Understanding Traditional Chinese Medicine Therapeutics: an Overview of the Basics and Clinical Applications
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healthcare Review Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications Luís Carlos Matos 1,2,3,* , Jorge Pereira Machado 2,4 , Fernando Jorge Monteiro 1,5 and Henry Johannes Greten 4,6 1 Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal; [email protected] 2 CBSIn—Centro de Biociências em Saúde Integrativa, Atlântico Business School, 4405-604 Vila Nova de Gaia, Portugal; [email protected] 3 CTEC—Centro Transdisciplinar de Estudos da Consciência, Universidade Fernando Pessoa, 4249-004 Porto, Portugal 4 ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal; [email protected] 5 INEB—Instituto de Engenharia Biomédica, Universidade do Porto, 4200-135 Porto, Portugal 6 German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany * Correspondence: [email protected]; Tel.: +351-22-508-1884 Abstract: Traditional Chinese medicine (TCM) is a systematic healthcare system developed from clinical experience based on a scientific model of regulation. TCM relies on unique theories and practices to treat diseases and enhance health. These practices include Chinese herbal medicine and dietetics, acupuncture and moxibustion, and other non-medication therapies such as Chinese bodywork or manual therapy, known as “Tuina”, and traditional biofeedback exercises, known as “Qigong” and “Taijiquan”. The integration of TCM in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. Citation: Matos, L.C.; Machado, J.P.; Understanding the structural concepts of the TCM language makes possible the parallelism to West- Monteiro, F.J.; Greten, H.J. ern physiology, and the inherent rational use of the reflex therapeutic systems, anti-inflammatory Understanding Traditional Chinese Medicine Therapeutics: An Overview mechanisms and mental training involved, for example, in acupuncture and “Qigong”. The results of the Basics and Clinical of TCM clinical trials and fundamental research on its nature and mechanisms have encouraged Applications. Healthcare 2021, 9, 257. the development and application of well-designed research strategies such as double blinding in https://doi.org/10.3390/ acupucture to overcome limitations and resistances in integrating these practices into the existing healthcare9030257 biomedical paradigms of the West. This review aims to overview some TCM theoretical concepts and the evidence-based clinical application of TCM’s leading practices to create an easy-to-consult Academic Editor: Pedram Sendi and condensed source of information, available for the healthcare community, facilitating the under- standing and communication between conventional health professionals and TCM practitioners and Received: 8 January 2021 acupuncturists. Accepted: 23 February 2021 Published: 1 March 2021 Keywords: traditional Chinese medicine; herbs; dietetics; acupuncture; moxibustion; “Tuina”; “Qigong”; “Taijiquan”; Heidelberg Model of TCM Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. 1. Introduction Although the origin of TCM remains uncertain, some evidence points to more than 5000 years of history. Indeed, some archaeological findings of acupuncture needles and traces of herbal treatments suggest 4000 to 8000 years of existence [1,2]. The “Yijing” Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. (“I Ching” or The Book of Changes) and the “Huangdi Neijing” (The Yellow Emperor’s This article is an open access article Classic of Internal Medicine) are the oldest known written sources of information in distributed under the terms and TCM philosophy and clinical application. The “Yijing”, dating back 3000 to 5000 years, conditions of the Creative Commons describes the course of life systematically based on a mathematical model of regulation. It Attribution (CC BY) license (https:// describes its changes and modalities, offering advice on personal emotional lifestyle and creativecommons.org/licenses/by/ guidance [3,4], while the “Huangdi Neijing” is comparable in importance to the Hippocratic 4.0/). Corpus in Greek medicine [5]. Healthcare 2021, 9, 257. https://doi.org/10.3390/healthcare9030257 https://www.mdpi.com/journal/healthcare Healthcare 2021, 9, 257 2 of 32 Healthcare 2021, 9, 257 2 of 33 The main TCM theories include the teaching of “yin” and “yang” and the Five tres- passes Phases (“Elements”).The main TCM They theories describe include the activity the teaching of effects of “yin” and and functional “yang”, the powers Five trespasses involved in bodyPhases function (“Elements”). such as They the “qi”,describe the the “blood” activity or of “xue”, effects asand well functional as the effectspowers involved of active and restingin body fluids function “jin such ye”, as and the the “qi”, differential the “blood diagnosis” xue, as ofwell syndromes, as the effects while of active and the primary practicesresting fluids include “jin acupuncture ye”, and the anddifferential moxibustion, diagnosis the of use syndromes, of Chinese while herbs the primary and dietetics, andpractices “Tuina”, include “Qigong” acupuncture and “Taijiquan”, and moxibustion, commonly the use known of Chinese as Tai herbs Chi. An-and dietetics, cient Chinese physiciansand “Tuina”, postulated “Qigong” that and everything “Taijiquan”, is commonly made of the known same as “substance”, Tai Chi. Ancient the Chinese “qi”. This philosophyphysicians stands postulated for oneness that everything and wholeness is made as of part the ofsame the same“substance”, paradigm, the “qi”. This considering thatphilosophy all existing stands things for oneness are symbiotically and wholeness connected as part of through the same the paradigm, system of considering “qi” [6]. One ofthat the all main existing goals things of TCM are is symbiotically to balance the conne effectscted of through the body’s the “qi”,system known of “qi” in [6]. One of the West as thethe “Vital main Force”, goals of to TCM live is in to harmony balance the with effe thects surroundingof the body’s “qi”.“qi”, known According in the West as to ancient Chinesethe “Vital culture, Force”, this to includes live in harmony the energies with of the “Heaven”, surrounding such “qi”. as theAccording energy to ancient of the sun, moon,Chinese planets, culture, and this constellations, includes the energies and the of energies “Heaven”, of “Earth”, such as suchthe energy as the of the sun, effects of geographicalmoon, planets, location, and the constellations, energy of the and plants, the soil,energies water, of animals,“Earth”, andsuch natural as the effects of formations [6].geographical TCM aims tolocation, treat not the only energy the secondaryof the plants, manifestations soil, water, (“biao”), animals, but and natural formations [6]. TCM aims to treat not only the secondary manifestations (“biao”), but also also the primary causes (“ben”) of several chronic and acute conditions; for example, in the primary causes (“ben”) of several chronic and acute conditions; for example, in internal medicine, gynecology, pediatrics, traumatology, external medicine, dermatology, internal medicine, gynecology, pediatrics, traumatology, external medicine, dermatology, emergency medicine, and eye, ear, nose and throat treatments. emergency medicine, and eye, ear, nose and throat treatments. The “Yijing” analysis performed by the mathematician Gottfried Leibniz in 1697 [4] The “Yijing” analysis performed by the mathematician Gottfried Leibniz in 1697 [4] allows for understanding TCM as a logical model of a system’s biology with a structural allows for understanding TCM as a logical model of a system’s biology with a structural mathematical language. The analogy to the binary system, considering 0 as “yin” and 1 mathematical language. The analogy to the binary system, considering 0 as “yin” and 1 as as “yang”, allows“yang”, for theallows understanding for the understanding of monograms, of monograms, bigrams and bigrams trigrams, and whichtrigrams, are which are related to the Phasesrelated and to thethe circularPhases regulatoryand the circular processes regulatory seen, for example,processes inseen, rhythmical for example, in seasonal changes,rhythmical daytime seasonal processes changes, and human daytime behavior processes (Figure and1 humana,b) [ 7, 8behavior]. These circular(Figure 1a,b) [7,8]. processes are expressedThese circular as sinusoidal processes functions,are expressed which as integratesinusoidal the functions, concepts which of “yin”, integrate the “yang”, and theconcepts Phases of as “yin”, cybernetic “yang”, elements and the and Phases vegetative as cybernetic functional elements tendencies and in vegetative human physiologicalfunctional regulation. tendencies in human physiological regulation. Figure 1. TheFigure creation 1. The of creation “yin yang” of “yin and yang” “Bagua” and “Bagua” (a); the “Taiji” (a); the symbol “Taiji” (symbolb). (b). The “yin yang”The concept “yin yang” is central concept in TCMis central philosophy. in TCM philosophy. This pair of This terms pair is of used terms to is used to describe functionaldescribe relationships functional inrelationships Chinese culture in Chinese and language culture and,and language metaphorically, and, metaphorically, has a broad list ofhas possible a broad meanings. list of possible Common meanings. examples Common related examples to “yin” related