- Aristolochia Clematis
- Astragalus membranaceus
- Banxia Houpo Tang
- Bing Gan Tang
- Bupleurum, Minor
- Chinese Herbs
- Chinese Patent Remedies
- Coptis Formula
- Fuzheng Jiedu Tang
- Hange Koboku-To
- Herbs, Chinese
- Jianpi Wenshen Recipe
- Magnolia and Pinelliae Formula
- Minor Bupleurum
- Shuang Huang Lian
- Tripterygium Hypoglaucum Hutch
- Yi Zhu Decoction
Other Proposed Uses
- Cancer Treatment Support
- Cardiovascular Disease
- Chronic Fatigue Syndrome
- Colds and Flus
- HIV Support
- Infertility in Women
- Irregular Menstruation
- Irritable Bowel Syndrome
- Menstrual Pain
- Muscle Spasms
- Respiratory Infections
- Sexual Dysfunction in Men
- Stroke Rehabilitation
- Tension Headache
- Weight Loss
The system of herbal medicine that developed in China differs in several significant ways from European herbal medicine. The most obvious difference is that the Western herbal tradition focuses on “simples,” or herbs taken by themselves. In contrast, traditional Chinese herbal medicine (TCHM) makes almost exclusive use of herbal combinations. More importantly, these formulas are not designed to treat symptoms of a specific illness; rather, they are tailored specifically to the individual according to the complex principles of traditional Chinese medicine. For this reason, TCHM is potentially a deeply holistic healing approach. On the other hand, it is both more difficult to use and to study than its Western counterpart.
TCHM is widely used in Asian countries, both in its traditional holistic form and in a simplified disease-oriented version. There have been a few properly designed scientific trials of TCHM, but the evidence base remains highly inadequate. In addition to questions regarding effectiveness, there remain serious safety concerns to be resolved.
History of Chinese Herbal Medicine
In China today, TCHM is used alongside conventional pharmaceutical treatment. Considerable attempts have been made to subject TCHM to scientific evaluation; however, most of the published Chinese studies on the subject fall far short of current scientific standards. (For example, they generally lack a placebo group.)
In neighboring Japan, a variation of the TCHM system known as Kampo has become popular, and the Japanese Health Ministry has approved many Kampo remedies for medical use. The scientific basis for these remedies remains incomplete, but several studies of minimally acceptable quality have been reported.
Principles of Traditional Chinese Herbal Medicine
Even a basic introduction to the principles of TCHM exceeds the scope of this article. Consider the following nothing more than a taste of this vast medical system.
According to the principles of all Chinese medicine, health exists when the body is balanced and its energy is freely flowing. The term “energy” refers to Qi, the life energy that is said to animate the body. The term “balance” refers to the relative factors of yin and yang—the classic Taoist opposing forces of the universe. Yin and yang find their expression in various subsidiary antagonists such as cold vs. heat, dampness vs. dryness, descending vs. ascending, at rest vs. active, and full vs. empty.
In an ideal state, yin and yang in all their forms are perfectly balanced in every part of the body. However, external or internal factors can upset this balance, leading to disease. Chinese medical diagnosis and treatment involves identifying the factors that are out of balance and attempting to bring them back into harmony. Diagnosis is carried out by means of “listening” to the pulse (in other words, taking the pulse with extraordinary care and sensitivity), observing and palpating various parts of the body, and asking a long series of questions.
It is important to realize that diagnosis according to TCHM differs greatly from Western diagnosis. To understand this, consider two hypothetical patients with the single Western diagnosis of migraine headaches. The first might be said to have “dryness in the liver and ascending Qi,” while another might be diagnosed with “exogenous wind-cold.” Based on these differing diagnoses, entirely different remedies might be applied. In other words, there is no such thing as a TCHM remedy for migraines per se; rather, treatment must be individualized to the imbalance determined by traditional theory.
The herbal formulas used in TCHM consist of four categories of herbs: ministerial, deputy, assistant, and envoy. The ministerial herb addresses the principal pattern of the disease. Deputy herbs assist the ministerial herb or address coexisting conditions. Assistant herbs are designed to reduce the side effects of the first two classes of herbs, and envoy herbs direct the therapy to a particular part of the body. For example, in the case of “dryness in the liver and ascending Qi” described above, an herbalist might employ a ministerial herb to reverse ascending Qi, a deputy herb to exert a moistening effect, an assistant herb to prevent the stagnation of Qi (Qi stagnation is said to be a side effect of moistening herbs), and an envoy to carry these effects to the liver.
TCHM remedies can also be designed to fit all common causes of migraines simultaneously, mostly by multiplying the number of ingredients. Practitioners of TCHM frown upon this “one-size-fits-all” approach, but it is often popular among consumers and easier to test scientifically.
Types of Chinese Herbal Remedies
To use Chinese herbal medicine in the most traditional fashion, you must visit an herbalist’s shop. There, experienced herb preparers will chop, grind, fry, and slice dried herbs according to the prescription given by an experienced herbalist. You will walk home with a packet of dried herbs that need to be prepared according to the instructions, which typically involve adding water, boiling for several hours in a ceramic pot, pouring off the liquid, adding more water, and repeating the process twice more. Certain herbs are supposed to be added right at the end, while others require extra-long preparation.
If you don’t wish to carry out such a complex process, or if a classic herbal shop is not available, you may wish to move one step away from tradition and purchase an already-prepared Kampo formula. There are several hundred such formulas designed to match the most commonly seen forms of imbalance. Available in powder, capsule, or tablet form, they can be used much more conveniently than fully traditional herbs. Many Kampo combinations are licensed in Japan and are manufactured there on a large scale by reputable manufacturers.
In the West, herbal medicine is part of folk medicine. However, in China there is a distinct tradition of Chinese folk medicine that is separate from the orthodox, rather academic TCHM approach. In this Chinese folk medicine, herbs are used more simply, somewhat in the manner of Western herbal medicine. Herbs most commonly used in this manner include astragalus , dong quai , ginger , kudzu ( Pueraria lobata ), licorice , lycium , Panax ginseng , and schizandra . For more information on the use of these herbs, see the appropriate individual articles.
What Is Chinese Herbal Medicine Used for Today?
In the traditional system of Chinese herbal medicine, herbal formulas can be used to treat virtually any condition. Some of the most common uses in China include liver disease ( hepatitis and cirrhosis ), sexual dysfunction in men , infertility in women , insomnia , colds and flus , menstrual pain , irregular menstruation, menopause , and cancer treatment support .
Acupuncture is often used along with herbs as a supplemental treatment; in addition, extraordinarily detailed lifestyle suggestions are common. It is not unusual for a traditional practitioner to “prescribe” dinner, as well as counsel changes in living situation (for example, move from the basement to the first floor or face the bed south rather than north). Exercise systems such as Tai Chi and Qigong may also be recommended.
What Is the Scientific Evidence for Traditional Chinese Herbal Medicine?
To establish the effectiveness of a treatment, it must be put through a double-blind, placebo-controlled trial . For this reason, our database is organized around such studies. However, there are a few issues that make it a bit difficult to study TCHM in this way.
The first problem involves diagnosis. As described above, there is no such thing as a TCHM remedy for migraine headaches, for example. Each person with migraines receives individualized treatment. This introduces an extra wrinkle for experimenters.
The best way to address this issue is as follows. People are chosen to participate in a study based on a Western diagnosis. Next, all participants are diagnosed by a classic herbal practitioner and prescribed a formula specific to their individual constitutions according to the principles of TCHM. Finally, another party steps in and provides participants with either the real formula or a placebo formula, under conditions whereby neither practitioners nor participants know which is which.
Other studies utilize a fixed remedy for all participants, in hopes that it will still prove effective on average. Such an approach doesn’t really test the effectiveness of true TCHM; rather, it tests a much-simplified form of it. Still, trials of this type are valid as far as they go.
Numerous other studies simply involve enrolling people with a certain condition and giving each participant an herbal remedy. Researchers then record the extent of improvement. Such “open label” trials , however, prove virtually nothing because even phony treatments will appear to cause benefits. (For more information, see Why Does This Database Rely on Double-blind Trials? ) We do not report open label trials here.
Hepatitis is a serious problem in many Asian countries, and conventional care leaves much to be desired. For this reason, herbal remedies are widely used.
Irritable Bowel Syndrome
- Rehmannia glutinosa
- Scutellaria baicalensis
- Polygonatum sibiricum
- Ginkgo biloba
- Epimedium sagittatum
- Psoralea corylifolia
- Schisandra chinensis
- Prunus mume
- Ledebouriella divaricata
- Angelica dahurica
- Astragalus membranaceus
osteoarthritisClematis mandshurica Trichosanthes kirilowii Prunella vulgaris
- Ledebouriella seseloides
- Potentilla chinensis
- Akebia clematidis
- Rehmannia glutinosa
- Paeonia lactiflora
- Lophatherum gracile
- Dictamnus dasycarpus
- Tribulus terrestris
- Glycyrrhiza uralensis
- Schizonepeta tenuifolia
Other Uses for Traditional Chinese Herbal Medicine
How to Choose a Practitioner of Traditional Chinese Herbal Medicine
There is no general certification for the practice of TCHM. Many people who are certified in acupuncture , however, have significant training in herbal medicine as well. (In general, 500 hours of specific training is considered necessary.) Some states offer the license of OMD (Doctor of Oriental Medicine); licensed OMDs are generally well versed in TCHM.
There are several serious safety concerns with the use of TCHM.
One concern involves the use of multiple herbs typical in this approach. In general, conventional medicine makes a point of using as few medications as possible (in theory, at least) because the greater the number of medications, the greater the risk of harm. (Also, when medications are used together and harm does result, it’s hard to know which drug was at fault.) From this perspective, formulas consisting of 5, 10, or 30 herbs are quite worrisome.
Interestingly, such combinations are actually designed for the purpose of reducing risks. According to TCHM theory, the various herbs in a formula balance and moderate each other. Unfortunately, this theory has never been put to the test, and there are reasons not to trust it. Simply put, it is very difficult to get an accurate picture of the risks of a treatment if you don’t keep systematic records of adverse effects, and the ancient Chinese government had no such system in place. In any case, the individualized nature of treatment would make it almost impossible to track harm. Herbalists would be expected to notice immediate, dramatic reactions to herbal formulas, and one can assume with some confidence that treatments used for thousands of years are at least unlikely to cause such problems in very many people who take them. However, certain types of harm could be expected to easily elude the detection of traditional herbalists. These include safety problems that are delayed, occur relatively rarely, or are difficult to detect without scientific instruments. How would a traditional herbalist ever know, for example, if a treatment caused liver failure in one out of 100,000 people who used it, especially if such failure took 2 or more years to develop? If such a death did occur in the herbalist’s patient population, it would probably be attributed to hepatitis or some other common cause.
These factors may explain why Chinese herbal medicine traditionally uses treatments that are now recognized as potentially dangerous, such as mercury, arsenic, lead, licorice, coltsfoot, and Aristolochia.
The bottom line: TCHM is a potentially dangerous form of treatment that should only be used under the supervision of a physician.
- Reviewer: EBSCO CAM Review Board
- Review Date: 08/2012 -
- Update Date: 08/29/2012 -