M?decine chinoise

Related Terms

Acupressure, acupuncture, acustimulation, acutherapy, Asian bodywork, auricular acupuncture, chi kung, Chinese herbal medicine, Chinese nutrition therapy, classical acupuncture, coining, cupping, eclectic Chinese medicine, electroacupuncture, ethnic Chinese traditional medicine, feng shui, five element acupuncture, I Ching, Japanese acupuncture, medical acupuncture, moxibustion (moxa), Qi gong, qigong, Reiki, scraping ("coining"), shiatsu, tai chi, taoism, tiji, ting sha, TCM, traditional acupuncture, traditional Chinese medicine, tui na.

Background

Chinese medicine is a broad term encompassing many different modalities and traditions of healing that share a common heritage of technique or theory rooted in ancient Chinese philosophy (Taoism). Given the distribution of the world population, it is likely that more people have been treated by Chinese medicine in its various forms than any other approach in history. There are many possible ways to categorize the modalities and traditions of Chinese medicine. The following categorization will be used in this monograph to describe the major approaches available:
Traditional Chinese medicine (TCM): In the 1940s and 50s, the government of China undertook an effort to combine the myriad forms of Chinese medicine into a unified system officially labeled traditional Chinese medicine (TCM). The intent was to integrate the country's large work force of traditional practitioners into a Western-style health service delivery system to help provide care for a large population, using familiar and inexpensive methods. TCM uses a well-defined theory and places a heavy emphasis on herbal medicine supplemented by acupuncture. Herbs are usually given in the form of manufactured or processed pills, extracts, capsules, tinctures, or powders, in contrast to the raw and dried form favored in ethnic Chinese traditional medicine.
Chinese herbal medicine: This is perhaps the oldest form of medicine based on Chinese medical principles. It is based on the energetic qualities of the herbs rather than the chemical properties as understood by Western pharmacology. There are over 2,000 different kinds of herbs (of which about 400 are commonly used). Chinese herbal medicine may be employed as a complete system of healing in itself, or may be combined with many of the other practices outlined below.
Eclectic Chinese medicine: The greatest number of Western practitioners of Chinese medicine may be described as eclectic, although their original training was in one of the specific forms above. Many practitioners draw from several different sources to create their own synthesis that works best for them in their own style of practice.
Ethnic Chinese traditional medicine: This is a loosely defined, generic form of Chinese medicine is usually practiced by ethnic Chinese practitioners in large urban centers in the United States and other countries. There is no single organized body of theory or training. This is in contrast to the more formal, organized system referred to as traditional Chinese medicine (TCM, described later). Both acupuncture and herbs may be used, and some practitioners use electrical stimulation of the needles. Practitioners commonly prepare raw herb formulas and send them home in paper wrappings or jars for the client to brew into a medicinal tea at home.
Auricular acupuncture: Auricular acupuncture is acupuncture performed at points exclusively on the ear. Many of its practitioners consider this approach to be a complete medical system for treating functional and allergic disorders, and they often use it exclusive of any other type of practice. It is also used for pain control and to assist in drug and alcohol withdrawal.
Japanese acupuncture: Japanese acupuncture is practiced by a small, but growing number of Western acupuncturists. Japanese needles are considerably thinner than others and as a result are now used by many practitioners of other forms of Chinese medicine because they are thought to be more gentle and subtle for the patient. Japanese acupuncture theory does not include herbs, although some practitioners do employ them based on other principles.
Medical acupuncture: This is acupuncture delivered by a Western-trained medical practitioner within the practice of Western medicine. Medical acupuncture developed in Europe as a result of the introduction of Chinese medical texts and practices by traders and missionaries in the17th and 18th Centuries.
Traditional acupuncture: Also known as "five element" or "classical acupuncture," traditional acupuncture evolved as a distinct practice (separate from herbs). It is the longest-established form of acupuncture practice in the United States. Its philosophy is that acupuncture without herbs is a complete medical system in itself.
Acupressure and shiatsu: These are both names for a technique of massage involving the use of finger pressure on acupuncture points (rather than using needles). Based on Chinese medical theory of the human energy system, acupressure and shiatsu seek to stimulate the flow and circulation of chi (vital energy, life force) through the person's meridian system (system of pathways of circulation of chi through the body).
Cupping and moxibustion: Cupping is the application of a heated cup over an area of the body. As the air inside cools its volume decreases and it creates a slight suction on the area that stimulates blood circulation. Moxibustion is the burning of an herb, such as mugwort (Artemisia vulgaris) or ginger, above the skin or on the acupuncture points in order to introduce heat into an acupuncture point to alleviate symptoms. It may be applied in the form of a cone, stick, or loose herb or it may be placed on the head of an acupuncture needle to manipulate the temperature gradient of the needle.
Other modalities: There are other related modalities of healing that have their origins in Chinese medicine concepts or theory. Many of these have been examined in scientific studies. Please read individual Natural Standard monographs for details.
Practitioners: Because of the diversity of forms in which Chinese medicine is practiced, there is no one single credential for all practitioners.

Theory

The ancient Chinese philosophy of Taoism provided the basis for the development of Chinese medical theory. Taoist principles as described below are present throughout the literature and teachings of the many forms of Chinese medicine.
Nature and the laws that govern the on-going, harmonious flow of life energy through the natural world are used to understand the body and health. The person is viewed as an ecosystem that is embedded in, and related to, the larger ecosystem of nature and subject to the same laws.
The life force, chi (qi), circulates through the body and enlivens it. Health is a function of a balanced, harmonious flow of chi and illness results when there is a blockage or an imbalance in the flow of chi. Yin and yang are opposite and complementary qualities of life energy (chi). Yin is regarded as the feminine principle and yang the masculine principle.
The human being has a system of pathways called meridians (also sometimes called channels) through which the chi flows. The body has been mapped with these meridians, which pass through all its organs, and specific meridians correspond with specific organs or organ systems (organ networks, described below). Health is an ongoing process of maintaining balance and harmony of the circulation of chi through all the organs and systems of the body.
Symptoms are regarded as signals of impaired flow or circulation of chi through the body. Symptoms are considered as part of a larger picture or pattern affecting the whole person. The practitioner seeks to connect seemingly unrelated symptoms and come up with a unifying explanation, in terms of what is going on with the person's chi on a global basis.
Most modern diseases are considered "chi deficiency" diseases, caused by not maintaining or supporting a harmonious internal ecology.
Harmony and disharmony are understood in two main conceptual frameworks: the eight principles, and the five elements, described below.
The eight principles are actually four pairs of complementary opposites describing patterns of disharmony within the person. Briefly the principles are interior/exterior, referring to the location of the disharmony in the body (internal organs vs. skin or bones); hot/cold, referring to qualities of the disease pattern, such as fever or thirst vs. chilliness or desire to drink warm liquids; full/empty, referring to whether the condition is acute or chronic, and whether the body's responses are strong or weak; and the balance of yin/yang, which adds to the description of the other six principles. The eight principles are the theoretical basis of the TCM approach described above.
The five elements are fire, earth, metal, water, and wood. These terms do not refer to basic constituents of matter, but are dynamic qualities of nature. They are used to describe the changing qualities of chi energy as it circulates through the person. Five element theory is the basis of the approach called traditional acupuncture (also referred to as classical or five element acupuncture).
The body has five organ networks, each corresponding with a particular element: heart/small intestine with fire, spleen/stomach with earth, lungs/large intestine with metal, kidneys/bladder with water, and liver/gall bladder with wood. The organ networks are named for the common meridian that circulates through and connects the organs, as it circulates chi throughout the larger, body-wide, meridian system. The practitioner's efforts to harmonize the five elements promote greater harmony in the functioning of all the organ networks.
Chinese medicine comprises many related but individual modalities, each with its own body of research, with varying degrees of scientific support. Natural Standard monographs are available for reviews of evidence for the following modalities employing principles of Chinese medicine: acupressure, acupuncture, acustimulation, Asian body work, chi kung, cupping, electroacupuncture, energy-based bodywork, macrobiotic diet, moxibustion, Qi gong, shiatsu, tai chi, taiji, traditional Chinese medicine (TCM), tuina, and others.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Borud EK, Alraek T, White A, et al. The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH) study: a study protocol of an ongoing multi-centre randomised controlled clinical trial. BMC Complement Altern Med 2007 Feb 26;7:6.
Chan B, Ui LQ, Ming TP. Methemoglobinemia after ingestion of Chinese herbal medicine in a 9-day-old infant. Clin Toxicol (Phila) 2007;45(3):281-3.
Cheng XR, Cheng K. Survey of studies on the mechanism of acupuncture and moxibustion treating diseases abroad. Zhongguo Zhen Jiu 2008 Jun;28(6):463-7.
He Y, Lu A, Lu C, et al, Symptom combinations assessed in traditional Chinese medicine and its predictive role in ACR20 efficacy response in rheumatoid arthritis. Am J Chin Med 2008;36(4):675-83.
Kwee SH, Tan HH, Marsman A, et al. The effect of Chinese herbal medicines (CHM) on menopausal symptoms compared to hormone replacement therapy (HRT) and placebo. Maturitas 2007 Sep 20;58(1):83-90.
Lu AP, Ding XR, Chen KJ. Current situation and progress in integrative medicine in China. Chin J Integr Med 2008 Sep;14(3):234-40.
Mao JY, Ge YB, Wang HH, et al. Summary of 32 patients with cardiac syndrome X treated by TCM therapy of regulating qi relieving chest stuffiness and promoting blood circulation. Chin J Integr Med 2007;13(1):17-21.
Oiso N, Yamadori Y, Higashimori N, et al. Allergic contact dermatitis caused by sesame oil in a topical Chinese medicine, shi-un-ko. Contact Dermatitis 2008 Feb;58(2):109.
Paterson RR. Cordyceps: a traditional Chinese medicine and another fungal therapeutic biofactory? Phytochemistry 2008 May;69(7):1469-95.
Pippa L, Manzoli L, Corti I, et al. Functional capacity after traditional Chinese medicine (qi gong) training in patients with chronic atrial fibrillation: a randomized controlled trial. Prev Cardiol 2007 Winter;10(1):22-5.
Qin XY, Li XX, Suteanu S. [Comparative study on Chinese medicine and western medicine for treatment of prolapse of lumbar intervertebral disc]. Zhongguo Zhen Jiu 2007 May;27(5):365-8.
Stockert K, Schneider B, Porenta G, et al. Laser acupuncture and probiotics in school age children with asthma: a randomized, placebo-controlled pilot study of therapy guided by principles of Traditional Chinese Medicine. Pediatr Allergy Immunol. 2007 Mar;18(2):160-6.
Tseng, SH, Chien TY, Tzeng CF, et al. Prevention of hepatic oxidative injury by Xiao-Chen-Chi-Tang in mice. J Ethnopharmacol 2007 May 4;111(2):232-9.
Yang HZ, Zhao JA, Dai M, et al. Traditional Chinese medicine syndromes of chronic hepatitis B with precore mutant. World J Gastroenterol 4-7-2005;11(13):2004-2008.
Zuskin E, Lipozencic J, Pucarin-Cvetkovic J, et al. Ancient medicine--a review. Acta Dermatovenerol Croat 2008;16(3):149-57.