Therapeutic wisdom in traditional
Chinese medicine: a perspective from
modern science

Wen-Yue Jiang

Department of Integrated Traditional Chinese and Western Medicine, Peking University Health Science Center,
Beijing 100083, PR China

The reasons why the standards of evaluating Western
medicine are not suitable for testing traditional Chinese
medicine (TCM) are explicit in the therapeutic objec-
tive and principles of TCM. TCM aims to correct mal-
adjustments and restore the self-regulatory ability of the
body, and not to antagonize specific pathogenetic
targets. Maladjustments in a disease can be classified
into several ‘patterns’ according to TCM theory. Multiple
diseases might share one ‘pattern’ and be treated by the
same herbal formula whereas one disease might display
several different ‘patterns’ and be treated by multiple
formulae. These principles are supported by evidence
that multi-system changes in one pattern can be modu-
lated by a herbal formula. The approaches used in
systems biology and pharmacogenetics are similar to
the practices of TCM. I propose that a combined
approach using specific parameters associated with
modern medicine, the general condition of individuals,
as outlined by TCM, and pattern stratification of diseases
should be employed to re-evaluate herbal formulae.

When modern scientist meets ancient philosopher
An increasing number of researchers are focusing their
attention on developing drugs from traditional Chinese
medicinal herbs and identifying the active ingredients of
these herbs and their pharmacological mechanism of
actions

[1,2]

. Recently, it has been suggested that herbal

remedies need quality control and rigorous clinical trials

[3,4]

. However, the real efficacy and toxicity of herbal

agents would not be tested adequately using the present
evaluation paradigm for single chemical compounds. The
therapeutic principles and goals of traditional Chinese
medicine (TCM) are different from those in Western medi-
cine. TCM does not focus solely on the disease defined by
specific pathological changes, but instead concentrates on
the overall functional state of the patient. However, it
remains unclear which parameters represent this general
functional state. TCM has a complete system of classifying
functional states but its unique and seemingly inacces-
sible language forms a mysterious veil over its therapeutic
philosophy. In this article, I attempt to elucidate the
therapeutic characteristics of TCM and their impact on

evaluating herbal medicine (linking with achievements in
integrative medicine), and discuss the possible solution to
re-evaluating herbal medicines.

Diseased person versus the person’s disease
TCM and Western medicine have different viewpoints
about etiology and pathology and thus different diagnostic
methodologies

[5]

. In Western medicine, a disease is

thought to develop as a result of one or more crucial
pathogenetic factors, whereas, in TCM, a disease is a
common product of both pathogenetic factors and mal-
adjustments in the body. The diagnosis proposed by TCM
focuses more on the body’s response to pathogenetic
factors than the pathological mechanisms. According to
Nesse’s theory, symptoms of a disease are regarded as
protective reactions (such as fever and cough) to outside
stimulants (e.g. microorganisms and environmental
changes)

[6]

. The number of potential different stimulants

is enormous but the number of reaction types elicited by
the body is limited. Poor knowledge about the pathological
changes that occur inside the body does not hinder
diagnosis by TCM. Indeed, in TCM, the visible signs and
symptoms of patients are analyzed to identify the type of
internal maladjustments (e.g. hypo-response or hyper-
response). Fever and an increased level of metabolism,
which are induced by infection, result in beneficial effects
such as the production of antibodies and defense against
pathogens

[6]

. However, high fever and over-stimulated

metabolism can, in turn, impair the body’s defense.
This ‘hyper-response’ is diagnosed as a ‘heat pattern’
(see Glossary) in TCM. The heat pattern refers not only to
local inflammation, but also, and mainly, to the general
functional state of the patient, which is the consequence
of synergetic adaptations of multiple systems within the
body. Therefore, a ‘pattern’ (‘Zheng’ in Chinese, or trans-
lated as ‘syndrome’) is the summary of a specific functional
state. Higher levels of neuroendocrine activation, thermo-
genesis, metabolism, respiration and circulation have
been demonstrated in patients with a heat pattern when
compared with normal people

[7]

. These changes are found

in patients with, for example, hypertension, diabetes,
thyroidism or schizophrenia. In TCM, if individuals with
one of these conditions exhibit signs and symptoms that
meet the criteria of a heat pattern, they are diagnosed as

Corresponding author: Jiang, W.-Y. ([e-mail]).
Available online 26 September 2005

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0165-6147/$ - see front matter Q 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.tips.2005.09.006

having a heat pattern. In summary, TCM focuses on the
diseased person instead of the person’s disease.

Modulation of the response versus antagonism of
the target
Differences in etiology and diagnostics in TCM and
Western medicine lead to the different therapeutic goals
and strategies of these approaches. In Western medicine,
drugs are developed to antagonize pathological targets
or eliminate pathogenetic factors, whereas in TCM the
therapy is aimed at a specific response (i.e. a ‘pattern’),
which reflects changes on multi-system and multi-organ
levels. This distinguishes TCM also from most folk
medicines in the world, which usually treat symptoms or
diseases. Following the Han Dynasty (200

AD

), TCM

practitioners adopted ‘pattern-differentiated’ therapeutic
strategies proposed by Zhang Zhongjing

[8]

.The choice of

treatment principles (such as ‘heat-clearing’ or ‘cold-
dissipating’) (see Glossary) and respective herbal for-
mulae is based on the pattern’s differentiation. For
example, chills, runny nose and slight fever are generally
observed during the initial stage of the common cold.
These symptoms are diagnosed by TCM practitioners as a
‘cold pattern’. Cold-dissipating herbs (e.g. cinnamon twig,
ephedra, ginger and perilla leaf ) are used to resolve this
kind of cold. In some other cases, if there is a marked fever
with thirst and sore throat, the functional state is con-
sidered a heat pattern. Heat-clearing formula (e.g. Lonicera
and Forsythia powder) are given to modulate the hyper-
adaptive level

[9]

.

A response to pathogenetic factors reflects the self-

regulatory state of the body. Response-oriented treatment
embodies the thinking of TCM and emphasizes restoring
the self-regulatory ability of the body. For example, cold-
dissipating herbal agents promote thermogenesis and
diaphoresis, dilate constricted superficial blood vessels,
and even excite the hypothalamus–pituitary–adrenal axis

[10]

. Thermogenesis helps the body to stimulate the

defense system: dilatation of blood vessels and sweating
can increase heat loss to keep the body’s temperature
balanced. The herbs do not aim to inhibit the thermogenic
center or kill the pathogens, although they might contain
some anti-organism ingredients. No medicine could be
more efficient than improving the self-healing mechan-
isms of the body, which are formed during evolution.
Except in the presence of a genetic defect in self-
regulation, drugs should not be designed to replace or
interfere with the self-healing process of the body. The role
of the drug in TCM is merely to either improve the body’s
regulatory mechanisms or remove factors that impair the
self-healing ability of the body.

Pharmacological basis of response modulation:
an example of heat-clearing herbs
Because the ‘target’ of TCM treatment is the pattern
that reflects multi-system changes, benefits produced by
herbal medication include not only the regulation of
several crucial targets but, more importantly, the modu-
lation of other associated general changes that delay the
healing process. The huge number of active ingredients in
one formula makes this formula suitable for multi-target
actions. For example, heat-clearing herbs (HCHs) are
often used to treat infection but their pharmacological
mechanisms are not limited to antibiotic actions. Indeed,
many other effects of HCHs result in beneficial outcomes
such as a decrease in damage following inflammation
(

Table 1

). Microorganisms are not the only important

factors involved in infection. In addition to the presence of
fever and local inflammation in infection, toxins and their
induced cytokines and mediators such as interleukin 1
and histamine can excite the CNS and sympathetic–
adrenomedullary system, increase the levels of metabo-
lites of proteins and sugars and capillary permeability,
and cause the dysfunction of blood coagulation and the
digestive system

[15]

. In turn, these effects could do harm

to the body, such as inhibit immune function and cause
arteriolar constriction, leading to a disturbance of the
microcirculation. Antibiotics alone would not be able to
solve all these problems. The recent concept of ‘systemic
inflammatory response syndrome’ (SIRS) reflects the new
understanding about inflammation, in which severe
damage is attributed mostly to the host’s abnormal reac-
tions because the process can be independent of infectious
etiologies

[16]

. For example, early ‘multiple organ dys-

function syndrome’ is rarely observed with infection,
despite the high rate of SIRS

[17]

. Suppose the index of

bacteriostatic or bacteriocidal effects is chosen to screen
the active ingredients of HCHs (in fact, such a procedure
was universally taken in evaluating HCHs), then chemi-
cals that were effective against other parameters (

Table 1

)

would be missed and the advantages of TCM therapy

Glossary

Pattern differentiation: the unique diagnostic method in TCM. The purpose of
collecting and analyzing symptoms and signs is to evaluate the overall
maladjustments in the body and to classify the pattern of maladjustment
through determining the nature and location of the maladjustment. The four
basic patterns of maladjustment nature are heat, cold, excess and deficiency.
The five locations of maladjustment include the lung, liver, heart, spleen and
kidney. There are O100 common patterns in TCM.
Heat pattern:

characterized by flushed face, fever or feverishness, thirst,

irritability and restlessness, constipation, deep-colored urine, reddened tongue
and rapid pulse. Herbs that alleviate a heat pattern have a ‘heat-clearing’ or
‘cold’ nature.
Cold pattern: characterized by pallor, intolerance of cold, absence of thirst,
loose stools, clear profuse urine, pale tongue and slow pulse. Herbs that
alleviate a cold pattern have a ‘cold-dissipating’ or ‘warm’ nature.
Excess pattern: the accumulation or stagnation of metabolic waste, body fluids
and blood. The excess pattern can be further divided into, for example, phlegm
stasis and blood stasis. Phlegm-stasis pattern is defined as the accumulation of
thick body fluids. Blood-stasis is defined as the stagnation and slowness of
blood circulation.
Deficiency pattern: ‘over-catabolism’ and ‘over-consumption’, the deficiency of
nutrients, and weakness.
Five organ systems (in TCM):

although the five visceral organ names

(i.e. kidney, liver, heart, spleen and lung) are the same as in Western medicine,
their connotations are fundamentally different. Ancient TCM doctors identified
the function of an organ on the basis of anatomical knowledge, as in Western
medicine (e.g. the kidney is located in the lumbus and is connected with the
ureter), but mainly by observing signs and symptoms of diseases. For example,
one patient complained of lumbar ache and told the doctor that the ringing in
his ears and the aching of the knees were also alleviated after taking certain
herbs that strengthen kidney function, and then the doctor associated the
kidney with the ears and bones. These are not accidental discoveries.
Subsequently, TCM practitioners have repeatedly shown that the kidney’s
function is related to reproduction, ear, bone, development and aging. Thus,
the name of an organ in TCM is only a symbol of a functionally inter-related unit
or system, and not the real structural organ in modern medicine. The scientific
basis of these functional associations has been partially proven but needs
further exploration.

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would be lost. Attempts to screen anti-HIV chemicals
from herbs reflect the same rooted reductionist habit

[18]

.

Thus, it is neither appropriate nor fair to evaluate the
efficacy of a herbal formula by a single parameter.

Multi-target strategies for treating complicated diseases

are becoming a trend in modern medicine

[19]

. Therapy

that involves antagonism of a single target might be an
ideal treatment for diseases with clear and simple mech-
anisms, but it is not for complicated diseases. For example,
the latest guidelines provided by the European Society of
Hypertension and European Society of Cardiology suggest
that a large proportion of patients with hypertension
require combination therapy with more than one agent

[20]

. Furthermore, Wald and Law’s work proved that a

‘polypill’ that contains six compounds could largely
prevent heart attacks and stroke if taken by those over
the age of 55

[21]

. It should be pointed out that chemical

compounds such as those used in ‘cocktail’ therapies for
AIDS, although multi-targeted, are conceptually and
methodologically different from TCM therapy because
their design is still based on internal pathological targets
and not the general response of the body. Considering the
immense inter-relationship between therapeutic targets
in chronic diseases, the pattern-classification of TCM, based
on functional association, is a practical simplification that
is worthy of exploring by modern medicine

[22,23]

. The

ongoing transition from analyzing a ‘parts list’ (e.g. genes,
proteins and cells) to searching for functional ‘hidden
units’ [e.g. non-structural connection modules (units
formed by connecting different independent parts to

accomplish a function) among genes and proteins] in sys-
tems biology

[24]

is precisely what TCM has been practicing.

The multiple actions (particularly the reduction of

nervous excitement) of HCHs might also explain their
applications for individuals with cardiovascular diseases
associated with a heat pattern. Recent evidence

[25]

of

the role of inflammation in atherosclerosis supports the
traditional indications, in addition to infection, of HCHs.

One formula for multiple diseases
In TCM, apparently distinct diseases (according to modern
diagnostics) can share a common pattern and be treated
with the same formula. Studies in China have shown that
different diseases can share common pathological changes

[26]

and be cured by a common formula.

Blood-stasis pattern (BSP) is commonly encountered in

many diseases. The connotation of BSP is much broader
than the modern concept of obstruction of venous return.
As mentioned earlier, almost all concepts of TCM patterns
is based on the analysis of visible signs of the body; BSP is
also deduced from symptoms and signs such as pain, mass
formation, purplish tongue and local ecchymosis (a small,
flat hemorrhagic patch on the skin or mucous membrane).
Modern study has verified the presence of hemorheo-
logical, microcirculatory and hemodynamic changes, and
tissue hyperplasia in patients with BSP (

Table 2

). These

changes, including atherosclerosis, increased blood vis-
cosity, disturbed microcirculation and hyperplasia, con-
stitute the common pathological basis of a huge number of
diseases. Thus, blood circulation-activating drugs (BCADs)

Table 1. Multiple pharmacological actions of ‘heat-clearing’ herbs

a

Actions

Action characteristics or mechanisms

b

Herbs

Latin name

Common name

Antimicrobial

Broad-spectrum antibacterial, antiviral and antifungal effects; rarely
induce drug-resistant species

Cortex phellodendri

Phellodendron bark

Flos lonicerae

Honeysuckle flower

Fructus forsythiae

Forsythia fruit

Rhizoma coptidis

Coptis root

Anti-toxic

Directly destroy and neutralize endotoxins or indirectly clear
endotoxins by hepatoprotective and immunopotentiating effects

[14]

Radix isatidis

Woad root

Flos lonicerae

Honeysuckle flower

Rhizoma coptidis

Coptis root

Anti-inflammatory

Counteract acute inflammation by inhibiting cytokines and mediators
and thus decrease the permeability and dilation of capillaries;
counteract chronic inflammation by reducing hyperplasia

Radix scutellariae

Skullcap root

Cortex moutan

Tree-peony bark

Herba andrographitis

Green chiretta

Antipyretic

Act mostly not through perspiration, but perhaps through inhibiting
arachidonic acid and the production of endogenous pyrogen, and
regulating central temperature-sensitive neurons

Rhizoma anemarrhe-
nae

Anemarrhenatuber

Flos lonicerae

Honeysuckleflower

Radix bupleuri

Thorowax root

Inhibition of platelet
aggregation

Improve microcirculation; however, mechanism unclear

Radixrehmanniae

Rehmanniaroot

Herbaandrographitis

Greenchiretta

Rhizoma coptidis

Coptis root

Sedative

Produce sedation probably by inhibiting dopamine-b-hydroxylase

Rhizoma
anemarrhenae

Anemarrhenatuber

Rhizoma coptidis

Coptisroot

Cortex moutan

Tree-peony bark

Immuno-regulatory

Enhance leukocytic phagocytosis and cellular and humoral immunity;
some also have anti-allergic effects

Radix isatidis

Woad root

Flos lonicerae

Honeysuckle flower

Radix scutellariae

Skullcap root

Hepatoprotective
and cholagogic

Protect against carbon tetrachloride- or galactosalmine-induced liver
injury; strengthen gallbladder contraction and promote the
metabolism of bilirubin

Fructusgardaniae

Cape-Jasminefruit

Radixscutellariae

Skullcaproot

Herba andrographitis

Green chiretta

a

An analysis and summary based on the data in

[11–13]

.

b

Summary based on the data in

[13]

(unless specified).

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have been applied widely to treat various diseases, such as
cerebrocardiovascular diseases, hepatocirrhosis, tumors,
immune diseases, chronic pains, menoxenia, neuroderma-
titis and even psychoses

[27]

.

Searching for the scientific nature of kidney-deficiency

pattern (KDP) is another project that has been investi-
gated intensely in China for 50 years. Here, the term
‘kidney’ does not correspond to the anatomical organ
(see Glossary). In TCM, each visceral organ represents a
pathophysiologically correlated multi-system-engaged
functional unit, summarized from clinical proof

[9]

. For

example, ancient doctors sometimes encountered a person
who indulged in sex and had manifestations such as
lumbar aching and frequent urination in addition to loose
teeth, tinnitus and presenility. Such a group of repeatedly
concomitant symptoms inspired the ancient doctors to
associate the kidney with the reproductive system, ear,
tooth, bone and aging, and to believe that the function of
the kidney is to govern these tissues, organs and systems.
The group of symptoms mentioned above was attributed to
the dysfunction of the kidney and diagnosed KDP. Many
studies indicated that the major mechanisms of KDP were
dysfunctions of hypothalamic–pituitary–target glands
(i.e. adrenal, thyroid and gonadal glands) and general
senescence, including lowered antioxidant, immune and
metabolic functions

[33–35]

. In other words, this multi-

system aging underlies the pathological mechanism of this
group of concomitant symptoms that are found in various
diseases. Kidney tonics were proven to regulate aging or
disorders in these neuroendocrine axes that were related
to many geriatric or asthenic conditions

[33]

. Further

studies showed that Bawei Dihuang Wan (BDW), a classic
formula for treating KDP, could regulate hormones,
enhance immunity, inhibit peroxidation, reduce blood
sugar and lipids, lower blood pressure, increase bone
density and delay the aging progress

[36–38]

. BDW is used

widely to treat the following diseases with KDP: benign
prostratic hyperplasia, dementia, chronic nephritis,
diabetes mellitus, impotence, infertility, hypertension,
cataracts and asthma

[36,39]

.

The above two examples of ‘pattern’ research show the

existence of a similar general response of self-regulation in

different diseases. Different diseases with similar under-
lying mechanisms have also been found in modern medi-
cine. For example, insulin resistance is shared by several
disorders, including hypertension, diabetes, obesity,
hyperlipidemia and atherosclerosis, and thus should
provoke physicians to innovate an integrated therapy
against this ‘common soil’ – the disordered metabolism of
sugar and lipids

[40,41]

.

Multiple formulae for one disease
Although different diseases have common pathological
mechanisms, the mechanism of one disease might not be
identical in different people. Another aspect challenging
the validation of the efficacy of herbal medicine is
individualized therapy. Individualized therapy in TCM
originated from the ancient physicians’ concern with
constitutional differences and different reactions to one
pathogenetic factor among individuals. Even when treat-
ing the same pathological change (e.g. myocardial
ischemia), TCM practitioners still give individualized
therapy based on the symptoms and the patient’s
constitution (

Table 3

). The different mechanisms that

cause ischemia validate the scientific basis of such
individualized treatment.

The constitution classification by TCM practitioners

has been partially proven. Wang’s work indicated that
cold-pattern constitution was relevant to functional
genomic changes

[44]

. We proposed to elucidate the

pattern-oriented genetic makeup by using pharmaco-
genetics methodologies

[45]

. Preliminary work supports

the viewpoint that the efficacy and toxicity of herbs are
associated with patterns in TCM (i.e. pharmacokinetics of
a formula correlated with the specific pattern)

[46]

. The

idea behind pattern-based individualized medication is in
accordance with the future point that pharmacogenetics
hopes to reach

[47]

.

Challenges and future prospects
Prerequisite for evaluating TCM: quality control of herbal
medicines
The ultimate requirements of drugs should be efficacy
and safety, whereas the elucidation of ingredients and

Table 2. Pathological changes in BSP and the therapeutic actions of BCAD

a

Modern parameters

Changes in BSP

b

Actions of BCAD

b

Formula examples

c

Refs

Organ blood flow

Y

[

Xuefu Zhuyu Tang

[9,28]

Blood or plasma viscosity

[

Y

Xuefu Zhuyu Tang

[9,28]

Platelet aggregation and thrombosis

[

Y

Xuefu Zhuyu Tang

[29]

RBC deformability

Y

[

Guizhi Fuling Wan

[30]

Blood sedimentation

[

Y

Xuefu Zhuyu Tang

[9,28]

Fibrinogen level

[

Y

Xuefu Zhuyu Tang

[28]

Microcirculation

Y

[

Xuefu Zhuyu Tang

[29]

Tissue-fibrosis

[

Y

Dahuang Zhechong Wan

[31]

Endothelial-dependent vascular dilatation,
serum nitric oxide

Y

[

Xiongshao Capsule

[32]

a

Abbreviations: BSP, blood-stasis pattern; BCAD, blood circulation-activating drug; RBC, red blood cell.

b

Data from

[27]

.

c

Herbal composition of formulae: Xuefu Zhuyu Tang – Semen Persicae (peach seed) 12 g, Flos Carthami (safflower) 9 g, Radix Angelicae Sinensis (Chinese angelica root) 9 g,

Rhizoma Chuanxiong (chuanxiong) 4.5 g, Radix Paeoniae Rubra (red peony root) 6 g, Radix Rehmanniae (rehmannia root) 9 g, Radix Bupleuri (thorowax root) 4.5 g, Radix
Cyathulae (cyathula root) 9 g, and Radix Glycyrrhizae (licorice root) 3 g; Guizhi Fuling Wan – Ramulus Cinnamomi (cinnamon twig), Poria, Cortex Moutan (moutan root bark),
Semen Persicae (peach seed), Radix Paioniae Alba (white peony root), each drug in equal weight proportion; Dahuang Zhechong Wan – Radix et Rhizoma Rhei (rhubarb),
Radix Scutellariae (skullcap root), Radix Glycyrrhizae (licorice root), Semen Persicae (peach seed), Semen Armeniacae Amarum (apricot kernel), Radix Paeoniae Rubra (red
peony root), Radix Rehmanniae (rehmannia root), Exsiccata Lacca (lacquer), Tabanus (tabanus), Hirudo (leech), Vermiculus Holotrichiae (June beetle grub), Eupolyphaga seu
Opisthoplatia (ground beetle), the weight proportion is 10:2:3:2:2:4:10:1:2:2:2:1 (in above drug order); Xiongshao Capsule – Rhizoma Chuanxiong (chuanxiong), Radix
Paeoniae Rubra (red peony root), equal weight proportion.

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mechanisms is not a must, although it is helpful.
Consistency of quality among different batches of herbal
drugs is a prerequisite for the use of herbal medicines. The
ever-increasing reported cases of herbal toxicity are
largely attributed to the ‘loose’ regulation of the quality
of herbal agents and untrained practitioners

[48]

. With

the implementation of Good Agriculture Practice and Good
Manufacture Practice and the introduction of advanced
analytical technologies

[49,50]

, quality control of herbs will

be improved during the next few years

[51,52]

.

Experimental research
Obviously, the use of disease-specific targets is not a
reasonable approach to evaluate TCM. However, it is not
easy to develop animal models that mimic the overall
functional state of humans. At present, induction of
specific pathological changes in animals after screening,
or altering the animal’s general condition are feasible but
are not ideal pattern models. For example, animals with a
high level of metabolism and sympathetic activity could be
used as a ‘heat (Yang-excess)’ model and aged animals
could be used as a KDP model (W-Y. Jiang, unpublished).

Clinical trials
Because the indication of one herbal formula is a specific
pattern, not a disease, stratifying a disease into several
patterns is a feasible procedure in clinical trials. End-
points measured should include specific modern para-
meters, other associated indices and general improvement
(i.e. quality of life or accumulated scores of symptoms)

[53]

.

Despite its difficulties, conforming to both traditional
diagnostic and therapeutic systems and modern methodo-
logical demands is achievable

[54]

. Quantitative stan-

dardization of pattern diagnosis is also a good method to
re-evaluate the efficacy of herbal formulae.

Although randomized control trials are regarded as a

reliable approach to obtain the evidence of efficacy and
toxicity, it is not the only effective and most economical
way of achieving this goal. The claimed efficacy of TCM is
not an ‘anecdote’ as frequently described. Ancient physi-
cians identified the connection between a specific pattern
and a corresponding formula and recorded the ‘trial’,
which was then tested by the successors repeatedly for
hundreds or even thousands of years. Thus, this is a
unique clinical trial, but not an anecdote. Scepticism
about TCM is mainly due to the inaccessibility of a vast
body of classical literature about such trials. Studying
a large number of ancient case records to master the

pattern-formula association is still a required course for
contemporary TCM practitioners.

Concluding remarks
The main feature of TCM is its modulation of character-
istic changes of functional ‘hidden’ units within the body.
China’s experience has shown that methodologically it is
not appropriate to apply reductionism to TCM research.
With the development of systems biology, new ideas,
methods and techniques will emerge as a result of explor-
ing the complex systems of life

[55]

; these will help

uncover the mystery of TCM and increase its application.
Simplifying the complexity is a wise approach invented by
the ancient TCM physicians. Providing the scientific
evidence to support such simplification will verify the
value of TCM in modern medicine. More attention
should be paid to the thinking behind TCM to develop
new drugs derived from TCM. In the struggle against
diseases and drug development, we are lacking wisdom
rather than knowledge.

Acknowledgements

This work was supported by the 211 project grant of Peking University.
I’d like to thank Zhen-gang Wang, Zhu-fan Xie, Gan-zhong Liu, Daniel A.
Calvin, Dean W. Brook, Jiang Gu and Shun-cheng Li for their helpful
suggestions and comments in my preparation for this paper.

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Table 3. Pattern differentiation in patients with angina pectoris, and respective herbal formulae

Pattern

Blood stasis

Phlegm stasis

Deficiency of both Qi and yin

Refs

Characteristic
symptoms

Stabbing pain with fixed
location

Oppression and distention in the chest

Taxation pain

[9]

Accompanied
constitution

Observed in various
constitutions

Obese

Thin and feeling fatigue

Formula

a

Xuefu Zhuyu Tang

Gualou Xiebai Banxia Tang

Shengmai San

[9]

Pharmacological
basis of formula

Mainly improves
hemorheological indices
(see

Table 2

)

Dilates coronary vessels, particularly
lowers blood cholesterol and inhibits
lipid peroxidation

Adjusts myocardiac metabolism to
tolerate hypoxia and enhances
contractibility and cardiac output

[42,43]

a

Formula composition: Xuefu Zhuyu Tang (see

Table 2

); Gualou Xiebai Banxia Tang – Fructus Trichosanthis (trichosanthes fruit) 15 g, Rhizoma Pinelliae (Pinellia tuber) 9 g,

Bulbus Allii Macrostemi (macrostem onion) 9 g, Vinum (white wine) 30 g; Shengmai San – Raix Ginseng 3–9 g, Radix Ophiopogonis (lilyturf root) 15 g, and Fructus
Schisandrae (magnoliavine fruit) 3–9 g.

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