Introduction
Traditional Chinese medicine (TCM), mainly composed of the traditional medicinal theory and practical experiences of China, is a medical science that studies the connection between health and illnesses (in a human being’s lifetime) and illness prevention, diagnosis and treatment, rehabilitation, and health preservation. With a long history of development, TCM theory is an integral system and possesses a myriad of practical experiences.
The uniqueness of TCM and its theory system
TCM and western medicine are two distinct systems. Although the life phenomena of the human body is their common subject, they are primarily distinguished from one another by academic thoughts, theoretical framework, the way of thinking, clinical practice, the theory of administering medicines, and other approaches and considerations
The characteristics that distinguish TCM from other fields of medicine
TCM, from the perspective of natural science, encompasses not only the features of both medicine and natural science but also the core principles of humanity and social science such as culture, philosophy, and other related fields. It embodies the integration of humanity and social science and natural science. TCM is based on eastern culture and philosophy and its way of thinking focuses on symbolic thinking.
TCM, from the perspective of fundamental theory, is anchored on the distinctive principles on physiology, pathology, and illness prevention. It focuses on mastering the rules of life and illness evolution from the perspective of holistic relation, functions, and dynamic change. It is first characterized by employing the theory and languages of humanity and social science to summarize the rule of TCM as a natural science; its outer shell of philosophy encompasses its inner core of medical science. Second, its theory is rooted from practice; the almost-cyclical process starts from clinical practice, analysis of results, then moves on again to clinical practice and analysis, thus improving the primary thoughts and leading to the strengthening of the theory of TCM. Third, it focuses on and benefits from a macro view of the human body.
TCM, from the perspective of clinical practice, is mainly characterized by individual pattern identification for treatment reasoning, principle of balance maintenance for prevention and treatment, treatment methods with humanity, multi-intervention approaches, and the tendency of using natural products as medicines. In terms of patterns, patient-centered treatment is emphasized, and balancing and harmonizing are also stressed.
TCM, from the aspect of pharmacological action, is based on natural products. Polychemical formulas are formed through ingredient compatibility. They function through multiple routes and layers, and targets to regulate certain conditions (patterns) of the human body.
The uniqueness and complexity of TCM theory system
TCM theory system is unique and complex. Influenced and guided by China’s ancient materialism and dialectics, it is a medical theory system characterized by pattern identification for treatment reasoning by employing the monism of Qi, Yin-yang, and the five elements as its worldview and methodology, the holistic concept as its guidance, the physiology and pathology of zhang-fu organs, and the meridians as its core. The concept of holism and pattern identification for treatment reasoning embody the uniqueness of its theory system. It is anchored on natural, social, and humanity sciences, eventually forming a body of knowledge with multiple subsystems and layers. Its scientific method that provides insights into life, health, and illness emphasizes the holistic concept. This symbiotic relationship demonstrates the characteristic of the complexity of science [
1].
The core theory of TCM mainly covers zhang-fu organs, Qi, blood, body fluids, illness causes and pathogenesis, patterns, diagnostic methods, pattern identification, treatment principles and methods, health preservation, meridians, acupuncture points, method of point combination, needling method, moxibustion, medicinal property, medicinal processing, formula formation and ingredient compatibility, and other related aspects. Each can be divided into several branches, which can then be further divided into a few parts. Therefore, to comb and comprehend the core theory of TCM is the prerequisite to grasp the research direction of TCM fundamental theory.
The characteristics of the basic research on TCM theory and the navigation and control of research direction
Certain characteristics and rules exist in and guide the research on TCM fundamental theory. These rules should be learned and followed properly and, in the process, paying respect to the characteristics as the basic research on TCM theory is conducted and pushing the innovation of TCM theory forward to provide theoretical support for clinical practice guidelines.
The characteristics of the basic research on TCM theory
The basic research on TCM theory should accomplish the following objectives. First, it should be based on clinical practice. The TCM clinical practice is the source from which TCM’s theory is derived. The clinical effect is the only yardstick used to evaluate the scientific merits of TCM theory. The purpose of the basic research on TCM theory is to guide clinical practice and ultimately enhance illness prevention and treatment. Therefore, the basic research on TCM theory should be conducted in clinical practice, based on it, and combined with it. Second, both traditional and contemporary methods are employed for the research. The traditional one, guided by TCM fundamental theory, is the process during which clinical practice is performed and knowledge is obtained. The knowledge is fed back to clinical practice and then the new set of knowledge is refined. It is eventually upgraded to the theory of TCM. The traditional one meets the rules on TCM’s development and can facilitate the enrichment and development of TCM theory system. However, the method is unable to completely merge with the contemporary one so it employs contemporary scientific method and approaches to interpret the scientific bases of TCM theory. The method may explain TCM’s scientific bases and bridge the gap between TCM and contemporary natural sciences, but the innovation of the theory requires the accumulation of research work, which will take a long time. Therefore, the two methods should be equally stressed. Third, the innovation of methodology should be given attention. It currently relies on the methodology, particularly experimental methodology [
2], because of the complexity of patterns and pharmacology of Chinese materia medica, to break the bottleneck that hinders the explanation of TCM fundamental theory with natural science.
The strategic consideration of the development phases of TCM fundamental theory research
A review of the history of TCM fundamental theory research (spanning more than 50 years after the foundation of the nation) reveals that the research is still strategically in the ‘uncovering’ phase, that is, exploiting the contemporary scientific and technological methods to strip off the outer layer of the philosophy covering TCM theory and crack the nut of its scientific connotation to reveal its nature as both a natural science and a medicine. The strategic ‘uncovering’ phase should last for a long period because the TCM theory is deep and extensive. The present innovation of TCM fundamental theory, concurrently absorbing contemporary science and technology, should focus on the traditional method and the results that are obtained through the analysis of clinical experiences and enhancement of the theoretical foundation.
The goal and thought of the basic research on TCM theory
The goal of the basic research on TCM theory is to inherit, enrich, and develop TCM fundamental theory, particularly the core theory of TCM that has profound impacts on the clinical effects through constant guiding of the practice. The primary thought is to combine the research with clinical practice and put equal stress on both methods. Multiple disciplines should be integrated into the research work, and academic democracy and justice should be encouraged. An open system should be specifically established to encourage the absorption and innovation of research methods.
The current situation on the deployment of the basic research on TCM theory
The National Basic Research Program (973 program) established “The Special Program of Basic Research on TCM Theory” in 2005. The total number of projects established and funded is 21 from 2005 to 2010. They mainly cover four research areas.
The basic research on TCM theory includes the following areas: the collation and integration of TCM references and the research on its fundamental theory for innovation; the basic research and the research for innovation on the cause of illness and patho-mechanisms in TCM theory; the basic research on the theory underlying TCM special therapies; the basic research on the zhang-fu correlation theory of “the exterior-interior relation of lung and large intestine” for application purpose; the basic research on the visceral manifestation theory underlying “kidney storing essence” and “liver governing free flow of Qi and storing blood”; and the research on TCM original thinking and its method framework of discerning health status.
The basic research on the theory of Chinese materia medica includes the following focal points: the research on the rule of ingredient compatibility; the basic research on the theory of medicinal property of Chinese materia medica and the advanced research on the thoery for innovation; the basic research on the theory related to the property and flavors, and actions and effects of Chinese materia medica; basic research on the key issues on Chinese materia medica (particularly those that are considered toxic but clinically effective for reasonable use); contemporary experimental and clinical research on several fixed formulas of Chinese materia medica; the relevant basic research on prominent classical formulas in terms of dose-effect relation; the research on the key scientific issue on the “eighteen antagonisms” of Chinese materia medica in ingredient compatibility.
The basic research on the theory of acupuncture and moxibustion includes the following approaches: the research on collateral disorder theory, and theory of acupuncture and moxibustion; the research on the specific effects of acupuncture points based on clinical practice; the basic research on acupuncture analgesia based on clinical practice; the research on the primary principle of moxibustion action and the rules for application; the research on the biological mechanism of the specific relations of the meridians on the surface of the human body and the research on dose-effect relation in terms of needle manipulations; the research on the bi-directional regulation effects of needling on functional intestinal illnesses and its mechanism.
The basic research on the evaluation of the treatment effects includes the fundamental theory research on the evaluation of the effects of the treatment guided by TCM’s pattern identification for treatment reasoning.
The consideration of the research direction of TCM fundamental theory
High-level research teams, on the basis of further understanding the characteristics and rules of research on TCM’s fundamental theory, should be organized across multiple disciplines to mainly conduct the following research tasks.
The basic research on the theory of TCM original thinking
From the perspective of the recognition methodology of original thinking in TCM theory, the formation and development process of TCM original thinking is dissected and the TCM scientific thinking is classified, summarized, and analyzed for improvement. The theoretical basic research on TCM academic thoughts for the innovation is emphatically supported.
The basic research on TCM theory
The research on visceral manifestation theory involves the following undertakings: the research on the physiological functions of the zhang-fu viscera and their relations; the research on the relations between the zhang-fu viscera and social-psychological factors and the natural environment; the research on the principles for illness pattern categorization; the efficacy and safety evaluation research on Chinese materia medica in terms of illness pattern categorization; the basic research on TCM health preservation and rehabilitation as medical disciplines; and the basic research on the guidelines for clinical practice. The research on illness causes, pathomechanism, treatment principles, and methods includes the following areas: the research on the illness causes and patho-mechanisms of external contraction, serious diseases, and frequently occurring diseases for the innovation of treatment principles and methods; the research on the clinical pharmacological efficacy evaluation of the compound formulas of Chinese materia medica in terms of TCM treatment principles and methods. The basic research on TCM’s applications in discerning health status, the objectivity of four examinations, and the principle of the examination instruments includes the following focal points: the research on the theory of TCM’s application in discerning health status; the research on the objectivity of TCM’s four examinations; and the research on the principle of TCM examination instruments. The research on the mechanisms for the prevention and treatment of illnesses (in which TCM excels) includes the following areas: the research on the mechanism for the prevention and treatment of current illnesses that are complicated and caused by multiple factors; and the research on the mechanism for the prevention and treatment of diseases caused by viruses.
The basic research on Chinese materia medica and formulas
The research on genome, chemical components, and active pharmaceutical ingredients of the original plants used in TCM involves the establishment of databases of genome maps and chemical components and active pharmaceutical ingredients from the original plants used in TCM. The basic research on the theory of ingredient compatibility and formula formation involves the research on ingredient compatibility theory and methods and modes in forming formulas using Chinese materia medica. The basic research on the theory of medicinal property involves the basic research on the theories of the four properties and five flavors, meridian tropism, ascending, “descending, floating and sinking,” and “seven emotions.” The research on fundamental theory of the biological effects of formulas involves the following areas: the research on the scientific expression of the biological effects of formulas and the material bases for the biological effects; the research on the correlation between illnesses, treatment methods, and the biological effects of formulas; and the research on the correlation between the clinical treatment effects and the biological effects of formulas. The research on the fundamental theory for the safe use of Chinese materia medica involves the following focal points: the research on the fundamental theory for the safe use of Chinese materia medica; the research on the relation among dosage, timing, efficacy, and toxicity of Chinese materia medica; research on the methodology and mechanism of the processing and ingredient compatibility of Chinese materia medica; the basic research on pattern identification for treatment dispensing and safe use of Chinese materia medica.
The basic research on meridians and collaterals
The basic research on the essence of meridians and collaterals involves the following approaches: the research on the mechanism, mode, and approach that explains the underlying and special connections among the specific parts of the human body; the study to map the schematic diagram of the connections in the human body through which the regulation and control are carried out; and the study to map the courses of the ‘regulating’ meridians, which are more consistent with the rules governing the special connections in the human body. The research on the special effects of the meridian points involves the following focal points: the research on the rules governing the special effects of the meridian points for diagnosis and treatment; the research on the rules governing the distribution of all types of reflecting spots and effective spots on body surface, and on the corresponding relations among the spots; and the research on the nature, type, and biological bases of reflecting spots on body surface, and on how are they connected to the diagnosis and treatment of illnesses. The basic research on the mechanism of acupuncture and moxibustion includes the research on the action mechanism of acupuncture and moxibustion and the research on the rules governing dosage and timing efficacy. The research on acupuncture and moxibustion framework of pattern identification for treatment reasoning involves the following: the research on the formation, evolution, and development tendency of the diagnosis and treatment modes of acupuncture and moxibustion; and the research on the primary elements of the theoretical framework of diagnosis and treatment of acupuncture and moxibustion, and their principles for clinical application.
Summary
The rule of TCM development must be followed in the basic research on TCM theory because of the complexity and uniqueness of the theory system of TCM and its characteristics. The relationship between inheritance and innovation should be properly handled. While the characteristics and advantages of TCM should be conscientiously inherited in terms of the application of clinical research theory and focus on the application of traditional research method, innovation should still be encouraged and the advanced theory and contemporary methods of science and technology actively exploited to promote the development of the theory and practice of TCM. By integrating state-of-the-art technology with TCM, the latter’s glory can be recreated to realize the goal of inheriting, enriching, and developing its fundamental theory.
Higher Education Press and Springer-Verlag Berlin Heidelberg
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