Traditional Chinese Medicine In China Research Articles

First Report of Alternaria alternata Causing Leaf Spot on Ipomoea purpurea in China

Ipomoea purpurea is widely used as an ornamental plant and in traditional Chinese medicine in China. Seed is used in treating edema and anuria, dispelling phlegm. In June 2016, severe leaf spot disease on I. purpurea with 30% disease incidence was observed in the Laoshan Mountain of Qingdao, China. Symptoms on leaves initially appeared as light to dark brown, necrotic spots with yellow borders or no borders. The spots gradually enlarged in size, becoming irregular. Tissue samples were taken from the margins of lesions, cut into small pieces, surface-disinfected with 70% ethanol for 30 seconds, rinsed with sterile water three times, placed on potato dextrose agar (PDA), and incubated at 25°C in the dark. A total of 10 isolates were obtained from 13 symptomatic leaf samples. Thereafter, 10 single spore isolates were obtained as described (Dong 2009) and transferred onto a potato carrot agar (PCA) medium (Mirkova 2003). After six days of growth on PCA at 25°C in the dark, colonies had round margins and aeria...

Validation and Application of the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM).

The MD Anderson Symptom Inventory (MDASI) is a brief, yet thorough, patient-reported outcomes measure for assessing the severity of common cancer-related symptoms and their interference with daily functioning. We report the development of an MDASI version tailored for use with Traditional Chinese Medicine in China (the MDASI-TCM). Chinese-speaking patients with mixed cancer types (n = 317) participated in the study. The development and validation process included four steps: 1) identify candidate TCM-specific items, with input from patients, oncologists, and TCM specialists; 2) eliminate candidate TCM items lacking relevance, based on patient report; 3) psychometrically examine the MDASI-TCM's validity and reliability in cancer patients receiving TCM-based care; and 4) cognitively debrief patients to assess the MDASI-TCM's relevance, understandability, and acceptability. Seven TCM-specific symptom items (sweating, feeling cold, constipation, bitter taste, coughing, palpitations, and heat in palms/soles) were clinically and psychometrically meaningful to add to the core MDASI. Approximately 61% of patients had moderate to severe symptoms (rated ≥5 on the MDASI-TCM's 0-10 scale). Cronbach α coefficients were .90 for symptom-severity items and .93 for interference items, indicating internal consistency reliability. Known-group validity was substantiated by the MDASI-TCM's detection of differences in symptom severity according to performance status (P < .001) and interference levels by cancer stage (P < .05). Cognitive debriefing indicated that patients found the MDASI-TCM to be an understandable, easy-to-use tool. The Chinese MDASI-TCM is a valid, reliable, and concise measure of symptom severity and interference that can be used to assess Chinese cancer patients and survivors receiving TCM-based care.

Diversity and distribution of the threatened medicinal vascular plants in Lancang

The rich diversity in medicinal plants provides an important material basic for the development of Traditional Chinese medicine in China. It is important to explore the present situation of medicinal plants within special regions in order to provide scientific instructions for their sustainable protection and exploitation and utilization. In this study, we carried out the field survey according to the guideline of national survey of Chinese material medica resources and the guideline of plant species diversity survey and estimation at county level with the line transect method. With the field surveyed data, we explored the diversity and distribution of the threatened medicinal vascular plants in Lancang. We found that there were 33 species of the threatened medicinal vascular plants in this county. These species were from 23 genera and 17 families, and were composed of one critical endangered, 10 endangered and 22 vulnerable species. They were widely distributed across the whole county and were most concentrated in the town of Nuozhadu, Fazhanhe, Nuofu and Zhutang, which were located in the southeastern, southwestern and western of Lancang, respectively. We also found that the plant species richness followed a unimodal pattern along elevation. In addition, we found that the areas of Nuozhadu Nature Reserve in Lancang only covered six threatened medicinal vascular plants, while most of the regions with high species richness were not well protected. Therefore, we proposed to make more efforts to improve the protection measurements in order to better protect and utilize the medicinal plants in Lancang.

Protective effect of Danhong Injection combined with Naoxintong Capsule on cerebral ischemia-reperfusion injury in rats

Ethnopharmacological relevanceDanhong Injection (DHI) and Naoxintong Capsule (NXT) are renowned traditional Chinese medicine in China. The drug combination of DHI and NXT is frequently applied for the treatment of cardiovascular and cerebrovascular diseases in clinic. However, there had been no pharmacological experiment studies of interaction between DHI and NXT. Due to the drug interactions, exploring their interaction profile is of great importance. Material and methodsIn this study, focal cerebral I/R injury in adult male Sprague-Dawley rats were induced by transient middle cerebral artery occlusion (tMCAO) for 1h followed by reperfusion. Rats were divided into 5 groups: sham group, ischemia reperfusion untreated group (IRU), DHI group (DHI 10mL/kg/d), NXT group (NXT 0.5g/kg/d), DHI plus NXT group (DHI-NXT, DHI 10mL/kg/d plus NXT 0.5g/kg/d). All drug-treated groups were respectively successive administrated for 7 days after ischemia/ reperfusion (I/R) injury. The effects on rat neurological function were estimated by neurological defect scores. Brain infarct volumes were determined based on 2, 3, 5-triphenyltetrazolium chloride (TTC) staining. Pathological changes in brain tissues were observed using hematoxylin and eosin (H&E) staining and transmission electron microscope (TEM). Levels of nitric oxide (NO), granulocyte colony-stimulating factor (G-CSF) and granulocyte macrophage colony-stimulating factor (GM-CSF) in serum were determined with enzyme-linked immunosorbent assay (ELISA). Immunohisto-chemistry and Western blot were used to detect the expressions of basic fibroblast growth factor (bFGF), von Willebrand factor-microvessel vascular density (vWF-MVD), vascular endothelial cell growth factor (VEGF), transforming growth factor-β1 (TGF-β1), angiogenin-1 (Ang-1), angiogenin-2 (Ang-2) and platelet derived growth factor (PDGF) at day 7 after ischemia/reperfusion (I/R) injury. ResultsCompared with IRU group and mono-therapy group (DHI group or NXT group), Danhong Injection combined with Naoxintong Capsule (DHI-NXT) group significantly ameliorated neurological deficits scores, infarct volume and pathological change, significantly decreased the overexpression of NO and the level of Ang-1, significantly increased the expressions of VEGF, Ang-2, G-CSF, GM-CSF, bFGF, PDGF, vWF, TGF-β1. ConclusionThe protective benefits on rat brain against I/R injury were clearly produced when DHI and NXT were used in combination, which provided rational guidance for clinical combined application of DHI and NXT, and this protection maybe associated with the up-regulation expressions of the related chemokines and growth factors of angiogenesis.

Divergent trajectories of sectoral evolution: The case of Traditional Chinese Medicine in China (1949–2015)

This article explores the divergent evolution trajectories within sectoral innovation system. A sectoral system is composed of three elements, i.e. knowledge and technology, actors and networks, and institutions. Since each of the three components could reveal multiple dynamics, different trajectories co-existing in the sector are able to be integrated shaped by the particular dynamics of the three components. Through investigating the evolution of two sub-sectors embedded in the Traditional Chinese Medicine industry in China, we find that sectoral development does not always follow single pattern but is able to be jointly pushed by the uneven development of different sub-sectors. The strategic policy supports towards a particular sector under such circumstance should therefore fully consider the heterogeneity within the sectoral system and foster the balanced development across different sub-sectors in the long term.

Using connectivity map to identify natural lignan justicidin A as a NF-κB suppressor

Justicidin A (JA), a natural lignan, was isolated from the whole plant of Justicia procumbens, one of the most popular traditional Chinese medicines in China and Taiwan. Gene expression signatures of JA from human colorectal cancer HT-29 and hepatocellular carcinoma Hep 3B cells were used to query connectivity map. A NF-κB suppressor (15-delta prostaglandin J2) was predicted to display similar molecular action of JA. In JA-treated HT-29 cells, suppression of nuclear NF-κB expression and decrease of NF-κB DNA-binding activity were indeed observed. The classical pathway was involved in JA-induced inhibition of NF-κB, characterized by decreases in phosphorylation of AKT, IκB kinase (IKK)-β/IKK-α, and IκB-α. Furthermore, JA caused significant translocation of apoptosis-inducing factor and endonuclease G, caspase-independent apoptotic signaling molecules, from the mitochondrial to the nuclei. Our data suggest anti-inflammatory and cytotoxic mechanisms of JA, and using gene expression signatures to identify novel molecular actions of phytochemicals is an effective approach.

New bisesquiterpenoid lactone from the wild rhizome of Atractylodes macrocephala Koidz grown in Qimen

The rhizomes of Atractylodes macrocephala are used as both a food source and traditional Chinese medicine in China. A phytochemical investigation was carried out on wild A. macrocephala grown in Qimen County in eastern China, and yielded a novel bisesquiterpenoid lactone, namely, biatractylenolide II (1), along with two known compounds, atractylenolide II (2) and taraxeryl acetate (3). The structure and relative configuration of the new compound were elucidated mainly by 1D and 2D NMR spectroscopic methods in combination with HRESIMS experiments. This paper describes the isolation and structural elucidation of the new bisesquiterpenoid lactone (1).

Exploration on the teaching system of the master of translation and interpreting (MTI) program in universities of Traditional Chinese Medicine in China

The Master of Translation and Interpreting (MTI) program in Universities of Traditional Chinese Medicine (TCM) in China should be committed to cultivating translation knowledge, medical knowledge, core translation competences and related translation professionalism. The program should develop various courses focusing on bilingual language ability, translation knowledge, translation strategy, TCM knowledge, intercultural communication competence, terminology and information communication technology. It should adopt student-centered teaching approaches and engage in the cultivation of faculty in order to improve the translation competence for MTI students in TCM universities. Key words: Master of translation and interpreting; TCM translation; Teaching strategies

Review on construction of legal system of traditional Chinese medicine in China

Review on construction of legal system of traditional Chinese medicine in China

Patients’ attitudes to the perioperative application of acupuncture: A Chinese survey

IntroductionThe primary purpose of this survey was to investigate the attitudes of patients undergoing elective surgery, towards the application of acupuncture to reduce perioperative complications, and to identify the possible factors that influenced their attitudes. MethodsThe survey was conducted in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine in China. A 20-item questionnaire was developed and piloted over a period of eight weeks. Results176 adult surgical inpatients completed the survey with a response rate of 98.9%. Only about one quarter of the participants had past experience of acupuncture treatment (n=46, 26.1%) and one third thought acupuncture was effective (n=61, 34.7%). Less than half of them were willing to use acupuncture for postoperative nausea and vomiting (PONV) (n=70, 39.8%), postoperative pain (n=79, 44.9%), preoperative anxiety and insomnia (n=65, 36.9%), postoperative gastrointestinal dysfunction (n=76, 43.2%), postoperative urinary retention (n=81, 46.0%). Patients who were professionals or office workers (chi square=26.181, p=0.001) or with better education (chi square=14.583, p=0.024) were more willing to use acupuncture, while age or gender did not affect their attitudes. A majority of patients would follow the doctor’s advice about acupuncture (n=111, 63.1%). Those who had history of PONV were less likely to receive acupuncture (chi square=10.664, p=0.005). ConclusionsOverall, the surveyed Chinese patients had limited experience and knowledge of acupuncture, and less than half had positive attitudes towards using acupuncture for reducing perioperative complications. Education of patients and their doctors may be promising strategies for improving patients’ willingness to use acupuncture.

Comparison of the chemical consituents and immunomodulatory activity of ophiopogonis radix from two different producing areas

Zhemaidong (ZMD) and Chuanmaidong (CMD) are the two genuine cultivation areas of Ophiopogonis Radix which has been widely used as a traditional Chinese medicine in China for treating cardiovascular and pulmonary diseases. Differences between ZMD and CMD in chemical constituents and pharmacological effects have been reported, however, the details remain largely unknown. The aim of this study was to comprehensively characterize the chemical composition of Ophiopogonis Radix from the two producing areas and compare their immunomodulatory activities. An approach of HPLC–MS coupled with multivariate statistical analysis was established to reveal the characteristic constituents of ZMD and CMD. Furthermore, the effects of ZMD and CMD on the macrophage phagocytosis and gastrointestinal peristalsis were also determined in zebrafish models for assessing the immunomodulatory activities of these two strains. The results revealed that the chemical constituents of ZMD and CMD were much different from each other, and 19 constituents could be served as chemical markers to distinguish these two strains. Moreover, ZMD showed higher promoting rates in macrophage phagocytosis and gastrointestinal motility than those of CMD, suggesting ZMD might possess better immunomodulatory activities. Taken together, the results generated from this study indicated that the herbs from different producing areas should be evaluated and considered in preparing TCM prescriptions.

Barriers and countermeasures in developing traditional Chinese medicine in Europe.

Traditional Chinese medicine (TCM) is one of the unique cultural treasures of Chinese; it represents a significant feature and prominent advantage of the healthcare cause in China. Data in this paper were fromWorld Health Organization, Chinese Bureau of Statistics, China National Knowledge Infrastructure, and PubMed. In recent years, TCM has established a solid foundation in Europe, which made great strides in legislation, education, research, and international exchange, and has enjoyed a vast development space in the continent. Now, TCM is embracing unprecedented development opportunities in Europe. At the same time, the stiff international competition poses a grave threat to China's TCM industry. With multiple cultural, legal, and institutional challenges, as well as talent shortages in the way, TCM is now facing many difficulties in Europe. To fully prepare and enact active and vigorous steps to seize opportunities, we should have a clear picture about the serious challenges hampering TCM development in Europe. The TCM development at overseas markets has shifted from a spontaneous trade activity into a national strategy spearheaded by the government and participated in by multiple stakeholders. We should make a systematic, comprehensive, and sustainable push in fields such as TCM therapy, healthcare, education, research, culture, and industry development. The ultimate goal is to bring TCMs to the global market and allow them to play a role in safeguarding public health along with modern medicines.

Total saponins of panaxnotoginseng promotes lymphangiogenesis by activation VEGF-C expression of lymphatic endothelial cells

Ethnopharmacological relevanceLymphatic system plays an important role in maintaining the fluid homeostasis and normal immune responses, anatomic or functional obstruction of which leads to lymphedema, and treatments for therapeutic lymphangiogenesis are efficiency for secondary lymphedema. Total saponins of panaxnotoginseng (PNS) are a mixture isolated from Panaxnotoginseng (Burkill) F.H.Chen, which has been used as traditional Chinese medicine in China for treatment of cardio- and cerebro-vascular diseases. The aim of this study was to determine the effect and mechanism of PNS on lymphangiogenesis. MethodsThe Tg (fli1: egfp; gata1: dsred) transgenic zebrafish embryos were treated with different concentrations of PNS (10, 50, 100μM) for 48h with or without the 6h pretreatment of the 30μM Vascular endothelial growth factors receptor (VEGFR)-3 kinase inhibitor, followed with morphological observation and lympangiogenesis of thoracic duct assessment. The effect of PNS on cell viability, migration, tube formation and Vascular endothelial growth factors (VEGF)-C mRNA and protein expression of lymphatic endothelial cells (LECs) were determined. The role of phosphatidylinositol-3 (PI-3)-kinase (PI3K), extracellular signal-regulated kinase (ERK)1/2 pathways, c-Jun N-terminal kinase (JNK) and P38 mitogen activated protein kinases (MAPK) signaling in PNS-induced VEGF-C expression of LECs by using pharmacological agents to block each signal. ResultsPNS promotes lymphangiogenesis of thoracic duct in zebrafish with or without VEGFR3 Kinase inhibitor pre-impairment. PNS promotes proliferation, migration and tube formation of LECs. The tube formation induced by PNS could be blocked by VEGFR3 Kinase inhibitor. PNS induce VEGF-C expression of LEC, which could be blocked by ERK1/2, PI3K and P38MAPK signaling inhibitors. ConclusionPNS activates lymphangiogenesis both in vivo and in vitro by up-regulating VEGF-C expression and activation of ERK1/2, PI3K and P38MAPK signaling. These findings provide a novel insight into the role of PNS in lymphangiogenesis and suggest that it might be an attractive and suitable therapeutic agent for treating secondary lymphedema or other lymphatic system impairment related disease.

Health Food and Traditional Chinese Medicine in China

Citation: Hou H, Li S, Ye Z (2016) Health Food and Traditional Chinese Medicine in China. J Nutr Health Sci 3(3): 301. doi: 10.15744/2393-9060.3.301 Volume 3 | Issue 3 Journal of Nutrition and Health Sciences

Protective effect of Naoxintong against cerebral ischemia reperfusion injury in mice

Ethnopharmacological relevanceNaoxintong (NXT), a renowned traditional Chinese medicine in China, has been used for the treatment of acute and chronic cardio-cerebrovascular diseases in clinic for more than 20 years. Aim of the studyTo evaluate the potential neuroprotective effect of NXT against ischemia reperfusion (I/R) injury in mice and investigate the underlying mechanisms. Materials and methodsFocal cerebral I/R injury in adult male CD-1 mice was induced by transient middle cerebral artery occlusion (tMCAO) for 1h followed by reperfusion for 23h. Mice were randomly divided into five groups: Sham group; tMCAO group; Vehicle group; NXT-treated groups at doses of 0.36g/kg and 0.54g/kg. The effects of NXT on murine neurological function were estimated by neurological defect scores, infarct volume and brain water content at 24h after tMCAO. Immunohistochemistry and Western blot were used to detect the expression of LOX-1, pERK1/2 and NF-κB at 24h after tMCAO. qRT-PCR was used to detect the expression of LOX-1 and NF-κB at 24h after tMCAO. ResultsCompared with Vehicle group, 0.54g/kg group of NXT significantly ameliorated neurological outcome, infarction volume and brain water content, decreased the expression of LOX-1, pERK1/2 and NF-κB (P<0.05). ConclusionNXT protected the mice brain against I/R injury, and this protection maybe associated with the down-regulation of LOX-1, pERK1/2 and NF-κB expression.

Chinese medicine packet plus wax therapy for periarthritis of the shoulder: study protocol for a multi-center, randomized controlled trial

Background: Periarthritis of the shoulder clinically manifests as pain and functional disorder of the shoulder joint. Although there is a tendency to self-heal, results are unsatisfactory. Nonsurgical treatments often used for clinical treatment of periarthritis, including simple closure, massage and acupuncture, do not improve symptoms. Chinese medicine packets and wax treatment effectively improves the local micro-circulation and regulates body functions. Therefore, this study aims to develop a new Chinese medicine wax treatment for periarthritis of the shoulder using these two techniques, and to observe its safety and efficacy. Methods/Design: A prospective, multi-center randomized, double-blind, placebo-controlled clinical trial will enroll patients with periarthritis of the shoulder who will be randomized into treatment and control groups. In the treatment group, packets will be immersed in a decoction of Chinese medicine. Prepared packets will be placed onto the shoulder joint followed by warm paraffin cake, once a day for 20 minutes, for 4 weeks. In the control group, Chinese medicine packets will be replaced by placebo; all other procedures will be identical. Outcome measures will be assessed at baseline and 1, 2, and 4 weeks after treatment. Primary outcome is the McGill Pain Questionnaire score. Secondary outcomes include shoulder disability questionnaire score, Oxford shoulder score, American Shoulder and Elbow Surgeons score, University of California, Los Angeles shoulder score, the efficacy in treating Traditional Chinese Medicine syndromes, visual analog scale score, and Constant-Murley shoulder score. Discussion: This trial will provide a quantitative basis to establish therapeutic guidelines and technical standards for Chinese medicine packet plus wax therapy for the treatment of periarthritis of the shoulder. Trial registration: Chictr.org.cn identifier: ChiCTR-IOR-15006149; registered on 11 March 2015. Written approval for this protocol was obtained from the Ethics Committee of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine in China (approval No. 2014ZX (KT)-010-02).

Current Status of Standardization of Traditional Chinese Medicine in China.

As an important component of traditional medicine, Traditional Chinese Medicine (TCM) is widely spread and applied in more than 100 countries across the world. The standardization of TCM is very important for the international application of Chinese medicine. In this paper, we have explained and analyzed the standardization situations of TCM in China with the purpose of providing reference for standardization and international development of TCM.

The Effect of the Modified Eighth Section of Eight-Section Brocade on Osteoporosis in Postmenopausal Women: A Prospective Randomized Trial.

Osteoporosis and related fragility fractures represent a serious and global public health problem.To evaluate whether the modified eighth section of Eight-section Brocade (MESE) exercise could improve the symptom and indexes associated with osteoporosis in postmenopausal women.Guangzhou and Liuzhou hospital of traditional Chinese medicine in China.Women (n = 198) aged 50 to 75 years were randomized into Control, Ca, MESE, and MESE + Ca.Subjects in Ca and MESE groups were separately asked to consume thrice daily Calcium Carbonate Chewable D3 tablet and to perform thrice daily MESE exercise by 7 repetitions per time for 12 months. Subjects in MESE + Ca group performed such the combined treatment project for 12 months. Body height and Hospital for Special Surgery (HSS) scores of both knees, chronic back pain visual analogue scale scores (VAS), bone mineral density (BMD) at L2 to L4 and the left femoral neck, 3-feet Up and Go Test (3′) and one-leg Stance (OLS).In our study, the improvement in chronic back pain of the patients in Ca, MESE, and MESE + Ca group was better than that in control group. There was 1.9% and 1.7%, 2.3%, and 2.1% net profit in left femoral neck and lumbar BMD after the treatment for 12 months in MESE and MESE + Ca groups. For the balance capacity, the subjects in MESE and MESE + Ca groups secured much better performance than those in Ca and control group after the treatment for 12 months (P < 0.001, P < 0.001).The treatment of MESE exercise is the most effective for the improvement of the symptom and indexes in postmenopausal women. Importantly, the low attrition and the high exercise compliance indicate that MESE exercise is safe, feasible, and well tolerated by postmenopausal women.

Salvia Miltiorrhiza: From the field to the bedside

Traditional Chinese medicine (TCM) has over 3000 years of history to treat diseases in China and has played a pivotal role in the Chinese health system. But its observation- or experience-based feature requires for the solid scientific evidence in quality, safety and efficacy to evolve it into an evidence-based medicine system. In the past 20 years or so, great progress has been achieved on the modernization of traditional Chinese medicine in China. Here we examined a typical Chinese medicinal herb named Chinese Salvia from its field cultivation to the basic research and finally to the development of marketed drug to reflect the recent achievements in the modernization of traditional Chinese medicines. Salvia miltiorrhiza was one of the earliest recorded Chinese herbs in “Shennong Bencao Jing” dating back to the Han dynasty. Since then, it was recorded in almost all ancient herbal books and now in Chinese Pharmacopoeia. It is now widely cultivated in the middle parts of China including provinces of Henan, Shaanxi, Shanxi, Sichuan and Zhejiang. The phytochemical investigation showed that it mainly contains salvianolic acids and tanshinones as its active components. Quantitative and qualitative determination and phytochemical profiling by series of hyphenated techniques clarified its main active constituents and minor ones. Pharmaokinetic investigation was thoroughly carried out to clarify its metabolic pathways. Biological research including adoption of systems biology approaches shed light on its action of mechanism and regulation network for the targeted proteins. The above-mentioned research laid a solid foundation for its clinical usage and new drug development. In the past years, a series of finished products directly developed from this herb or products using Danshen as the main ingredient have been marketed in China and now the total annual groß sales of Danshen related products reached 5 billion dollars. To name a few typical products are Depside salt (0.8 billion $/year), Dantonic pill (0.5 billion $/year). The future perspective of TCM modernization will be finally projected.

Integrated pharmacokinetics and biodistribution of multiple flavonoid C-glycosides components in rat after oral administration of Abrus mollis extract and correlations with bio-effects

Ethnopharmacological relevanceAbrus mollis, a commonly used traditional Chinese medicine in China and other Asia countries, has been used clinically to prevent and treat hepatitis and alcoholic liver disease for decades. Materials and methodsA modified HPLC–MS method was developed for the determination of vicenin-2 (AM-I), isoschaftoside (AM-II), and schaftoside (AM-III) of AM extract (AME) in rat plasma and tissues (heart, liver, spleen, lungs, and kidneys). Following oral administration of AME to rat at a dose of 200mg/kg, the concentrations of AM-I, II and III in plasma and tissues were quantified. An integrated double peak pharmacokinetics model was used to fit the concentration–time curves. The effects of drug on the bile flow and toe swelling of rats induced by carrageenan were also studied. ResultsThe limit of quantitation of this modified HPLC–MS method decreased from 25 to 5ng/mL for plasma and from 100 to 10ng/g for tissue. These concentration–time curves show two successive maximum concentrations. The results of integrated double peak pharmacokinetics in this paper indicated that the three flavonoid C-glycosides may be absorbed by two sites of intestine in vivo. These results of bile flow and toe swelling showed a significant correlation between the pharmacokinetics and pharmacodynamics. ConclusionsThe novel integrated double peak pharmacokinetic approach to studying the holistic pharmacokinetic properties of traditional Chinese medicine has been successfully developed and validated using AM as a model drug. This study would be a useful guide for the holistic double peak pharmacokinetic study in consistence with the intrinsic theory and characteristics of traditional Chinese medicine.