Syndrome differentiation in traditional Chinese medicine (TCM) is the comprehensive analysis of clinical information gained by the four main diagnostic TCM procedures: observation, listening, questioning, and pulse analysis, and it is used to guide the choice of treatment either by acupuncture and/or TCM herbal formulae, that is, Fufang.
TCM syndrome differentiation can be used for further stratification of the patients’ conditions with certain disease, identified by orthodox medical diagnosis, which could help the improvement of efficacy of the selected intervention. In modern TCM research it is possible to integrate syndrome differentiation with orthodox medical diagnosis leading to new scientific findings in overall medical diagnosis and treatment.
Currently traditional Chinese medicine (TCM) is an essential part of the healthcare system in several Asian countries, and is considered a complementary or alternative medical system in most Western countries. The general practice of TCM depends on the accurate diagnosis and treatment procedures known as Bian Zheng Lun Zhi (syndrome differentiation followed by treatment procedures).
Syndrome differentiation is one of most important concepts in the practice of TCM that consists of a series of diagnostic procedures. Syndrome differentiation is different from the conventional diagnosis methodology used in orthodox medical practice. It is the process of comprehensive analysis of clinical information obtained by the four main diagnostic TCM procedures: observation, listening, questioning, and pulse analyses.
It is used to guide the choice of TCM treatment using acupuncture and or TCM herbal formulae, that is, Fufang. Thus the complete TCM process is known as Bian Zheng Lun Zhi, “Treatment based on syndrome differentiation”. Correct TCM syndrome differentiation is the most important principle that guides the prescribing of Chinese herbal formulae.
It is possible to integrate TCM syndrome differentiation and biomedical diagnosis in modern clinical practice. In diseases diagnosis if shown in the transversal way for patient classification and TCM syndrome differentiation shown in the longitudinal way indicate a cross relationship.
A patient can suffer from 2 or more diseases at same time, and one disease can show 2 or more TCM syndromes. Similarly a patient can show a mixture of TCM syndromes (2 or more syndrome), and one TCM syndrome can be shown in different diseases. Moreover, syndrome differentiation is dynamic, and one syndrome could be altered after TCM treatment according to the previous TCM diagnostic pattern (symptoms, signs, tongue appearance and pulse feelings).
The information obtained from syndrome differentiation, including symptoms, pulse feelings and tongue appearance, is often considered to be subjective. Patients’ responses to treatment and their feelings can be recorded objectively in terms of patients’ reported outcomes (PROs), using instruments such as the scaling ruler and questionnaires.
Recently TCM syndromes were detected and verified in many diseases, including Fibromyalgia Syndrome, amnestic mild cognitive impairment and Alzheimer's dementia, hyperlipidaemia, gastric mucosal dysplasia, thoracic diseases.
Some correlations between certain TCM syndrome and the disease were also validated: the association between Shen (kidney) deficiency syndrome and postmenopausal osteoporosis, Xue Yu (blood stasis) syndrome and coronary heart disease.
Such observations have provided the substantial evidence for the objectiveness of TCM syndrome differentiation.
TCM has its origins in China and the information for the TCM syndrome differentiation is used in the past by the Chinese based on the Chinese cultural development and understanding of TCM and its philosophies. The medical service based on TCM syndrome differentiation may be difficult to be understood in the west, but in the recent years where TCM practice outside China is widespread, the TCM concepts have been adopted and practised gradually.
However scientists in the west may not be familiar with the intricacies of the syndrome differentiation and have generally focused on phytochemical approaches on Chinese materia medica (CMM) with no reference on TCM syndrome differentiation research. Yet recently researchers outside China have demonstrated that the TCM syndromes can be observed in patients who are not of Chinese origin.
For instance, evidence was observed in the distribution of similar TCM syndromes in Australian and Chinese women with primary dysmenorrhoea; the Shen deficiency syndrome could be diagnosed in both German and Chinese menopausal women under the same diagnostic criteria.
TCM syndrome differentiation, if adopted as the diagnostic method for the substantial part in modern TCM research, would lead to new scientific findings for medical sciences.
These and other Traditional Chinese practices all form part of TCM, each adding a little to the history and methodology of Acupuncture and Herbs.
Eca Brady is a fully licensed physician of Chinese Medicine BSc(Ac) MBAcC PGDip(CHM), practicing Acupuncture and Chinese Herbs from Harley Street, London. Make an appointment for an acupuncture or Herbs treatment and we can discuss how we can help you, to read more about Eca click here.
Extract from Journal of Ethnopharmacology