Inevitably traditional Chinese medicine has gone global. Whether it is Olympic athletes using cupping therapy to keep themselves healthy or famous entrepreneurs opting for Chinese medicine instead of Western medicine to treat cancer and inflammatory diseases, there is undeniable evidence that the influence of Chinese medicine has spread throughout the world. In the West there are multiple signs of Chinese medicine becoming increasingly popular. Because the West along with the rest of the global community has become more concerned about the effects of chemicals on our body and the environment, Chinese medicine, which is extracted from natural substances, has become increasingly in demand. Last year, with the objective of advancing clinical studies of Chinese medicine in Hong Kong, HKBU established the Endowed Chair of Chinese Medicine Clinical Studies* with the support of the Tsang Shiu Tim Charitable Foundation. Professor Bian Zhaoxiang, Associate Vice-President (Chinese Medicine Development), Director and Chair Professor of the Clinical Division, the School of Chinese Medicine of HKBU, has been appointed as this Endowed Chair.
Professor Bian joined HKBU in 2001 as one of the early members of the School of Chinese Medicine. Under his leadership, HKBU has set up a network of 16 Chinese medicine clinics throughout Hong Kong. Professor Bian has been a long-term advocate for the establishment of a Chinese medicine hospital in Hong Kong. In addition, he initiated the establishment, and later became Director, of the Hong Kong Chinese Medicine Clinical Study Centre, the first and only centre focusing on Chinese medicine clinical trials in the territory. Also worthy of note is that Professor Bian and his team have secured the backing of the Jockey Club to establish the “Hong Kong Baptist University – Jockey Club Chinese Medicine Disease Prevention and Health Management Centre”. As an expert in basic and clinical research of treating gastrointestinal (GI) diseases with Chinese medicine, Professor Bian firmly believes that clinical studies are essential for the internationalisation of Chinese medicine. “The key to making Chinese medicine integrate into mainstream medical practice is to provide sufficient clinical evidence of its efficacy and safety. Therefore, we must conduct stringent clinical studies in order to show how effective and how safe Chinese medicine is,” said Professor Bian.
As pointed out by Professor Bian, Chinese medicine, one of the world’s oldest medical systems, represents the collective wisdom of our ancestors gained over the past 3,000 years. Its theories are based on experience. Many Chinese herbal medicine formulas are in frequent use today but their efficacy and the mechanisms have still to be proven by clinical studies. Also, clinical studies have to be conducted up to Western medical standards if they are going to be recognised. In view of this situation, Professor Bian started collaborating with experts from the University of Oxford in the UK, the University of Ottawa in Canada, the Beijing University of Chinese Medicine and Sichuan University in China in order to work on standardised reporting guidelines for Chinese medicine clinical trials. In 2017, the group published a recommendation for reporting clinical trials with Chinese medical formulas in the internationally renowned journal Annals of Internal Medicine. Three versions of the paper, in English, traditional Chinese and simplified Chinese, were published simultaneously online. This is the first time since the journal was launched in 1927 that it has published a paper in three versions, indicating the great importance that the international medical community attaches to Chinese medicine research.
“Currently, tens of thousands of clinical trials have been conducted on Chinese herbal medicine formulas, but the quality of reporting is unsatisfactory. Inadequate reporting quality not only reduces the value of Chinese herbal medicine but also affects the judgement about the efficacy and safety of Chinese medicines in general. Therefore, there is an urgent need to establish reporting guidelines for clinical trials of Chinese herbal medicine. This encourages the publication of clinical trial reports compiled by researchers in different countries and thus enhances the global influence of Chinese medicine,” said Professor Bian.
The clinical studies conducted by HKBU’s School of Chinese Medicine currently are about digestive system diseases, arthritis, metabolism, tumours and Alzheimer’s disease, i.e. diseases that are recognised as major public health concerns. Digestive system diseases are Professor Bian’s research focus. As indicated by the American College of Gastroenterology, “A good digestive system plays an important role in the health of the entire body, so our digestive system deserves even more attention from us than our brain.” GI diseases are common among city dwellers. For example, colorectal cancer is the most common cancer in Hong Kong. Irritable bowel syndrome (IBS), another prevailing GI disease that causes bowel dysfunction, gastric disorder or intestinal hypersensitivity, affects over 300,000 people in Hong Kong.
Professor Bian, who has studied GI diseases since graduation, said he has seen many patients deeply troubled by GI diseases. “Patients have to visit the doctor once or twice a week. Their daily lives are greatly affected. Their condition gets worse once they stop taking medication. If they suffer from inflammation or an ulcer, they need to take steroids, which will cause side effects such as osteoporosis after prolonged use. Some patients who have received colorectal cancer treatment such as surgery or chemotherapy are afflicted by the side effects that result. In these cases, Chinese medical treatment is complementary to Western medicine, such as by alleviating the side effects caused by chemotherapy, and can help patients recover.”
As a recognised leading expert in his field, Professor Bian possesses 52 patents and was awarded second prize in the National Science and Technology Advancement Award of China. Among his seminal contributions over the years, in 2016, his team found that a natural compound, Pd-Ib, extracted from the Chinese herbs Bupleurum malconense could effectively alleviate acute ulcerative colitis. The research team was granted a US patent and is expected to develop Pd-Ib into a new drug. In the same year, HKBU entered into a cooperation agreement with The Chinese University of Hong Kong (CUHK) and PuraPharm Corporation Ltd to develop new drugs for treating IBS. This collaboration was founded on a pioneer project between Professor Bian’s research team and the Faculty of Medicine of CUHK that had been treating IBS with Chinese medicine since 2002.
Having over three decades of experience, Professor Bian fully realises that clinical studies of Chinese medicine consume a large amount of time and resources. Completion of each clinical study depends on the concerted efforts of every team member. Taking the clinical study of a Chinese medicine formula for treating functional constipation as an example, Professor Bian explained that the study involved several stages: first, understanding the reason for studying this formula; second, proving the ideal dosage of the medicine and its efficacy and safety; third, comparing its efficacy and safety with first-line drugs; lastly, explaining the mechanism behind the treatment, i.e. why this medicine can treat a certain disease. “Clinical trials of Western medicine are usually first performed on animals. However, in Chinese medicine, we use human subjects from the very beginning. As long as patients are involved, the time and the money required are much more than in ordinary scientific research. A great amount of financial resources is needed!” Professor Bian said. He further illustrated that a patient’s lifestyle habits affect the efficacy of the medicine they take. Also, unlike in Western medicine, a Chinese herbal medicine formula contains more than a single compound. Therefore, it takes much more effort to ensure that each patient receives the same dosage of medicine.
Professor Bian indicated that his research had been fortunate to receive financial support from related research institutes and generous donors in the community. He also expressed his deep gratitude to the Tsang Shiu Tim Charitable Foundation for establishing the Endowed Chair of Chinese Medicine Clinical Studies. He knew that the Tsang family is enthusiastic about serving the community, in particular caring for education and the health of elderly. Through the Foundation, the Tsang family wishes to promote the development of Chinese medicine for the benefit of society. After becoming the Endowed Chair of Chinese Medicine Clinical Studies, Professor Bian expects in the short term to launch a new drug for gastrointestinal diseases. In the long term, he hopes he can develop more drugs for treating a number of incurable or serious illnesses.
Talking about the future development of Chinese medicine, Professor Bian believed that Chinese medicine must become modernised, internationalised and more scientific. He once met experts from Harvard University, Cornell University, the University of Toronto and the China Academy of Chinese Medical Sciences to explore the various treatments for colorectal cancer. “Meeting experts in the same field can always bring new ideas and inspiration. There will be more and more of this kind of collaboration in the future and I think this definitely helps increase the influence of Chinese medicine in the international arena.”
Professor Bian is a sports lover. He played all kinds of ball sports when he was young. Now he loves jogging. He said jogging can clear his mind and make him more focused to deal with his daily workload. Realising the importance of a healthy digestive system, Professor Bian told us his tips for keeping healthy: “Never eat too much. Eat until you feel seventy percent full,” and “Eat more whole grains such as oatmeal and brown rice.” Professor Bian treats himself to the simplest of foods that are best for his health after putting in a hard day at work. We city dwellers should learn from Professor Bian if we want to be as healthy as him.
*This interview was published in 2017. The endowed professorship bestowed upon Professor Bian Zhaoxiang was renamed as Tsang Shiu Tim Endowed Professor in Chinese Medicine Clinical Studies in 2020.