga definira neučinkovit in nezadosten inzulin ali odpornost na inzulin.
Ljudje, ki pijejo alkohol, pretirano uživajo sladko in z maščobo bogato hrano in živijo nezdrav ali sedeč življenjski stil, imajo večje tveganje za razvoj ‘xiaoke’. Klasični simptomu vključujejo pogosto uriniranje, ekstremna žeja ali lakota, neobičajna izguba telesne teže, utrujenost in razdražljivost.
Profesorica Juliana Chan Chung-noor, direktorica Chinese University's Institute of Diabetes and Obesity (kitajski Univerzitetni inštitut za diabetes in debelost), verjame, da se lahko tradicionalna zelišča, ‘ ki še morajo biti identificirana in prepoznana’, “izkažejo za učinkovita na kompleksen način pri uravnavanju zniževanju krvnega sladkorja z manj stranskimi učinki.”
Vendar Chan hkrati opozarja: “Nekateri izmed teh pripravkov imajo lahko resne stranske učinke. V primerjavi z zahodno medicino je postopek registracije zeliščnih mešanic ali TKM v vzhodni medicini manj strikten in pogosto pretirane trditve pacientom vsadijo nerealistična pričakovanja.”
Še vedno pa je tu prisotna potreba po cenovno dostopnem in varnem alternativnem zdravljenju. “Znanstvena ocena TKM bo lahko izboljšala naše razumevanje bolezni in vodila do odkritja novih poti, ki bodo lahko zadovoljile nekatere izmed neizpolnjenih potreb diabetikov,” pravi Chan.
Ta članek je bil objavljen v tiskani izdaji South China Morning Post pod naslovom Getting to the root of diabetes treatment.
prevod: Tanja Topić
Alternatively speaking: Will Chinese medicine lead to a new diabetes cure?
As the blending of alternative and mainstream medicine gains traction worldwide, more studies emerge on the benefits of embracing both Eastern and Western philosophies. A recent one published in the journal PLOS ONE found that a conventional diabetes drug, when taken alongside traditional Chinese medicine herbs, was significantly more effective in treating type 2 diabetes.
The study by researchers from Peking University and Australia's University of Queensland involved 800 mainland patients with poorly controlled type 2 diabetes - which leads to complications including blindness, amputation and early death.
Patients were randomly assigned to get either the anti-diabetic drug glibenclamide alone or the "xiaoke pill", a compound of Chinese herbs and glibenclamide.
After 48 weeks, patients treated with the pill had a significant reduction in risk for hypoglycaemia (low blood sugar) and similar improvements in blood glucose control compared to patients who took only glibenclamide.
Professor Ji Linong, the study's main author and director of the department of endocrinology and metabolism at Peking University People's Hospital, believes the results add clinical support for the product's effectiveness. "Traditional Chinese medicine [TCM] is used widely in treating type 2 diabetes not only in China, but also in the other parts of the world," says Ji.
"But the role of TCM and other herbal medicines in the management of [the disease] is still not established. The absence of scientific understanding has caused scepticism and criticism about TCM, often because of the low methodological quality of trials."
He hopes the recent evidence on TCM's effectiveness in managing diabetes will contribute towards "reducing entrenched inequity in access to effective care for poor people", as more than 80 per cent of people in developing countries depend on herbal medicine for basic health care.
Eighty percent of people with diabetes worldwide live in low- and middle-income countries, according to the International Diabetes Federation. In Hong Kong, about one in 10 individuals, or 700,000 people, have or will develop type 2 diabetes. That number is set to more than double by 2030.
Diabetes is known as xiaoke in TCM, because in chronic cases, patients usually manifest emaciation ( xiao in Chinese) and thirst ( ke). Other illnesses with these symptoms can be called xiaoke as well.
A Xiaoke pill contains 0.25 micrograms of gilbenclamide, along with the herbs Radix puerariae (Pueraria root), Radix astragali (Astragalus root), Radix rehmanniae (Rehmannia root), Radix trichosanthis (Trichosanthis root), cornsilk, dried magnolia vine fruit and Chinese yam.
Li believes there is growing evidence that the first two herbs may exert action, directly or indirectly, in two brain regions known to be involved in glucose-sensing.
Type 2 diabetes is a largely preventable metabolic condition defined by insufficient insulin and insulin resistance.
People who drink alcohol, eat sugary or high-fat foods, and lead an unhealthy or sedentary lifestyle are at greater risk of developing xiaoke. Classic symptoms include frequent urination, extreme thirst or hunger, unusual weight loss, fatigue and irritability.
Professor Juliana Chan Chung-ngor, director of Chinese University's Institute of Diabetes and Obesity, believes that some "yet to be identified" traditional herbs may prove to "work in a complex manner to reduce blood glucose with fewer side effects".
But Chan also cautions: "Some of these preparations may have severe side effects. Compared to Western medicine, the procedure of registration for TCM or herbal mixtures is less stringent and, often, exaggerated claims may give patients unrealistic expectations."
Still, there is a need for affordable and safe alternative treatment. "The scientific evaluation of TCM may advance our understanding of the disease and lead to [the] discovery of novel pathways which may address some of the unmet needs [of diabetics]," says Chan.
This article appeared in the South China Morning Post print edition as: Getting to the root of diabetes treatment