7월 18, 2011

5. Situation and Future Direction of TKM

1) Making the Research Activate

These days, research on oriental medicine, as an alternative medicine, is being carried out globally.

In the West, especially Britain, Germany, France, the United States is actively researching oriental medicine. First, in the case of Britain, it was officially recognized that acupuncture is effective for chronic nonspecific backache. We should note that recognizing formally Acupuncture treatment in the UK is based on the accumulated clinical studies.
Recently, with interest and discussion on Evidence-Based Medicine(EBM) animated, the interest in clinical research is becoming more concentrated in oriental medicine as well as in western medicine.
Oriental studies in Europe is very active and decent. Many oriental medicine books is written, translated, and published, let alone publication of Magazine, academic journal. Research and medical activities of the oriental medicine in Germany, France and Eastern Europe research is remarkable. In Germany, there are many college of medicine taking oriental medicine into required subjects. Also there are some hospitals with department of oriental medicine.

In Asia, China, Japan, Vietnam, Taiwan in order strives to study Oriental medicine, but Korea not even in the rankings.
In case of China, setting a ambitious goal to dominate 21st century world health by TCM and accelerating development of TCM, TCM has been fostered.
On the other hand, in the case of Korea compared to foreign, research results are very disappointing.
Last five years, Looking at the present condition of the 11 colleges of Oriental medicine annual average Master's and Doctor's dissertations, annual 300 of the thesis was submitted. But, there's not much practical results and there were many cases ending in research to research, rather in conjunction with clinical research.
Also, in the last two years, application of new oriental medical technologies was 26cases, but one case did not even pass. Like this, there is a lack of investment and research in this area. Clinical Research and medical device development based on oriental medicine theory is insufficient, and the concept of research ethics lacks.
Therefore, lot of interest and support in TKM(Traditional Korea Medicine) research is needed. TKM studies should be aimed at contribution to human society and the nation's industrial development. The direction should correpond the contents of education, research, treatment with evidence-based research reproducibility obtained, modernizing and approaching scientifically oriental medicine theory.


2) Taking the Lead in the Standardization of Traditional Medicine

Standardization of TM(Traditional Medicine) means making an international standard about system or treatment of TM that can be equally applied to every country in the world. Lack of standard is the reason that TM is criticized by many people and the weak point of TM compared to Western medicine. Therefore, making a scientific and clear standard is a matter of great importance to increase reliability of TM. And why it is important for Korea to take the lead in the standardization of TM is that if we take the initiative of standardization in global TM market, it can be the jackpot for development of TKM(Traditional Korean Medicine) industry and securing national competitiveness.
Nowadays, the standardization of TM revolves around the competition of Korea, China, and Japan through WHO(World Health Organization) and ISO(International Organization for Standardization). WHO is leading the standardization of terminology and name of diseases of TM, and ISO takes the charge of standardization for global industry of TM.
In 2008, Korea succeeded in international standardization of meridian points on the body, winning the competition with China and Japan. Recently, however, China is taking the lead in the international standardization and Korea and Japan are barely following. Chinese government has invested a huge budget for TCM(Traditional Chinese Medicine)-driven standardization and trying to take the lead continuously. They organized a committee called TC249 in ISO and insisted to decide an official name of traditional medicine as TCM. Korea and Japan, in response, insisted to decide the official name as TM and suggested standards for quality and safety. Nowadays, discussions about the official name and the standardization are going along separately. In case of Japan, they stand out in the field of herbal medicine. Tsumura, Japanese herbal medicine company, is globally famous for standardization through thorough quality control and doing a role of an actual standard in medicinal herb research. They encoded herbal medicine whose effectiveness is proved by thesis. In January, Japan held a conference about standardization of Japanese herbal medicine, demonstrating that they are ready to take the lead in the international standardization of herbal medicine.
Korea is also striving for standardization of TM with KIOM(Korea Institute of Oriental Medicine) as the center. KIOM has been designated as WHO Cooperation Center and is pushing ahead with standardization of acupuncture, moxa, etc. They also have published a standardized onomasticon of stroke. Furthermore, Korean Medicine Technology Standardization Center, which will be the research space for EBM(Evidence-Based Medicine) based standardization, is being established and will be completed in 2012. Like these, Korea is making many efforts for TKM-driven standardization, but we are still in the preparation stage and have a long way to go.
What we need for taking the lead in the standardization of TM is 'emphasizing a characteristic of TKM' and 'efforts for standardization through research'. The representative characteristic of TKM is 'Four-constitutional Medicine(Sasang typology)'. TKM and TCM have similar roots, but after Lee Je-ma's Dong-Eui-Su-Sae-Bo-Won(東醫壽世保元), Four-constitutional Medicine which prescribes different medicines according to personal physical constitution has been developed as TKM's differentiated characteristic. Also, for international standardization, national standardization based on careful research has to be a priority. I mean, like an example of Tsumura, we have to prove effectiveness of Four-constitutional Medicine thorough research to insist on our KM as the international standard.


3) Making the most of KCM's characteristics

(1) More personalized medicine

KM(Korean Medicine) organizes more personalized medicine than TCM(Traditional Chinese Medicine) does, and Four-Constitution Medicine(四象醫學) of KM represents it well. this theory was first created and published by Lee Je-ma (李濟馬) in 1894 at Dongeuisoosebowon(東醫壽世保元).
KM divides person's constitution into four groups, which are greater yang person(太陽人)·greater yin person(太陰人)·lesser yang person(少陽人)·lesser yin person(少陰人).
In TCM, It's general to perscribe same medicine to same disease.
But Four-Constitution Medicine considers patient's personality, psychological status, nutrition, function of internal organs, medical action and perscribe different medicine to same disease because those factors can vary from constitution.
In other words, through categorizing patients by constitution, medicine that fits to personal condition can be prescribed. Recently, western medicine also tries to prescribe the most appropriate prescription though analyzing DNA sequence. Judging from this fact, if we improve and inform Four-Constitution Medicine which has personalized medicine trait, it would achieve international status as much as TCM does.

(2) A therapeutic follwing confirming symptom(辨證施治)
A therapeutic following confirming symptom(辨證施治) has a proper characteristic in oriental medicine, which can be grasped but by pathological body reflection not by histological or molecular level etiology. It is also able to be selected a prescription by means of clinical trials which promote human body's natural resurgent.
The Pattern(證) means diagnostic conclusion of the pathological changes at a certain stage of a disease, including the location cause, and nature of the disease as well as the trend of development, not simply giving a respective meaning for a symptom. It grasp a physical reaction to the patholocial changes of disease's process and promotes the self-recovery capacity of human body by selecting and prescribing medicine against certain patterns. In TKM(Traditional Korean Medicine), it is often to call a disease as the name, adding the letter ‘證’ to a medicinal instead of a name of disease in certain case. The Eight Principle Pattern Identification(八綱辨證) is representative of therapeutic following confirming symptom, dealing with Yin(陰), Yang(陽), Exterior and Interior(表裏); the outer part of the body(the skin, body hair, flesh and superficial meridians) and the inner part of the body(the towels and viscera, qi, blood, and bone marrow), Cold and Heat(寒熱), Deficiency and Excess(虛實). Otherwise there are some pattern identification methods like Visceral Pattern Identification(臟腑辨證), Six-Meridian Pattern Identification(六經辨證), Defense, Qi, Nutrient and Blood PAttern Identification(衛氣營血辨證).
There are two concepts explaining the principle. One is Same treat ment for different diseases(異病同治), and the other is Different treatments for the same disease(同病異治). The former appies the same method of treatment to patients with different kinds of disease but have the same pattern. On the other hand, the latter applies different methods of treatment to the same kind of disease but have different patterns. In recent years, the disease highly diverses and the patients complain of complex disorders by the indefinite mechanism. Thus KM can strengthen the strength of Therapeutic following confirming symptom, systematize a disease by multi-levels and suggest distinct treatment principle.

(3) Diversity
Unlike TCM(Traditional Chinese Medicine), KM(Korean Medicine) still has diverse schools. a number of schools have been formed with KM being studied among people in non-official circles, and they started academic arguments that eventually led KM to a world-wide study. representatively, there are the school of Dongeuibogam(東醫寶鑑), the school of experiential prescription, the school of Introduction to Medicine(醫學入門;medical book), the school of life nurturing, the school of Four-Constitution Medicine(四象醫學), the school of acupuncture and moxibustion, the school of restoring yang(扶陽), etc. as each school has a independent point of view about diagnosing and prescribing medicine, there can be various, effectual remedies in wider range than that of TCM. also, doctors of KM established many academic societies in The Association Of Korean Oriental Medicine to maintain this diversity and to accept new paradigms and widen the range of KM, like the society of tuina(massage) therapy, the society of herbal acupuncture, the society of rehabilitative traditional korean medicine, the society of naturopathy, etc. if we maintain and improve this diversity, not settling for the present and not being satisfied, KM can be an world-famous, independent study substantially different from TCM.

4) International Standardization of TCM

China continues to dominate Standardization of TCM and other related countries, Korea and Japan are just keeping up.
WHO named TCM 'traditional medicine' from early on, and continually recommended that each countries should respect it as their traditional medicine and absorb it in national health care system by shedding new light on its medical values. WHO is also implementing policies which underline the traditional medicine's contribution to health promotion, and leading its standardization of medical terms and diseases.
If WHO focuses on policies of traditional medicine, ISO is in charge of institutional basis to globalize industrial values of traditional medicine. China has huge influence on ISO to accelerate the standardization business. China recognized the need of international standardization of TCM and investments strong budgets and manpower on it, so we should discuss how to deal with it from now on.
Nation's only government-funded research organization, traditional medicine Korea Institute of Oriental Medicine (KIOM), builds a cooperative system with Korean oriental doctors' association.
Now, KIOM is leading the standardization of TCM terms, information, diagnose, and medical equipments, along with ISO's standardization project. KIOM's information center practices study of standardization of TCM terms to establish standard health data contents. It collects terms from all sorts of TCM books, clinical charts, and papers, and then refines and disseminate them, connecting them with WHO IST and U.S. National Library of Medicine's UMLS. Also it focuses on ensuring interoperability of TCM and western medicine by connecting TCM terms with International terms. The convergence of TCM and the latest IT research through the Medical Ontology for Intelligent Medical Research is underway to implement the system. It is the basic research to conceptualize TCM terms in computer language.
In addition, the 2012 ISO/TC249 (traditional medicine International Organization for Standardization Technical Committee) 2nd meeting is to be held in South Korea, so South Korea will have a great opportunity to popularize our TCM's excellence and confirm the initiative of international stnadardization.

댓글 1개:

  1. Thank you for the info. It sounds pretty user friendly. I guess I’ll pick one up for fun. thank u


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