Traditional Chinese medicine (TCM) has guided health maintenance and disease treatment for thousands of years and has been widely used in many countries around the world. TCM regards each individual as unique so all corresponding therapeutic and preventive approaches in TCM are personalized. Personalized medicine, also referred to as precision medicine, is an emerging medical paradigm that points toward a new direction for future medical development. TCM constitution studies the holistic body condition, which is affected by both inborn and acquired factors. Body constitution lays the foundation for disease diagnosis, prevention and treatment. Different constitution types predispose individuals to different disease susceptibilities. Examining an individual’s unique body constitution can promote effective health management and benefit the application of personalized medicine significantly. This review will introduce and discuss the application of the TCM constitution for health maintenance and disease prevention. In last decade, a number of modern techniques have been employed in the constitution research to evaluate the health status of individuals. The TCM constitution reflects the current status and future trends of human health in four aspects, i.e., individual differences, life processes, psychological condition and adaptability to natural and social environments. This TCM constitution theory has already been applied in the Chinese public health management at different levels with promising outcome. The constitution theory and practice provide a new approach for health maintenance and disease prevention.
The constitution of traditional Chinese medicine was established in 1970s by Chinese scholars, in which the constitutions of Chinese people were classified into nine types for study. The phlegm-dampness constitution is one of the nine constitutions and is the most common type in constitution study. Genomics studies found four upregulated genes: COPS8, GNPDA1, CD52 and ARPC3; and six downregulated genes: GSPT2, CACNB2, FLJ20584, UXS1, IL21R and TNPO in the phlegm-dampness constitution. Gene functional analyses on genes affecting the differences between the phlegm-dampness constitution and the balanced constitution indicated that people with phlegm-dampness constitution were susceptible to hyperlipemia and diabetes. Results of epidemiological surveys also revealed that people with phlegm-dampness constitution have a much higher risk of obesity, metabolic syndrome, hypertension and diabetes than people with a balanced constitution. Therefore, differentiation of phlegm-dampness constitution could be performed in the normal population with the Constitution of Chinese Medicine Scale to estimate the risks of those diseases for prediction. For people with phlegm-dampness constitution, Chinese medicine could be used to reduce risk of related diseases. Constitution-based strategies in disease prevention and treatment are consistent with the current proposed 4P medical mode (personalized, predictive, preventive and participatory). With the rising burden of global disease and increasing medical expenditure, the objectives of medicine are transforming from treatment to prevention. Thus, studies on the phlegm-dampness constitution of traditional Chinese medicine are significantly important for the prediction and prevention of related diseases and maintenance of human health.
In the Western medicine system, scholars have explained individual differences in terms of behaviour and thinking, leading to the emergence of various classification theories on individual differences. Traditional Chinese medicine has long observed human constitutions. Modern Chinese medicine studies have also involved study of human constitutions; however, differences exist in the ways traditional and modern Chinese medicine explore individual constitutions. In the late 1970s, the constitutional theory of Chinese medicine was proposed. This theory takes a global and dynamic view of human differences (e.g., the shape of the human body, function, psychology, and other characteristics) based on arguments from traditional Chinese medicine. The establishment of a standard for classifying constitutions into nine modules was critical for clinical application of this theory. In this review, we describe the history and recent research progress of this theory, and compare it with related studies in the western medicine system. Several research methods, including philology, informatics, epidemiology, and molecular biology, in classifying constitutions used in the constitutional theory of Chinese medicine were discussed. In summary, this constitutional theory of Chinese medicine can be used in clinical practice and would contribute to health control of patients.
Traditional Chinese medicine (TCM), Japanese-Chinese medicine, and Korean Sasang constitutional medicine have common origins. However, the constitutional medicines of China, Japan, and Korea differ because of the influence of geographical culture, social environment, national practices, and other factors. This paper aimed to compare the constitutional medicines of China, Japan, and Korea in terms of theoretical origin, constitutional classification, constitution and pathogenesis, clinical applications and basic studies that were conducted. The constitutional theories of the three countries are all derived from the Canon of Internal Medicine or Treatise on Febrile and Miscellaneous Diseases of Ancient China. However, the three countries have different constitutional classifications and criteria. Medical sciences in the three countries focus on the clinical applications of constitutional theory. They all agree that different pathogenic laws that guide the treatment of diseases govern different constitutions; thus, patients with different constitutions are treated differently. The three countries also differ in terms of drug formulations and medication. Japanese medicine is prescribed only based on constitution. Korean medicine is based on treatment, in which drugs cannot be mixed. TCM synthesize the treatment model of constitution differentiation, disease differentiation and syndrome differentiation with the treatment thought of treating disease according to three categories of etiologic factors, which reflect the constitution as the characteristic of individual precision treatment. In conclusion, constitutional medicines of China, Japan, and Korea have the same theoretical origin, but differ in constitutional classification, clinical application of constitutional theory on the treatment of diseases, drug formulations and medication.
Chinese herbal medicine (CHM) has been widely used as an adjunctive therapy for breast cancer, while its efficacy remains unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with chemotherapy for breast cancer. The study results showed that CHM combined with chemotherapy significantly increased tumor response and KPS as compared to using chemotherapy alone (RR = 1.36; 95% CI = 1.24–1.48; P < 0.00001; RR = 1.38; 95% CI = 1.26–1.52; P < 0.00001, resp.). Besides, CHM as an adjunctive therapy significantly reduced the nausea and vomiting at toxicity grade of III–IV (RR = 0.37; 95% CI = 0.27–0.52; P < 0.00001). Moreover, the combined therapy significantly prevented the decline of WBC in patients under chemotherapy at toxicity grade of III–IV (RR = 0.49; 95% CI = 0.34–0.69; P < 0.00001) and prevented the decline of platelet at toxicity grade of III–IV or I–IV (RR = 0.29; 95% CI = 0.12–0.73; P = 0.008; RR = 0.77; 95% CI = 0.63–0.94; P = 0.009, resp.). This study suggests that CHM combined with chemotherapy in comparison with chemotherapy alone can significantly enhance tumor response, improve KPS, and alleviate toxicity induced by chemotherapy in breast cancer patients. However, a firm conclusion could not be reached due to the lack of high quality trials and large-scale RCTs, so further trials with higher quality and larger scale are needed.
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