Overview of Traditional Chinese Medicine (石家庄)

Historical Ideology

Traditional Chinese Medicine, known as TCM, is based on Yin-Yang and the 5 elements. There are 5-zang (organs) and 6-fu qi, blood, and meridians. TCM emphasizes harmony and balance within the individual and the universe, categorizing cause of disease into external and internal. The important diagnostic methods of TCM include, but are not limited to: acupuncture, cupping, Chinese herbology, medicinal use of animals and minerals.

Tongue and Pulse Reading in Chinese Medicine

In traditional Chinese medicine, there are 4 exams to diagnose treatment. Those are seeing, touching, asking, and listening/smelling. Looking at the tongue and feeling the pulse are most important, seeing the state of health from minute details. The tongue can reflect food intolerances, and can correspond to different organs such as the back of the tongue representing the kidney and the tip representing the heart. A color and shape of the tongue, among other details, are also observed. A red tongue with a yellow coat indicates heat (huo) from inflammation, where a pale and thin tongue represents a deficient blood condition. Pulse indicates strength of the energy, and can help determine conditions such as weakness in the organs.

Chinese Medicine Industry (and its Problems)

There are three groups of Chinese medicine in China: raw herbal medicine, sliced herbal medicine, and patent medicine. There are over 1500 manufacturers producing sliced herbal medicine and over 850 manufactures producing patent medicine in China, according to
research on ncbi.nlm.nih.gov. Although herbal extracts are technically herbal medicine, they are not based on Chinese herbology but are active ingredients extracted from herbs, listed as biomedicine in China. There is an improvement of quality control with implementations over laws over the years, but there still needs to be more to improve the quality control in production of herbs in China. There is also no strict standard for critical components in patent medicine, meaning some manufacturers use less effective components or cheap substitutes.

Research on TCM Intervention

Research done on TCM herbs is conducted by characterizing multiple-herb constituents, isolating active components from herbs, and testing pharmacological activities in pursuit of discovering new drugs. The US Pharmacopeial Convention’s Herbal Medicines Compendium provides this standard for herbs and their components. One famous example of active ingredients being successfully extracted from TCM are artesunate used for severe malaria. Some TCM formulations are also undergoing FDA trials in the US for fulfilling the requirements of good clinical practice. The major problem with the TCM system is the lack of high quality clinical trials done with good
methodology, and consistency of results across multiple cases and multiple locations. Some critics say there was a lack of repeatable trials, lack of details, unclear methods, high bias risk, or sufficient numbers of participants. This highlights the large disparity between quantity and quality of TCM RCTs (Randomized controlled trials), largely a result of the medicines origins and lack of regulation in China and abroad.

Challenges of Applying Evidence-based Medicine to TCM

One of the largest issues in conducting valid RCTs is batch-to-batch variation due to the Chinese medicine Industry. There is lots of variation between products and this creates a lack of reproducibility between clinical trials. This can be overcome, however, by using
technology. Using analytical tools can profile constituents of herbs using high-pressure liquid chromatography and the batches can be compared for variability. The 2nd issue is creating a placebo for multiple-herb herbal decoctions. The herbs are very unique in shape, smell, and taste, and a good quality placebo will seem similar to the real product but have no pharmacological activity and allow for a control to be used for comparison.

References

Fung, Foon Yin, and Yeh Ching Linn. “Developing Traditional Chinese Medicine in the
Era of Evidence-Based Medicine: Current Evidences and Challenges.”
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425037, 2015, pp. 1–9, https://doi.org/10.1155/2015/425037.
Raphals, Lisa. “Chinese Philosophy and Chinese Medicine.” Stanford.edu, 28 Apr.
2015, plato.stanford.edu/entries/chinese-phil-medicine/#Aca. Accessed 10 Oct.
2024.
“Tongue and Pulse Reading according to Chinese Medicine.” Stramcenter.com,
stramcenter.com/blog/blog-detail/tongue-and-pulse-reading-according-to-chinese
-medicine/.
Xu, Judy, and Yue Yang. “Traditional Chinese Medicine in the Chinese Health Care
System.” Health Policy, vol. 90, no. 2-3, May 2009, pp. 133–139,
www.ncbi.nlm.nih.gov/pmc/articles/PMC7114631/,
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