Integrative medicine in clinical practice: From pattern differentiation in traditional Chinese medicine to disease treatment

Abstract

Pattern (syndrome) differentiation is the key theory in traditional Chinese medicine (TCM) and the important diagnostic principle for TCM therapy. More and more medical researchers recognize that the combination of disease diagnosis in biomedicine and pattern differentiation in TCM is essential for the clinical practice, and it has been a common practice model in China since it will produce better clinical effects (1) . Pattern differentiation is mainly based on symptoms (including self-mentioned signs), tongue appearance and pulse palpation. The symptoms, tongue appearance and pulse palpation are often diversified. Some of them, not closely related to the disease diagnostic parameters, are less focused upon by modern medicine, such as thirst and turbid urine and yellow tongue fur in rheumatoid arthritis (RA) (2) . Although symptoms are diversified in a disease, they can be clustered into specific groups with biostatistical approaches, even though traditionally they are classified into groups based on TCM theory and clinical experiences. A multicenter RCT study on RA had shown that 18 symptoms (5 related to joint, 13 not related to joint but focused by TCM) in 396 patients could be classified into 4 factors (symptom combinations) with factor analysis. The symptom combinations are similar to the patterns differentiated by TCM theory in RA patients, which divides RA into three basic patterns: cold, hot and deficient patterns (3)