|梁 秉 中 获 亚 洲 创 科 银 奖|
A herbal remedy can help cure stubborn diabetic ulcers
When Professor P.C. Leung, an orthopaedic surgeon with the Chinese University of Hong Kong, first heard about using simple Chinese herbs to cure diabetic foot ulcers, he was highly sceptical. He remembers hearing a lecture on the topic in 1998 from an "old herbalist from a Shanghai hospital," who claimed the results were excellent.
"I didn't believe him because I found it all too simple, too good," remembers Leung. "And a lot of reports from China are just not worth believing; they're just not worthy. But I kept my mind open."
It's good he did. From that first lecture until today, Leung, as management-committee chairman of the university's new Institute for Chinese Medicine, has spearheaded the effort to test the herbs on elderly diabetic patients, along with more-conventional diabetic care.
The goal: to see if the herbs, given as a drink, can indeed help heal the resistant foot ulcers in diabetics that so often lead to amputation. "In every big hospital in Hong Kong, in at least 10 of them, one expects to see a dozen to twenty amputations a year due to diabetic ulcers," says Leung.
Internationally, the problem is also great. According to the University of Texas Health Science Centre in San Antonio, diabetes mellitus is the "most common underlying cause of lower-extremity amputation in the United States and Europe." Of the 120,000 nontraumatic amputations done annually in the U.S. alone, 45%-83% involve diabetes.
That's why the results of Leung's initial efforts are so promising. Since March last year, at least 40 diabetic patients with severe foot ulcers, most of them elderly, have been treated with the herbs in the institute's pilot study at Hong Kong's Prince of Wales Hospital.
It's called an "efficacy-driven" approach to testing alternative medicine, sanctioned by the World Health Organization and the U.S. National Institutes of Health. In Leung's case, the success rate of the tests, where ulcers have healed and limbs were saved, has consistently been around 85%.
"After six patients, we were convinced we should continue," says Leung, noting the treatment worked in a period of between two weeks and six months. "So I got approval from the hospital ethics committee to go deeper. We were impressed with the clinical picture."
Now, Leung and his colleagues have embarked on a larger, two-year HK$1 million ($129,000) clinical trial of the herbs involving 100 patients and another hospital, Kwong Wah in Hong Kong's Yau Ma Tei district. The goal this time around is not only to save limbs, to show the herbs work, but also to understand why such herbal potions improve the chance of healing.
"Is it due to local improvement of circulation?" asks Leung during a lengthy interview. "Is it due to granulation tissue formation, which is a very important step towards wound healing? . . . All these questions need to be answered."
If all goes well, the university and its Institute of Chinese Medicine hope to generate sufficient interest among local and international pharmaceutical companies to invest in the next stage: analyzing herbs, identifying active ingredients and developing drugs. It's a long, time-consuming and expensive process that typically takes about 5-10 years from discovery to approval and costs anywhere from $50 million to $300 million, according to Johns Hopkins Singapore, the Asia-based research and education arm of Johns Hopkins Medicine in the U.S.
Assuming the best, how significant is Leung's innovation? "If it works on diabetic ulcers, it should work on all wounds failing to heal and that would be a much wider area," he says.
But would it be considered a major advance in medicine? "If we repeatedly prove such an effectiveness, yes, it would be a major advance in medicine," he says. "But we should be more modest because it's just the beginning of a serious attempt. We should not be overly optimistic. But we should have sufficient confidence to believe it might well prove successful."