Traditional Chinese Medicine: 

An Introduction 

Traditional Chinese medicine (TCM) originated in ancient China and 

has evolved over thousands of years. TCM practitioners use herbs, 

acupuncture, and other methods to treat a wide range of conditions. 

In the United States, TCM is considered part of complementary and 

alternative medicine (CAM). This fact sheet provides a general 

overview of TCM and suggests sources for additional information. 

Key Points 

	 Herbal remedies and acupuncture are the treatments most 

commonly used by TCM practitioners. Other TCM practices 

include moxibustion, cupping, massage, mind-body therapy, and 

dietary therapy. 

	 The TCM view of how the human body works, what causes 

illness, and how to treat illness is different from Western 

medicine concepts. Although TCM is used by the American 

public, scientific evidence of its effectiveness is, for the most 

part, limited. Acupuncture has the largest body of evidence and 

is considered safe if practiced correctly. Some Chinese herbal 

remedies may be safe, but others may not be. 

	 TCM is typically delivered by a practitioner. Before using TCM, 

ask about the practitioner’s qualifications, including training and 

licensure. 

	 Tell all your health care providers about any complementary and 

alternative practices you use. Give them a full picture of what 

you do to manage your health. This will help ensure coordinated 

and safe care. 

Background 

Traditional Chinese medicine, which encompasses many different 

practices, is rooted in the ancient philosophy of Taoism and dates 

back more than 5,000 years. Today, TCM is practiced side by side 

with Western medicine in many of China’s hospitals and clinics. 
 

TCM is widely used in the United States. Although the exact number of people who use TCM in 

the United States is unknown, it was estimated in 1997 that some 10,000 practitioners served 

more than 1 million patients each year. According to the 2007 National Health Interview 

Survey, which included questions on the use of various CAM therapies, an estimated 3.1 

million U.S. adults had used acupuncture in the previous year. In addition, according to this 

same survey, approximately 17 percent of adults use natural products, including herbs, 

making it the most commonly used therapy. In another survey, more than one-third of the 

patients at six large acupuncture clinics said they also received Chinese herbal treatments at 

the clinics. 

Underlying Concepts 

Underlying the practice of TCM is a unique view of the world and the human body that is 

different from Western medicine concepts. This view is based on the ancient Chinese 

perception of humans as microcosms of the larger, surrounding universe—interconnected 

with nature and subject to its forces. The human body is regarded as an organic entity in 

which the various organs, tissues, and other parts have distinct functions but are all 

interdependent. In this view, health and disease relate to balance of the functions. 

The theoretical framework of TCM has a number of key components: 

	 Yin-yang theory—the concept of two opposing, yet complementary, forces that shape the 

world and all life—is central to TCM. 

	 In the TCM view, a vital energy or life force called qi circulates in the body through a 

system of pathways called meridians. Health is an ongoing process of maintaining balance 

and harmony in the circulation of qi. 

	 The TCM approach uses eight principles to analyze symptoms and categorize conditions: 

cold/heat, interior/exterior, excess/deficiency, and yin/yang (the chief principles). TCM also 

uses the theory of five elements—fire, earth, metal, water, and wood—to explain how the 

body works; these elements correspond to particular organs and tissues in the body. 

These concepts are documented in the Huang Di Nei Jing (Inner Canon of the Yellow Emperor), the 

classic Chinese medicine text. 

Treatment 

TCM emphasizes individualized treatment. Practitioners traditionally used four methods to 

evaluate a patient’s condition: observing (especially the tongue), hearing/smelling, 

asking/interviewing, and touching/palpating (especially the pulse). 

TCM practitioners use a variety of therapies in an effort to promote health and treat disease. 

The most commonly used are Chinese herbal medicine and acupuncture. 

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	 Chinese herbal medicine. The Chinese materia medica (a pharmacological reference book 

used by TCM practitioners) contains hundreds of medicinal substances—primarily plants, 

but also some minerals and animal products—classified by their perceived action in the 

body. Different parts of plants such as the leaves, roots, stems, flowers, and seeds are used. 

Usually, herbs are combined in formulas and given as teas, capsules, tinctures, or powders. 

	 Acupuncture. By stimulating specific points on the body, most often by inserting thin 

metal needles through the skin, practitioners seek to remove blockages in the flow of qi. 

Other TCM therapies include moxibustion (burning moxa—a cone or stick of dried herb, 

usually mugwort—on or near the skin, sometimes in conjunction with acupuncture); cupping 

(applying a heated cup to the skin to create a slight suction); Chinese massage; mind-body 

therapies such as qi gong and tai chi; and dietary therapy. 

Status of TCM Research 

In spite of the widespread use of TCM in China and its use in the West, scientific evidence of 

its effectiveness is, for the most part, limited. TCM’s complexity and underlying conceptual 

foundations present challenges for researchers seeking evidence on whether and how it works. 

Most research has focused on specific modalities, primarily acupuncture and Chinese herbal 

remedies. 

Acupuncture research has produced a large body of scientific evidence. Studies suggest that it 

may be useful for a number of different conditions, but additional research is still needed. 

Chinese herbal medicine has also been studied for a wide range of conditions. Most of the 

research has been done in China. Although there is evidence that herbs may be effective for 

some conditions, most studies have been methodologically flawed, and additional, better 

designed research is needed before any conclusions can be drawn. 

Examples of TCM Uses and Studies 

Both acupuncture and Chinese herbal medicine have been used and studied for a wide range 

of conditions. A few examples are: 

Acupuncture 	 Chinese herbal medicine 

 Back Pain  Cancer 


 Chemotherapy-induced nausea  Heart disease 


 Depression  Diabetes 


 Osteoarthritis  HIV/AIDS
 

Safety 

The U.S. Food and Drug Administration (FDA) regulations for dietary supplements (including 

manufactured herbal products) are not the same as those for prescription or over-the-counter 

drugs; in general, the regulations for dietary supplements are less strict. Some Chinese herbal 

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treatments may be safe, but others may not be. There have been reports of products being 

contaminated with drugs, toxins, or heavy metals or not containing the listed ingredients. 

Some of the herbs are very powerful, can interact with drugs, and may have serious side 

effects. For example, the Chinese herb ephedra (ma huang) has been linked to serious health 

complications, including heart attack and stroke. In 2004, the FDA banned the sale of ephedracontaining dietary supplements used for weight loss and performance enhancement, but the 

ban does not apply to TCM remedies or to herbal teas. 

Acupuncture is considered safe when performed by an experienced practitioner using sterile 

needles. 

Training, Licensing, and Certification 

Most states license acupuncture, but states vary in their inclusion of other TCM components 

(e.g., herbal medicine) in the licenses they issue. The federally recognized Accreditation 

Commission for Acupuncture and Oriental Medicine (ACAOM) accredits schools that teach 

acupuncture and TCM, and about one-third of the states that license acupuncture require 

graduation from an ACAOM-accredited school. The National Certification Commission for 

Acupuncture and Oriental Medicine (NCCAOM) offers separate certification programs in 

acupuncture, Chinese herbology, and Oriental bodywork. Almost all licensing states require 

completion of NCCAOM’s national written exam; some states also require a practical exam. 

If You Are Thinking About Using TCM 

	 Look for published research studies on TCM for the health condition that interests you. 

	 If you are thinking about trying TCM herbal remedies, it is better to use these products 

under the supervision of a medical professional trained in herbal medicine than to try to 

treat yourself. 

	 Ask about the training and experience of the TCM practitioner you are considering. 

	 Do not use TCM as a replacement for effective conventional care or as a reason to postpone 

seeing a health care provider about a medical problem. 

	 If you are pregnant or nursing, or are thinking of using TCM to treat a child, you should be 

especially sure to consult your health care provider. 

	 Tell all your health care providers about any complementary and alternative practices you 

use. Give them a full picture of what you do to manage your health. This will help ensure 

coordinated and safe care. For tips about talking with your health care providers about 

CAM, see NCCAM’s Time to Talk campaign at nccam.nih.gov/timetotalk/. 

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NCCAM-Funded Research 

Recent NCCAM-supported studies have been investigating: 

 TCM for endometriosis-related pelvic pain, irritable bowel syndrome, and 

temporomandibular (jaw) disorders 

 Chinese herbal medicines for food allergies and for osteoarthritis of the knee 

 Consistency of TCM practitioners’ diagnosis and herbal prescriptions for rheumatoid 

arthritis patients. 

Selected References 

Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 

2007. CDC National Health Statistics Report #12. 2008. 

Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. Rev. ed. Seattle, WA: Eastland Press; 1993. 

Cassidy, C. Chinese medicine users in the United States. Part I: utilization, satisfaction, medical plurality. Journal of 

Alternative and Complementary Medicine. 1998;4(1):17-27. 

Eisenberg DM, Cohen MH, Hrbek A, et al. Credentialing complementary and alternative medical providers. Annals of 

Internal Medicine. 2002;137(12):965-973. 

National Center for Complementary and Alternative Medicine. Acupuncture: An Introduction. Bethesda, MD: National 

Center for Complementary and Alternative Medicine. NCCAM publication no. D404. 

National Center for Complementary and Alternative Medicine. Using Dietary Supplements Wisely. Bethesda, MD: 

National Center for Complementary and Alternative Medicine. NCCAM publication no. D426. 

National Institutes of Health Consensus Panel. Acupuncture: National Institutes of Health Consensus Development Conference Statement. 

National Institutes of Health Web site. Accessed at http://consensus.nih.gov/1997/1997acupuncture107html.htm on July 15, 2008. 

O’Brien KA, Xue CC. The theoretical framework of Chinese medicine. In: Leung PC, Xue CC, Cheng YC, eds. A Comprehensive Guide 

to Chinese Medicine. River Edge, NJ: World Scientific Publishing Co.; 2003. 

Shang A, Huwiler K, Nartey L, et al. Placebo-controlled trials of Chinese herbal medicine and conventional medicine 

comparative study. International Journal of Epidemiology. 2007;36(5):1086-1092. 

Shankar K, Liao, LP. Traditional systems of medicine. Physical Medicine and Rehabilitation Clinics of North America. 

2004;15(4):725-747. 

Traditional Chinese medicine. Natural Medicines Comprehensive Database. Accessed at http://www.naturaldatabase.com on 

June 4, 2008. 

Traditional Chinese medicine (TCM). Natural Standard Database Web site. Accessed at http://www.naturalstandard.com on 

June 4, 2008. 

Xue CC, O’Brien KA. Modalities of Chinese medicine. In: Leung PC, Xue CC, Cheng YC, eds. A Comprehensive Guide to 

Chinese Medicine. River Edge, NJ: World Scientific Publishing Co.; 2003. 

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For More Information 

NCCAM Clearinghouse 

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications 

and searches of Federal databases of scientific and medical literature. The Clearinghouse does 

not provide medical advice, treatment recommendations, or referrals to practitioners. 

Toll-free in the U.S.: 1-888-644-6226 

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 

Web site: nccam.nih.gov 

E-mail: info@nccam.nih.gov 

PubMed® 

A service of the National Library of Medicine (NLM), PubMed contains publication information 


and (in most cases) brief summaries of articles from scientific and medical journals. CAM on 


PubMed®:, developed jointly by NCCAM and NLM, is a subset of the PubMed system and 


focuses on the topic of CAM.
 

Web site: www.ncbi.nlm.nih.gov/sites/entrez 


CAM on PubMed®: nccam.nih.gov/research/camonpubmed/ 


The Cochrane Database of Systematic Reviews 

The Cochrane Database of Systematic Reviews is a collection of evidence-based reviews 

produced by the Cochrane Library, an international nonprofit organization. The reviews 

summarize the results of clinical trials on health care interventions. Summaries are free; fulltext reviews are by subscription only. 

Web site: www.cochrane.org/reviews 

ClinicalTrials.gov 

ClinicalTrials.gov is a database of information on federally and privately supported clinical 

trials (research studies in people) for a wide range of diseases and conditions. It is sponsored 

by the National Institutes of Health and the U.S. Food and Drug Administration. 

Web site: www.clinicaltrials.gov 

Research Portfolio Online Reporting Tool (RePORT) 

RePORTER is a database of information on federally funded scientific and medical research 

projects being conducted at research institutions. 

Web site: projectreporter.nih.gov 

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NIH National Library of Medicine’s MedlinePlus 

To provide resources that help answer health questions, MedlinePlus brings together 

authoritative information from NIH as well as other Government agencies and health-related 

organizations. 

Web site: www.medlineplus.gov 

Acknowledgments 

NCCAM thanks the following people for their technical expertise and review of this 

publication: Brian Berman, M.D., University of Maryland Center for Integrative Medicine; 

Adeline Ge, M.D., O.M.D., NCCAM Complementary and Integrative Medicine Consult Service, 

NIH Clinical Center; and Partap Khalsa, D.C., Ph.D., NCCAM. 

This publication is not copyrighted and is in the public domain.
 

Duplication is encouraged.
 

NCCAM has provided this material for your information. It is not intended to substitute 

for the medical expertise and advice of your primary health care provider. We encourage 

you to discuss any decisions about treatment or care with your health care provider. The 

mention of any product, service, or therapy is not an endorsement by NCCAM. 

National Institutes of Health 



U.S. Department of Health and Human Services 

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D428 

Created March 2009 

Updated June 2010