A critical examination of the main premises of Traditional Chinese Medicine

Abstract

Traditional Chinese Medicine (TCM) consists of a plethora of therapeutic approaches aiming to both characterize and treat diseases. Its utilization has gained significant popularity in the western world and is even backed by the World Health Organization's decision to include TCM diagnostic patterns into the new revision of the International Classification of Diseases code, the global standard for diagnostic health information. As these developments and potentially far-reaching decisions can affect modern healthcare systems and daily clinical work as well as wildlife conservation, its underlying factual basis must be critically examined. This article therefore provides an overview of the evidence underlying the basic TCM concepts, such as Qi, meridians, acupuncture, pulse and tongue diagnostics as well as traditional herbal treatments. Moreover, it discusses whether scientific literature on TCM reflects the current standard for evidence-based research, as described in good scientific practice and good clinical practice guidelines. Importantly, misinformation regarding the therapeutic efficacy of animal-derived substances has lead and currently leads to problems with wildlife preservation and animal ethics. Nevertheless, the (re-)discovery of artemisinin more than 50 years ago introduced a novel development in TCM: the commingling of Eastern and Western medicine, the appreciation of both systems. The need for more rigorous approaches, fulfilment of and agreement to current guidelines to achieve high-quality research are of utmost relevance. Thereby, ancient knowledge of herbal species and concoctions may serve as a possible treasure box rather than Pandora's box.

Keywords: Acupuncture; Meridians; Pulse diagnostics; Qi; Tongue diagnostics.

Fig. 1

Visualization of publication numbers for the medical subject headings (MeSH) search term Traditional Chinese medicine. The inquiry was conducted on 28.10.2019 using the National Institute for Biotechnology Information´s (NCBI) PubMed database. A timeframe was set, ranging from 1966 to 2019

Fig. 2

a Flow chart demonstrating our approach to quantitative and qualitative analysis of TCM publications. All information was obtained using the program Publish or Perish utilizing the Google Scholar database. The inquiry was conducted on 02.03.2019 and 28.10.2019. b Results of the examination of TCM article publishers with more than 20 articles uploaded on Google Scholar. The data were obtained according to the methodology described in (a). The absolute numbers have been sorted by the particular publisher and are shown above the bars

Fig. 3

a Criteria underlying our predefined binary point system used to evaluate the quality of the 100 most cited TCM publications. If an article met the criteria of one of the sub-areas defined above, one point was assigned to the publication. b Results of our frequency analysis of unscientific argumentation patterns. The data were obtained according to the methodology displayed in Fig. 2a. Articles were clustered according to the number of scientific fallacies observed. Each column represents the number of articles included in the respective cluster. c Results depicting the frequency of each unscientific argumentation pattern observed in the analysis of the 100 most cited TCM publications. Data were obtained according to the methodology provided in Fig. 2a.