Chinese herbal medicine

Related Terms

Acupressure, acupuncture, acustimulation, acutherapy, Asian bodywork, auricular acupuncture, chi kung, Chinese herbal medicine, Chinese herbs, Chinese nutrition therapy, Chinese patent remedies, 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), qigong, Reiki, scraping, shiatsu, tai chi, taoism, tiji, ting sha, TCM, traditional acupuncture, tui na.

Background

Chinese medicine is a broad term encompassing many different modalities and traditions of healing. They share a common heritage of technique and theory rooted in ancient Chinese philosophy (Taoism), elements of which are believed to date back over 5,000 years. The first recorded use of TCM is said to have been around 2,000 years ago. The phrase traditional Chinese medicine (TCM) is actually a recent development with a specific meaning in the long history of Chinese medicine. In the 1940s and 1950s, the Chinese government undertook an effort to combine many diverse forms of Chinese medicine into a unified system to be officially defined as traditional Chinese medicine. The intent was to integrate the country's large workforce of traditional practitioners into an organized health service delivery system. This would aid in providing care for a large population by using familiar and inexpensive methods.
Because TCM and Western medicine are used side by side in modern China, China is relatively advanced compared to Western countries in using the concept of "integrative medicine." TCM figures are prominently in treatment and planning of services -- including for major illnesses such as cancer and heart disease. According to the World Health Organization (WHO), TCM is fully integrated into the Chinese health system with 95% of Chinese hospitals practicing it. As an example of such integration, it is common that children being treated with intravenous antibiotics are simultaneously treated with Chinese herbs in order to counteract the side effects of the antibiotic and boost the child's immune system.
TCM places strong emphasis on herbal medicine since herbs can be taken every day. TCM regards acupuncture as more of a supportive treatment, although the two are used together when feasible for the patient. Herbs are usually given in the form of manufactured or processed pills, extracts, capsules, tinctures, or powders. This contrasts with the raw and dried form used in the more informal and older forms of practice. There are more than 2,000 different kinds of herbs of which about 400 are commonly used.
TCM has herbal regimens for use with major illnesses, such as cancer and heart disease. Herbal combinations are commonly used to reduce the side effects of chemotherapy and improve immune functioning in cancer and to improve cardiovascular health in heart and circulatory diseases. Other herbal combinations are used in diabetes, infections, and other conditions.
Cupping is a therapeutic method in TCM that refers to the application of a heated cup over an area of the body. As the air inside cools, its volume decreases thus creating a slight suction on the area that stimulates blood circulation.
Moxibustion is a therapeutic method in TCM in which an herb, usually mugwort (Artemisia vulgaris), is burned above the skin or on the acupuncture points to introduce heat into an acupuncture point and alleviate symptoms. The herb 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.
TCM practitioners may call upon a wide range of other modalities as well, from meditation and martial arts to feng shui.
In the West, TCM offers a popular alternative to conventional medicine. Despite this growing popularity, there is debate as to the evidence of its effectiveness. The modality within TCM with the largest body of evidence is acupuncture. Few well-designed trials of TCM herbal formulas are available. Establishing and applying stronger clinical trial methodologies in TCM is imperative for integrating it with modern medicine and achieving the end goal of creating evidence-based options for patient care.
Note: To supplement the evidence described in this TCM monograph, the evidence table below gives additional examples of research that have taken place using TCM herbs for various conditions. This is not a complete list of evidence on traditional Chinese medicine. It should be noted that there has been very little standardization of Chinese herbal medicine. This makes the available evidence weak for establishing reliable evidence-based expectations for treatment of any condition with Chinese herbs.

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 that pass through all its organs, and specific meridians correspond with specific organs or organ systems ("organ networks," below). Health is an ongoing process of maintaining balance and harmony of the circulation of chi through all of 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 develop a unifying explanation of what is going on with the person's chi overall.
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 further to the description of the other six principles. The eight principles are the theoretical basis of the TCM approach.
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 traditional acupuncture (also referred to as classical or five element acupuncture), which does not use herbs. However, some TCM practitioners also use the concept of the five elements.
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.

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 *


TCM herb combinations have been used to stabilize arrhythmia after viral myocarditis (inflammation of the heart). Furthermore, patients with atrial fibrillation who underwent Qi gong training walked on average more at the end of treatment. More studies are needed before recommendations can be made.

C


TCM herb combinations have been used to stabilize arrhythmia after viral myocarditis (inflammation of the heart). Furthermore, patients with atrial fibrillation who underwent Qi gong training walked on average more at the end of treatment. More studies are needed before recommendations can be made.

C


Laser acupuncture and probiotics provided a beneficial clinical effect in children with asthma. Further studies are needed to confirm these findings.

C


Laser acupuncture and probiotics provided a beneficial clinical effect in children with asthma. Further studies are needed to confirm these findings.

C


TCM uses over 120 different herbs in cancer treatment, depending on the type of cancer and its cause according to Chinese medical theory. Studies have reported significant benefits include reducing tumors, reducing treatment side effects, and improved response to treatment. Types of cancer that have been treated with TCM include breast, colorectal, hepatocellular, and others. More studies of stronger design are needed before TCM can be recommended with confidence as an adjunct to cancer treatment.

C


TCM uses over 120 different herbs in cancer treatment, depending on the type of cancer and its cause according to Chinese medical theory. Studies have reported significant benefits include reducing tumors, reducing treatment side effects, and improved response to treatment. Types of cancer that have been treated with TCM include breast, colorectal, hepatocellular, and others. More studies of stronger design are needed before TCM can be recommended with confidence as an adjunct to cancer treatment.

C


TCM herb formulas as well as the traditional Chinese method of Liqi Kuanxiong Huoxue combined with conventional treatment have been reported to reduce symptoms of stable and unstable angina. However, more studies are needed before recommendations can be made.

C


TCM herb formulas as well as the traditional Chinese method of Liqi Kuanxiong Huoxue combined with conventional treatment have been reported to reduce symptoms of stable and unstable angina. However, more studies are needed before recommendations can be made.

C


TCM herbs have been reported to improve symptoms and improve immune function in COPD patients. However, research designs have been weak and more studies of better design are needed before recommendations can be made.

 C


TCM herbs have been reported to improve symptoms and improve immune function in COPD patients. However, research designs have been weak and more studies of better design are needed before recommendations can be made.

 C


Many studies of TCM herbs have focused on treatment of congestive heart failure. Further research of better design is needed before recommendations can be made.

 C


Many studies of TCM herbs have focused on treatment of congestive heart failure. Further research of better design is needed before recommendations can be made.

 C


TCM herb combinations have been found to improve some markers of coronary heart disease. More studies of better design are needed before recommendations can be made.

C


TCM herb combinations have been found to improve some markers of coronary heart disease. More studies of better design are needed before recommendations can be made.

C


TCM herbal combinations have been used for the treatment of dementia and reportedly improve cognitive function and activities of daily living. More studies of better design are needed before recommendations can be made.

 C


TCM herbal combinations have been used for the treatment of dementia and reportedly improve cognitive function and activities of daily living. More studies of better design are needed before recommendations can be made.

 C


TCM herbs may augment conventional Western medicine for better outcomes in diabetic nephropathy. More studies of better design are needed before recommendations can be made.

 C


TCM herbs may augment conventional Western medicine for better outcomes in diabetic nephropathy. More studies of better design are needed before recommendations can be made.

 C


Chinese herbal preparations, including Si-Wu-Tang (SWT) have been used to effectively decrease menstrual pain. Such herbal preparations have been reported to provide better relief than acupuncture. Further studies of higher methodological quality are needed to confirm these findings.

 C


Chinese herbal preparations, including Si-Wu-Tang (SWT) have been used to effectively decrease menstrual pain. Such herbal preparations have been reported to provide better relief than acupuncture. Further studies of higher methodological quality are needed to confirm these findings.

 C


TCM herbs are a popular complementary therapy in HIV/AIDS. However, study results conflict. More studies are needed before the potential benefits of TCM herbs in HIV/AIDS can be established.

C


TCM herbs are a popular complementary therapy in HIV/AIDS. However, study results conflict. More studies are needed before the potential benefits of TCM herbs in HIV/AIDS can be established.

C


When compared to TCM therapy alone or Western therapy alone, a mixture of TCM and Western medicine has been shown to reduce pain and improve mobility of knee joints in patients with knee osteoarthritis. Further study is needed in this area.

 C


When compared to TCM therapy alone or Western therapy alone, a mixture of TCM and Western medicine has been shown to reduce pain and improve mobility of knee joints in patients with knee osteoarthritis. Further study is needed in this area.

 C


TCM may provide liver protection. For example, the RDP (removing dampness and purgative) method has been shown to improve the efficacy of comprehensive treatment for chronic severe hepatitis. However, more studies are needed before recommendations can be made.

C


TCM may provide liver protection. For example, the RDP (removing dampness and purgative) method has been shown to improve the efficacy of comprehensive treatment for chronic severe hepatitis. However, more studies are needed before recommendations can be made.

C


TCM herbs may augment conventional Western medicine for better outcomes in lower back injury. Additional study is needed before a recommendation can be made.

 C


TCM herbs may augment conventional Western medicine for better outcomes in lower back injury. Additional study is needed before a recommendation can be made.

 C


TCM herbs are commonly used for menopausal symptoms such as hot flashes. Evidence is mixed. More studies are needed to explore the possible contributions of TCM herbs in menopausal symptoms.

C


TCM herbs are commonly used for menopausal symptoms such as hot flashes. Evidence is mixed. More studies are needed to explore the possible contributions of TCM herbs in menopausal symptoms.

C


TCM herbs have been reported to improve the therapeutic effectiveness and counteract adverse reactions to hormone therapy in treating nephrotic syndrome as well as reduce the recurrence of symptoms. More studies of better design are needed before recommendations can be made.

 C


TCM herbs have been reported to improve the therapeutic effectiveness and counteract adverse reactions to hormone therapy in treating nephrotic syndrome as well as reduce the recurrence of symptoms. More studies of better design are needed before recommendations can be made.

 C


TCM herbs have been reported to not reduce symptoms, but to increase pregnancy rates in women with polycystic ovary syndrome. More studies are needed to explore the possible contributions of TCM herbs in this condition.

 C


TCM herbs have been reported to not reduce symptoms, but to increase pregnancy rates in women with polycystic ovary syndrome. More studies are needed to explore the possible contributions of TCM herbs in this condition.

 C


It has been reported that TCM is more effective than Western medicine in decreasing symptoms associated with rheumatoid arthritis. A combination of TCM and Western medicine may be a very effective treatment. More studies are necessary in this area.

 C


It has been reported that TCM is more effective than Western medicine in decreasing symptoms associated with rheumatoid arthritis. A combination of TCM and Western medicine may be a very effective treatment. More studies are necessary in this area.

 C


Currently, study results conflict, but overall results show promise for TCM in immunomodulation effects and decreasing depression associated with SARS.

 C


Currently, study results conflict, but overall results show promise for TCM in immunomodulation effects and decreasing depression associated with SARS.

 C


Based on early data, Chinese herbal medicines may be helpful when combined with prescription medications. Schizophrenia should be treated by a qualified healthcare practitioner including a psychiatrist and pharmacist.

C


Based on early data, Chinese herbal medicines may be helpful when combined with prescription medications. Schizophrenia should be treated by a qualified healthcare practitioner including a psychiatrist and pharmacist.

C


It has been reported that a combination of acupuncture, moxibustion, and enema of Chinese herbs in combination with Western medicine was more effective at treating stroke than Western medicine alone. However, Danqi Piantan Jiaonang (NeuroAidT), a traditional Chinese medicine a mixture of 14 herbal and natural extracts, was ineffective in treating stroke. More studies need to be conducted in this area.

 C


It has been reported that a combination of acupuncture, moxibustion, and enema of Chinese herbs in combination with Western medicine was more effective at treating stroke than Western medicine alone. However, Danqi Piantan Jiaonang (NeuroAidT), a traditional Chinese medicine a mixture of 14 herbal and natural extracts, was ineffective in treating stroke. More studies need to be conducted in this area.

 C
(jaw pain)

TCM has been shown to decrease jaw pain more than naturopathic medicine or state-of-the-art specialty care. Further research is needed in this area.

 C
(jaw pain)

TCM has been shown to decrease jaw pain more than naturopathic medicine or state-of-the-art specialty care. Further research is needed in this area.

 C


TCM has been studied for diarrhea predominant irritable bowel syndrome but herbal formulations used in available studies have not led to global symptom improvement. Further studies may be necessary to characterize the role of TCM in the management of IBS.

 D


TCM has been studied for diarrhea predominant irritable bowel syndrome but herbal formulations used in available studies have not led to global symptom improvement. Further studies may be necessary to characterize the role of TCM in the management of IBS.

 D
* 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).

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