# Analysis of the Characteristics of Dominant Diseases in Traditional Chinese Medicine: Based on 95 Diseases

Authors: Hanting Wu; Yi Liang; Qiushuang Li; Peijie Hei; Juan Liang; Rongchen Dai; Conghua Ji
Journal: Evidence-Based Complementary and Alternative Medicine
 (2022)

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## Abstract

Background. Traditional Chinese medicine (TCM) has been widely used all over the world and has shown its superiority in some diseases. However, there are no clear evaluation criteria for TCM. In 2019, a list of TCM dominant diseases was published by the Chinese National Administration of Traditional Chinese Medicine. This study aimed to systematically summarize the characteristics of 95 TCM dominant diseases and provide a reference for the establishment of evaluation criteria for TCM dominant diseases. Methods. The diagnosis and treatment protocols of all the 95 TCM dominant diseases were screened. The data of disease classification, diseases’ code of TCM, length of hospital stay, treatment protocols, and clinical pathways were reviewed and summarized. Results. The diseases of the genitourinary and nervous systems accounted for 14.74% and 12.73% of the TCM dominant diseases, respectively. The length of hospital stay for 55 (57.89%) diseases was no more than less than 14 days. Each disease had its specific Chinese herbal decoction pieces and Chinese patent drugs. Chinese medical injections were not widely used. TCM external treatments for these diseases are abundant, with hundreds optional. Conclusion. Some potentially promising TCM dominant diseases remain to be identified and deserve further research to establish the evaluation criteria of TCM dominant diseases.


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## Body

## 1. Introduction

TCM has been widely used in the treatment of various diseases in China for thousands of years and has shown its potential and superiority in many diseases such as leukemia, irritable bowel syndrome, and angina pectoris [1–5]. Therefore, the conception of TCM dominant diseases was born. The dominant diseases of TCM mainly refer to diseases for which there is currently no targeted western medical treatment and TCM has a definite effect, or the toxic side effects and drug-induced, iatrogenic disorders of TCM were less than western therapy [6]. For example, some chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), are commonly treated with corticosteroids, which are often accompanied by side effects [7]. Based on conventional therapies, the application of TCM not only significantly improved the symptom of acute exacerbations of COPD (AECOPD) but also reduced hospital stay (mean difference, −1.21 days; P=0.003) and the number of AECOPD readmissions (RR, 0.41; P=0.015), greatly reducing the overall burden of disease [8].The evaluation criteria of dominant diseases of TCM are used to define a certain disease as the dominant disease of TCM. However, the criteria should be recognized by the majority of medical workers before it is beneficial for better clinical promotion and application of TCM to provide patients with better curative medical services. Currently, the consensus within countries or industries concerning the evaluation criteria and evaluation tools for dominant diseases of TCM has not been reached yet [9]. There are no mature evaluation systems for the definition of TCM’s dominant diseases.Commissioned by the Chinese National Administration of Traditional Chinese Medicine, the China Association of Chinese Medicine assembled a panel of TCM experts from across the country in 2018 to systematically collect and summarize opinions on dominant diseases of TCM. In 2019, a list of 95 dominant diseases of TCM was published by the Chinese National Administration of Traditional Chinese Medicine with the diagnosis, treatment program, and clinical pathway of these diseases [10]. Definite Chinese medical treatment options, clinical pathway, and objective evaluation criteria of the clinical efficacy were established for these diseases through clinical practice, with broad consensus. This study was conducted to comprehensively summarize the classification of these TCM dominant diseases and the application of TCM treatment, aiming to identify the characteristics of the 95 dominant diseases of TCM and provide a reference for the further selection of TCM dominant diseases and establishment of clear evaluation criteria.


## 2. Methods

### 2.1. Data Sources

The 95 TCM dominant diseases, promulgated by the Chinese National Administration of Traditional Chinese Medicine, were selected as the subjects of this study. Basic information about the International Classification of Diseases (ICD) 10 code [11], ICD 11-code [12], disease classification, and length of hospital stay was collected. Chinese medical treatment protocols were categorized as TCM (oral TCM decoction, oral Chinese patent medicine, and TCM injection) and external treatment of TCM (including external treatment of TCM, acupuncture, moxibustion, manipulation, anorectal of TCM, special therapy of TCM, and comprehensive therapy of TCM).ICD is a health statistics coding tool and is widely used in clinical practice. Based on ICD 10, substantial improvement was made in ICD 11. More unique codes for injuries and diseases and a new chapter focusing on traditional medicine were also included in ICD 11 [12].


### 2.2. Data Extraction

The diagnosis and treatment protocols of each disease were screened and data were extracted by two researchers independently using a standard data extraction table. Then, they crosschecked the table after primary extraction. Disagreements were resolved through discussion or the suggestion of a third reviewer. The main contents of the table were as follows: disease, classification of diseases, diseases’ code of TCM, length of hospital stay, diseases’ name in western medicine, code in ICD-10 and ICD-11, optional TCM therapies, and optional TCM external therapies.


### 2.3. Statistical Methods

Statistical analyses were performed using the SPSS software (SPSS Standard version 23.0, SPSS Inc., Chicago, IL). Continuous variables were presented as means ± SD, minimum value, and maximum value. Categorical variables were classified and shown as numbers and percentages. Differences between groups were tested by Student’st-test, chi-square test, or rank-sum test, respectively. Significant differences were defined as P<0.05.


## 2.1. Data Sources

The 95 TCM dominant diseases, promulgated by the Chinese National Administration of Traditional Chinese Medicine, were selected as the subjects of this study. Basic information about the International Classification of Diseases (ICD) 10 code [11], ICD 11-code [12], disease classification, and length of hospital stay was collected. Chinese medical treatment protocols were categorized as TCM (oral TCM decoction, oral Chinese patent medicine, and TCM injection) and external treatment of TCM (including external treatment of TCM, acupuncture, moxibustion, manipulation, anorectal of TCM, special therapy of TCM, and comprehensive therapy of TCM).ICD is a health statistics coding tool and is widely used in clinical practice. Based on ICD 10, substantial improvement was made in ICD 11. More unique codes for injuries and diseases and a new chapter focusing on traditional medicine were also included in ICD 11 [12].


## 2.2. Data Extraction

The diagnosis and treatment protocols of each disease were screened and data were extracted by two researchers independently using a standard data extraction table. Then, they crosschecked the table after primary extraction. Disagreements were resolved through discussion or the suggestion of a third reviewer. The main contents of the table were as follows: disease, classification of diseases, diseases’ code of TCM, length of hospital stay, diseases’ name in western medicine, code in ICD-10 and ICD-11, optional TCM therapies, and optional TCM external therapies.


## 2.3. Statistical Methods

Statistical analyses were performed using the SPSS software (SPSS Standard version 23.0, SPSS Inc., Chicago, IL). Continuous variables were presented as means ± SD, minimum value, and maximum value. Categorical variables were classified and shown as numbers and percentages. Differences between groups were tested by Student’st-test, chi-square test, or rank-sum test, respectively. Significant differences were defined as P<0.05.


## 3. Results

### 3.1. Basic Characteristics

Diseases were classified using ICD-10. Of the 95 included diseases, diseases of the genitourinary system accounted for the largest proportion (n = 14, 14.74%); other classifications proportional from high to low in turn were diseases of the nervous system (n = 12, 12.63%), diseases of the digestive system (n = 10, 10.53%), diseases of the respiratory system (n = 8, 8.42%), neoplasms (n = 8, 8.42%), certain infectious and parasitic diseases (n = 7, 7.37%), diseases of the musculoskeletal system and connective tissue (n = 7, 7.37%), diseases of the skin and subcutaneous tissue (n = 7, 7.37%), diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (n = 7, 7.37%), diseases of the circulatory system (n = 5, 5.26%), diseases of the eye and adnexa (n = 4, 4.21%), mental and behavioral disorders (n = 3, 3.16%), endocrine, nutritional, and metabolic diseases (n = 2, 2.11%), and diseases of the ear and mastoid process (n = 1, 1.05%). The 95 dominant diseases covered almost all disease systems.Although there was specific TCM therapy for each disease, not every one of them had a TCM disease code. The results showed that 33 (34.74%) of the 95 diseases had no TCM disease name and used a western medicine name in clinical practice.Length of hospital stay ranged from ≤7 days to ≤35 days. As is shown in Table1, a total of 50 (52.63%) diseases’ average length of stay was ≤14 days and maximally not exceeding 35 days.Table 1
Basic characteristics of 95 dominant diseases of traditional Chinese medicine.
Disease classificationDiseasesDiseases’ coding of TCMLength of hospital stayNProportion (%)AvailableNo≤7≤14≤21≤28≤35Diseases of the genitourinary system1414.74122014000Diseases of the nervous system1212.6312003450Diseases of the digestive system1010.539112430Diseases of the respiratory system88.427116010Neoplasms88.423505111Certain infectious and parasitic diseases77.371604210Diseases of the musculoskeletal system and connective tissue77.373402320Diseases of the skin and subcutaneous tissue77.374311230Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism77.370705200Diseases of the circulatory system55.263204100Diseases of the eye and adnexa44.213100130Mental and behavioral disorders33.163012000Endocrine, nutritional, and metabolic diseases22.111102000Diseases of the ear and mastoid process11.051010000Total95100623355020191TCM, traditional Chinese medicine.


### 3.2. Application of TCM

The application of TCM was summarized in Table2; Chinese herbal decoction pieces and Chinese patent drugs were all used in the 95 dominant diseases of TCM. However, the utilization of Chinese medical injections varied from 28.57 to 100.00%, with a total rate of 63.16%. The lowest rate (2/7) of Chinese medical injections use was seen in diseases of the skin and subcutaneous tissue.Table 2
Application of TCM in the treatment of 95 dominant diseases of TCM.
Disease classificationNumber of diseasesChinese herbal decoction piecesChinese patent drugsChinese medical injectionsnProportion (%)nProportion (%)nProportion (%)Diseases of the genitourinary system1414100.0014100.00642.86Diseases of the nervous system1212100.0012100.00866.67Diseases of the digestive system1010100.0010100.00770.00Diseases of the respiratory system88100.008100.00562.50Neoplasms88100.008100.00787.50Certain infectious and parasitic diseases77100.007100.007100.00Diseases of the musculoskeletal system and connective tissue77100.007100.00571.43Diseases of the skin and subcutaneous tissue77100.007100.00228.57Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism77100.007100.00571.43Diseases of the circulatory system55100.005100.00240.00Diseases of the eye and adnexa44100.004100.00375.00Mental and behavioral disorders33100.003100.00133.33Endocrine, nutritional, and metabolic diseases22100.002100.00150.00Diseases of the ear and mastoid process11100.001100.001100.00Total9595100.0095100.006063.16


### 3.3. Application of TCM External Treatment

Table3 and Table 4 indicated that, for each of included diseases, there was at least one TCM external therapy, and the number of external therapies can reach a maximum of 10. Acupuncture, moxibustion, manipulation, and Chinese medical plastering therapy were most widely applied in these diseases. Among them, acupuncture included ear acupuncture, collateral pricking, cutaneous needle, plum-blossom needle, and many other techniques. Uncommon characteristic therapies of TCM such as acupoint injection, TCM ion introduction, TCM enema, and TCM positive ridge were also widely used in these diseases.Table 3
Application of TCM external treatment in 95 dominant diseases of TCM.
Disease classificationNumber of diseasesNumber of optional TCM external therapiesNumber of optional TCM external therapies/number of diseasesDiseases of the musculoskeletal system and connective tissue7476.71Diseases of the skin and subcutaneous tissue7324.57Diseases of the circulatory system5224.40Diseases of the respiratory system8344.25Diseases of the ear and mastoid process144.00Diseases of the nervous system12463.83Neoplasms9343.78Diseases of the genitourinary system14473.36Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism6193.17Diseases of the digestive system10292.90Diseases of the eye and adnexa4112.75Certain infectious and parasitic diseases7182.57Endocrine, nutritional, and metabolic diseases252.50Mental and behavioral disorders362.00Total953543.73Table 4
Application of TCM external treatment in 95 dominant diseases of TCM (detailed).
Serial numberDisease name in western medicineDisease code in ICD 10Disease code in ICD 11Optional TCM external therapiesDisease classification1Viral encephalitis (acute stage)A86/G05.11C80(1) Acupuncture① Ear acupuncture② Collateral pricking③ Cutaneous needle④ Plum-Blossom needleCertain infectious and parasitic diseases2Dengue feverAP0 × 001D2Z(1) TCM external washing(2) TCM enemaCertain infectious and parasitic diseases3Ramsay Hunt syndromeB02.2038B88.Y(1) Acupuncture① Body acupuncture② Electroacupuncture(2) Moxibustion(3) Cupping(4) ManipulationCertain infectious and parasitic diseases4Hand, foot, and mouth disease（severe ）B08.4011F05.0(1) Acupuncture(2) ManipulationCertain infectious and parasitic diseases5Hepatitis B virus associated glomerulonephritisB10.910+GB40 and1E51.0Z(1) Acupuncture(2) Electronic biofeedback therapeutic instrument(3) TCM enemaCertain infectious and parasitic diseases6Viral hepatitis EB17.2021E51.3(1) Acupuncture(2) Ear pressure beans(3) TCM enema(4) MoxibustionCertain infectious and parasitic diseases7Infectious mononucleosis (without serious complications)B27.9011D81.Z(1) TCM spray pharynx(2) TCM compressCertain infectious and parasitic diseases8Malignant neoplasm of breast (perioperative period)C50.9002C6Z(1) Acupuncture(2) Acupoint application(3) Moxibustion(4) TCM hot compressNeoplasms9Malignant neoplasm of breast (consolidation stage)C50.9022C6Z(1) Acupuncture(2) Moxibustion(3) Ear pressure beans(4) TCM diagnosis and treatment equipmentNeoplasms10Malignant neoplasm of ovaryC56.X002C73.Z(1) TCM application(2) Acupuncture(3) Ear pressure beans(4) Cupping(5) MoxibustionNeoplasms11Malignant neoplasm of prostateC61.x002C82.Z(1) TCM soaking(2) Moxibustion(3) Acupoint application(4) AcupunctureNeoplasms12Malignant lymphoma/aggressive lymphoma (after chemotherapy)C822B33.5(1) TCM compress(2) Acupuncture;(3) MoxibustionNeoplasms13Acute lymphoblastic leukemiaC91.0012B33.3(1) Acupoint application(2) Ear pressure beans(3) TCM soaking(4) Medicated diet and dietotherapyNeoplasms14Acute myeloblastic leukemia (elderly)C92.0042A60.3Z(1) Ear pressure beans(2) Moxibustion(3) Acupoint application(4) Acupoint ironingNeoplasms15Acute promyelocytic leukemia (low and intermediate risk)C92.401，M986604/32A60.0(1) TCM compressNeoplasms16Polycythemia veraD45.X012A20.4(1) TCM foot bath(2) Acupoint application(3) Acupuncture(4) TCM compress(5) Bloodletting therapyNeoplasms17Megaloblastic anemiaD53.1003A01.Y(1) Medicated diet and dietotherapy(2) Acupuncture(3) MoxibustionDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism18Purpura nephritis (children)D69.005GB55.Y/3B60(1) Moxibustion(2) Ear pressure beans(3) Low-frequency pulse electrical stimulation(4) TCM fumigationDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism19Secondary thrombocytopenia (after chemotherapy)D69.6023B64.1Y(1) TCM compress(2) Acupoint applicationDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism20Leukopenia(after chemotherapy)D72.9014B00.01(1) Acupuncture(2) Moxibustion(3) Acupoint injectionDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism21Essential thrombocythaemiaD47.3003B63.1Z(1) Acupuncture(2) Moxibustion(3) Manipulation(4) TCM compressDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism22Anemia (tumor associated)D52.1003A71.0(1) Moxibustion(2) Acupoint application(3) Medicated diet and dietotherapyDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism23Abnormality of lipid metabolism (diabetic)E14.6005C62and5A14(1) Acupuncture(2) Moxibustion(3) Ear acupuncture(4) ManipulationEndocrine, nutritional and metabolic diseases24Diabetic footE14.606BD54(1) TCM compressEndocrine, nutritional and metabolic diseases25Mental and behavioral disorders due to the use of alcoholF10.9006C40.6Z(1) Transcutaneous electrical acupoint stimulation(2) Ear acupuncture(3) Bloodletting therapyMental and behavioral disorders26Acute stress responseF43.0QE84(1) AcupunctureMental and behavioral disorders27Dissociative [conversion] disordersF446B60.Z(1) Acupuncture(2) Acupoint applicationMental and behavioral disorders28Motor neuron diseaseG12.2108B60.Z(1) Acupuncture(2) Moxibustion(3) Acupoint injection(4) Cutaneous needle(5) ManipulationDiseases of the nervous system29Parkinsonism-plus syndromeG20.028A00.Y(1) Acupuncture: ① scalp acupuncture; ② body acupuncture(2) TCM soaking(3) Moxibustion(4) ManipulationDiseases of the nervous system30Parkinson disease (with bladder dysfunction)G20.028A00.Y(1) Acupuncture(2) Moxibustion(3) TCM compress(4) TCM psychotherapy(5) Low-frequency pulse electrical stimulationDiseases of the nervous system31Alzheimer diseaseG30.98A20(1) Sensory irritation(2) Cognitive stimulation(3) Emotional interventionDiseases of the nervous system32Neuromyelitis opticaG36.0018A43.Z(1) AcupunctureDiseases of the nervous system33Cervical headacheG44.8018A84.Y(1) Acupuncture(2) Manipulation(3) Traction treatment (4) MoxibustionDiseases of the nervous system34Posterior circulation ischemiaG45.08B10.Y(1) TCM compress(2) AcupunctureDiseases of the nervous system35Carpal tunnel syndromeG56.0018C10.0(1) Manipulation(2) Electroacupuncture(3) TCM hot compress(4) TCM soakingDiseases of the nervous system36Ankle canal syndromeG57.5028C1Z(1) Manipulation(2) Acupuncture(3) Electroacupuncture(4) TCM hot compress(5) TCM soaking; 6)MoxibustionDiseases of the nervous system37Chronic inflammatory demyelinating polyneuropathyG61.8018C01.3(1) Acupuncture(2) Moxibustion(3) Manipulation(4) TCM soakingDiseases of the nervous system38Myasthenia gravisG70.0008C60.Z(1) Acupoint injection(2) Cutaneous needle(3) TCM soaking(4) Manipulation(5) Acupoint applicationDiseases of the nervous system39Muscular dystrophy (progressive)G71.0018C70(1) External TCM(2) Acupoint injection(3) TCM enemaDiseases of the nervous system40Retinal artery occlusion (branch)H34.2029B74.0(1) Acupuncture(2) Moxibustion(3) Ear pressure beans(4) Acupoint injectionDiseases of the eye and adnexa41Senile macular degeneration (atrophic) (exudative)H35.3119B75.0Y(1) Acupuncture(2) MoxibustionDiseases of the eye and adnexa42Vitreous hemorrhageH43.1009B83(1) Acupoint injection(2) Ocular iontophoresis(3) Acupuncture(4) MoxibustionDiseases of the eye and adnexa43External ophthalmoplegiaH49.8079C82.Z(1) AcupunctureDiseases of the eye and adnexa44Ménière’s diseaseH81.000AB31.0(1) Acupuncture: ① body acupuncture; ② ear acupuncture; ③ scalp acupuncture(2) Moxibustion(3) Acupoint injection(4) Ear pressure beansDiseases of the ear and mastoid process45Viral myocarditis (children)I40.001\I41.1BC42.1(1) Acupuncture(2) Manipulation(3) Acupoint application(4) Acupoint injectionDiseases of the circulatory system46Diabetic peripheral angiopathyI79.202BD53.Y(1) Acupuncture(2) Moxibustion(3) TCM fumigationDiseases of the circulatory system47ThrombophlebitisI80.902BD70.Z(1) TCM compressDiseases of the circulatory system48VaricoceleI86.1015A81.1(1) Acupuncture(2) Moxibustion(3) Needle-picking(4) Acupoint application(5) Acupoint injectionDiseases of the circulatory system49Mesenteric lymphadenitis (children)I88.002BD90.1(1) Acupoint application(2) Manipulation(3) Moxibustion(4) TCM ion introduction(5) TCM hot iron(6) TCM soaking(7) Acupuncture(8) Ear pressure beans(9) CuppingDiseases of the circulatory system50Acute tonsillitis (children)J03.900CA03.Z(1) Acupoint application(2) Acupuncture(3) MoxibustionDiseases of the respiratory system51Mycoplasma pneumoniaJ15.702CA40.04(1) TCM chest compress(2) Acupoint application(3) Cupping(4) TCM ion introduction(5) Umbilical therapyDiseases of the respiratory system52Severe community-acquired pneumoniaJ15.903CA40.Z(1) TCM ion introduction(2) TCM enemaDiseases of the respiratory system53Hospital-acquired pneumoniaJ18.8CA40.Z(1) Acupuncture(2) TCM atomization inhalation(3) TCM enema(4) TCM compress(5) Skin scraping therapyDiseases of the respiratory system54Acute tracheitis/bronchitisJ20.902CA42.Z(1) Acupoint application(2) Moxibustion(3) Acupuncture(4) Cupping(5) Stone needle therapyDiseases of the respiratory system55BronchiolitisJ21.902CA40.Z(1) Infantile tuina(2) TCM ion introduction(3) Acupoint application(4) TCM chest compress(5) TCM enema(6) Acupuncture(7) Ear pressure beans(8) Chiropractic therapyDiseases of the respiratory system56Pharyngeal abscessJ36.X00; J39.001; J39.003; J05.100CA0K.0(1) Acupuncture: ① body acupuncture; ② Bloodletting therapy(2) TCM external therapy: ① Insufflating medicinal powder, gargle, dissolving in the mouth, nebulization, compress, and evacuation of pus(3) Lifting and scraping therapyDiseases of the respiratory system57BronchiectasisJ47.x00CA24(1) Acupuncture(2) Moxibustion(3) Acupoint application(4) Acupoint injectionDiseases of the respiratory system58Gastritis (Helicobacter pylori-associated) (refractory)A49809 + （……）∗DA42.1(1) Acupuncture(2) Moxibustion(3) Abdominal paste massage(4) Acupoint applicationDiseases of the digestive system59Cryptitis(anal)K62.801DB70.Z(1) TCM fumigation(2) TCM compress(3) TurundaDiseases of the digestive system60Hypertrophy of anal papillaK62.806DB71.2(1) TCM fumigation(2) Turunda(3) TCM enemaDiseases of the digestive system61Alcoholic cirrhosis of liverK70.301DB94.2(1) Acupoint applicationDiseases of the digestive system62Hepatic failure (hepatitis B related) (early stage)K72.004DB99.7and1E51.0Z(1) TCM enema(2) TCM rectal instillationDiseases of the digestive system63Chronic hepatic failureK72.101DB99.8(1) TCM enema(2) TCM compressDiseases of the digestive system64Ascites (hepatitis B related) (hepatic sclerosis)K74 ＋ R181E51.0Z/DB93.1 + ME04.0(1) TCM umbilical therapy(2) Acupuncture(3) TCM enemaDiseases of the digestive system65Cholestatic hepatitisK75.802DB97.Y(1) TCM enema(2) Liver disease therapeutic apparatus(3) Acupuncture(4) MoxibustionDiseases of the digestive system66GallstoneK80.203DC11(1) Acupuncture(2) Moxibustion(3) Ear pressure beans(4) TCM enema(5) TCM applicationDiseases of the digestive system67Cholangitis (primary) (sclerosing)K83.0DB96.2Z(1) TCM fumigation(2) Liver disease therapeutic apparatusDiseases of the digestive system68ImpetigoL01.0001B72.Z(1) TCM external therapy(2) Acupuncture(3) MoxibustionDiseases of the skin and subcutaneous tissue69Pilonidal cyst (sacrococcygeal)L05.900EG63.0(1) TCM compress(2) TCM fumigationDiseases of the skin and subcutaneous tissue70Pustular psoriasisL40.100EA90.4(1) Acupuncture(2) Triangular needle quick puncture(3) Cupping and exsanguinationDiseases of the skin and subcutaneous tissue71PemphigusL10EB40.Z(1) TCM collapse stains(2) TCM scrub treatment(3) Moxibustion(4) TCM bath(5) Acupoint injection(6) AcupunctureDiseases of the skin and subcutaneous tissue72Erythroderma psoriasisL40.801EA90.3(1) TCM wet compress(2) TCM bath(3) TCM ointment or oil(4) Acupoint application(5) Acupuncture(6) Moxibustion(7) CuppingDiseases of the skin and subcutaneous tissue73Chronic actinic dermatitisL57.801EJ30.1(1) TCM external therapy(2) Acupuncture(3) Moxibustion(4) Ear pressure beansDiseases of the skin and subcutaneous tissue74Allergic cutaneous vasculitisL95.8024A44.BZ(1) TCM collapse stains(2) TCM scrub treatment(3) Acupuncture(4) Moxibustion(5) Ear acupuncture(6) TCM hydronium spray(7) Acupoint applicationDiseases of the skin and subcutaneous tissue75Lupus nephritisM32.101+4A40.0Y(1) Acupuncture(2) MoxibustionDiseases of the musculoskeletal system and connective tissue76Juvenile idiopathic scoliosisM41.992FA70.1(1) Tendon-soothing manipulation(2) TCM hot compress(3) TCM fumigation(4) Acupuncture(5) Manipulation(6) Chiropractic treatment(7) Needle knife treatment(8) Positive ridge(9) Traction(10) MoxibustionDiseases of the musculoskeletal system and connective tissue77Spondylolisthesis (lumbar)M43.162FA81.Z&XA0D60(1) Tendon-soothing manipulation(2) TCM hot compress(3) TCM fumigation(4) Acupuncture(5) Manipulation(6) Needle knife treatment(7) Positive ridge(8) Traction(9) MoxibustionDiseases of the musculoskeletal system and connective tissue78Contracture of muscle (gluteal)M62.405FB32.4&XA48F2(1) Manipulation(2) Acupuncture(3) Moxibustion(4) TCM hot compress(5) TCM soakingDiseases of the musculoskeletal system and connective tissue79MetatarsalgiaM77.401FB54.4(1) Body acupuncture(2) Ear acupuncture(3) Acupoint application(4) Moxibustion(5) TCM hot compressDiseases of the musculoskeletal system and connective tissue80FibromyalgiaM79.792MG30.01(1) TCM health exercises(2) Acupoint application(3) Acupuncture(4) TCM bath(5) TCM fumigation(6) TCM ion introduction(7) Musical therapy(8) MoxibustionDiseases of the musculoskeletal system and connective tissue81Degenerative lumbar spinal stenosisM48.061FA82(1) Tendon-soothing manipulation(2) TCM hot compress(3) Acupuncture(4) Manipulation(5) Needle knife treatment(6) Positive ridge(7) Traction(8) MoxibustionDiseases of the musculoskeletal system and connective tissue82Acute glomerulonephritisN00 + B95.5GB40(1) Acupuncture: ① body acupuncture② Ear acupunctureDiseases of the genitourinary system83Primary nephrotic syndrome (primary) (children)N04.900GB41(1) Moxibustion(2) Acupuncture(3) TCM compressDiseases of the genitourinary system84Idiopathic membranous nephropathyN05.201GB41(1) Medicated diet and dietotherapy(2) TCM soaking(3) Acupoint applicationDiseases of the genitourinary system85Acute pyelonephritisN10.X01GB51(1) AcupunctureDiseases of the genitourinary system86UrolithiasisN20.951GB70.Z(1) Acupuncture(2) MoxibustionDiseases of the genitourinary system87Hyperplasia of prostate (benign)N40GA90(1) Acupuncture(2) TCM umbilical therapy(3) TCM enema(4) TCM enemaDiseases of the genitourinary system88Orchitis/epididymitis (acute/chronic)N45.903; N45.902GB02.Y(1) TCM external therapy(2) Acupuncture(3) MoxibustionDiseases of the genitourinary system89Vesiculitis (seminal)N49.001GB07.0(1) TCM enema(2) Acupuncture(3) MoxibustionDiseases of the genitourinary system90Mastitis (plasma cell)N61.X02GB20.0(1) TCM application(2) Acupoint application(3) TCM ion introductionDiseases of the genitourinary system91Granulomatous lobular mastitis (abscess)N61.x07GB21.Y(1) TCM compress(2) Ironing therapy(3) TCM external Washing/TCM fumigation(4) Moxibustion(5) Collateral prickingcupping(6) TCM ion introduction(7) Catheter perfusion(8) TCM external therapyDiseases of the genitourinary system92Pelvic congestion syndromeN94.803GA34.Y(1) Rectal administration(2) Ironing therapy(3) TCM compress(4) Acupuncture(5) MoxibustionDiseases of the genitourinary system93Minimal change nephropathy (adult)NO5.004GB40(1) TCM soaking(2) Moxibustion(3) T CM fumigationDiseases of the genitourinary system94Hyperemesis gravidarumQ21.951JA60.Z(1) Acupuncture(2) Moxibustion(3) Cupping(4) Ear pressure beansDiseases of the genitourinary system95Polyuria (neurogenic)R35.X51MF50.0(1) Acupuncture(2) Ear pressure beans(3) Acupoint application(4) ManipulationDiseases of the genitourinary system


## 3.1. Basic Characteristics

Diseases were classified using ICD-10. Of the 95 included diseases, diseases of the genitourinary system accounted for the largest proportion (n = 14, 14.74%); other classifications proportional from high to low in turn were diseases of the nervous system (n = 12, 12.63%), diseases of the digestive system (n = 10, 10.53%), diseases of the respiratory system (n = 8, 8.42%), neoplasms (n = 8, 8.42%), certain infectious and parasitic diseases (n = 7, 7.37%), diseases of the musculoskeletal system and connective tissue (n = 7, 7.37%), diseases of the skin and subcutaneous tissue (n = 7, 7.37%), diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (n = 7, 7.37%), diseases of the circulatory system (n = 5, 5.26%), diseases of the eye and adnexa (n = 4, 4.21%), mental and behavioral disorders (n = 3, 3.16%), endocrine, nutritional, and metabolic diseases (n = 2, 2.11%), and diseases of the ear and mastoid process (n = 1, 1.05%). The 95 dominant diseases covered almost all disease systems.Although there was specific TCM therapy for each disease, not every one of them had a TCM disease code. The results showed that 33 (34.74%) of the 95 diseases had no TCM disease name and used a western medicine name in clinical practice.Length of hospital stay ranged from ≤7 days to ≤35 days. As is shown in Table1, a total of 50 (52.63%) diseases’ average length of stay was ≤14 days and maximally not exceeding 35 days.Table 1
Basic characteristics of 95 dominant diseases of traditional Chinese medicine.
Disease classificationDiseasesDiseases’ coding of TCMLength of hospital stayNProportion (%)AvailableNo≤7≤14≤21≤28≤35Diseases of the genitourinary system1414.74122014000Diseases of the nervous system1212.6312003450Diseases of the digestive system1010.539112430Diseases of the respiratory system88.427116010Neoplasms88.423505111Certain infectious and parasitic diseases77.371604210Diseases of the musculoskeletal system and connective tissue77.373402320Diseases of the skin and subcutaneous tissue77.374311230Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism77.370705200Diseases of the circulatory system55.263204100Diseases of the eye and adnexa44.213100130Mental and behavioral disorders33.163012000Endocrine, nutritional, and metabolic diseases22.111102000Diseases of the ear and mastoid process11.051010000Total95100623355020191TCM, traditional Chinese medicine.


## 3.2. Application of TCM

The application of TCM was summarized in Table2; Chinese herbal decoction pieces and Chinese patent drugs were all used in the 95 dominant diseases of TCM. However, the utilization of Chinese medical injections varied from 28.57 to 100.00%, with a total rate of 63.16%. The lowest rate (2/7) of Chinese medical injections use was seen in diseases of the skin and subcutaneous tissue.Table 2
Application of TCM in the treatment of 95 dominant diseases of TCM.
Disease classificationNumber of diseasesChinese herbal decoction piecesChinese patent drugsChinese medical injectionsnProportion (%)nProportion (%)nProportion (%)Diseases of the genitourinary system1414100.0014100.00642.86Diseases of the nervous system1212100.0012100.00866.67Diseases of the digestive system1010100.0010100.00770.00Diseases of the respiratory system88100.008100.00562.50Neoplasms88100.008100.00787.50Certain infectious and parasitic diseases77100.007100.007100.00Diseases of the musculoskeletal system and connective tissue77100.007100.00571.43Diseases of the skin and subcutaneous tissue77100.007100.00228.57Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism77100.007100.00571.43Diseases of the circulatory system55100.005100.00240.00Diseases of the eye and adnexa44100.004100.00375.00Mental and behavioral disorders33100.003100.00133.33Endocrine, nutritional, and metabolic diseases22100.002100.00150.00Diseases of the ear and mastoid process11100.001100.001100.00Total9595100.0095100.006063.16


## 3.3. Application of TCM External Treatment

Table3 and Table 4 indicated that, for each of included diseases, there was at least one TCM external therapy, and the number of external therapies can reach a maximum of 10. Acupuncture, moxibustion, manipulation, and Chinese medical plastering therapy were most widely applied in these diseases. Among them, acupuncture included ear acupuncture, collateral pricking, cutaneous needle, plum-blossom needle, and many other techniques. Uncommon characteristic therapies of TCM such as acupoint injection, TCM ion introduction, TCM enema, and TCM positive ridge were also widely used in these diseases.Table 3
Application of TCM external treatment in 95 dominant diseases of TCM.
Disease classificationNumber of diseasesNumber of optional TCM external therapiesNumber of optional TCM external therapies/number of diseasesDiseases of the musculoskeletal system and connective tissue7476.71Diseases of the skin and subcutaneous tissue7324.57Diseases of the circulatory system5224.40Diseases of the respiratory system8344.25Diseases of the ear and mastoid process144.00Diseases of the nervous system12463.83Neoplasms9343.78Diseases of the genitourinary system14473.36Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism6193.17Diseases of the digestive system10292.90Diseases of the eye and adnexa4112.75Certain infectious and parasitic diseases7182.57Endocrine, nutritional, and metabolic diseases252.50Mental and behavioral disorders362.00Total953543.73Table 4
Application of TCM external treatment in 95 dominant diseases of TCM (detailed).
Serial numberDisease name in western medicineDisease code in ICD 10Disease code in ICD 11Optional TCM external therapiesDisease classification1Viral encephalitis (acute stage)A86/G05.11C80(1) Acupuncture① Ear acupuncture② Collateral pricking③ Cutaneous needle④ Plum-Blossom needleCertain infectious and parasitic diseases2Dengue feverAP0 × 001D2Z(1) TCM external washing(2) TCM enemaCertain infectious and parasitic diseases3Ramsay Hunt syndromeB02.2038B88.Y(1) Acupuncture① Body acupuncture② Electroacupuncture(2) Moxibustion(3) Cupping(4) ManipulationCertain infectious and parasitic diseases4Hand, foot, and mouth disease（severe ）B08.4011F05.0(1) Acupuncture(2) ManipulationCertain infectious and parasitic diseases5Hepatitis B virus associated glomerulonephritisB10.910+GB40 and1E51.0Z(1) Acupuncture(2) Electronic biofeedback therapeutic instrument(3) TCM enemaCertain infectious and parasitic diseases6Viral hepatitis EB17.2021E51.3(1) Acupuncture(2) Ear pressure beans(3) TCM enema(4) MoxibustionCertain infectious and parasitic diseases7Infectious mononucleosis (without serious complications)B27.9011D81.Z(1) TCM spray pharynx(2) TCM compressCertain infectious and parasitic diseases8Malignant neoplasm of breast (perioperative period)C50.9002C6Z(1) Acupuncture(2) Acupoint application(3) Moxibustion(4) TCM hot compressNeoplasms9Malignant neoplasm of breast (consolidation stage)C50.9022C6Z(1) Acupuncture(2) Moxibustion(3) Ear pressure beans(4) TCM diagnosis and treatment equipmentNeoplasms10Malignant neoplasm of ovaryC56.X002C73.Z(1) TCM application(2) Acupuncture(3) Ear pressure beans(4) Cupping(5) MoxibustionNeoplasms11Malignant neoplasm of prostateC61.x002C82.Z(1) TCM soaking(2) Moxibustion(3) Acupoint application(4) AcupunctureNeoplasms12Malignant lymphoma/aggressive lymphoma (after chemotherapy)C822B33.5(1) TCM compress(2) Acupuncture;(3) MoxibustionNeoplasms13Acute lymphoblastic leukemiaC91.0012B33.3(1) Acupoint application(2) Ear pressure beans(3) TCM soaking(4) Medicated diet and dietotherapyNeoplasms14Acute myeloblastic leukemia (elderly)C92.0042A60.3Z(1) Ear pressure beans(2) Moxibustion(3) Acupoint application(4) Acupoint ironingNeoplasms15Acute promyelocytic leukemia (low and intermediate risk)C92.401，M986604/32A60.0(1) TCM compressNeoplasms16Polycythemia veraD45.X012A20.4(1) TCM foot bath(2) Acupoint application(3) Acupuncture(4) TCM compress(5) Bloodletting therapyNeoplasms17Megaloblastic anemiaD53.1003A01.Y(1) Medicated diet and dietotherapy(2) Acupuncture(3) MoxibustionDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism18Purpura nephritis (children)D69.005GB55.Y/3B60(1) Moxibustion(2) Ear pressure beans(3) Low-frequency pulse electrical stimulation(4) TCM fumigationDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism19Secondary thrombocytopenia (after chemotherapy)D69.6023B64.1Y(1) TCM compress(2) Acupoint applicationDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism20Leukopenia(after chemotherapy)D72.9014B00.01(1) Acupuncture(2) Moxibustion(3) Acupoint injectionDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism21Essential thrombocythaemiaD47.3003B63.1Z(1) Acupuncture(2) Moxibustion(3) Manipulation(4) TCM compressDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism22Anemia (tumor associated)D52.1003A71.0(1) Moxibustion(2) Acupoint application(3) Medicated diet and dietotherapyDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism23Abnormality of lipid metabolism (diabetic)E14.6005C62and5A14(1) Acupuncture(2) Moxibustion(3) Ear acupuncture(4) ManipulationEndocrine, nutritional and metabolic diseases24Diabetic footE14.606BD54(1) TCM compressEndocrine, nutritional and metabolic diseases25Mental and behavioral disorders due to the use of alcoholF10.9006C40.6Z(1) Transcutaneous electrical acupoint stimulation(2) Ear acupuncture(3) Bloodletting therapyMental and behavioral disorders26Acute stress responseF43.0QE84(1) AcupunctureMental and behavioral disorders27Dissociative [conversion] disordersF446B60.Z(1) Acupuncture(2) Acupoint applicationMental and behavioral disorders28Motor neuron diseaseG12.2108B60.Z(1) Acupuncture(2) Moxibustion(3) Acupoint injection(4) Cutaneous needle(5) ManipulationDiseases of the nervous system29Parkinsonism-plus syndromeG20.028A00.Y(1) Acupuncture: ① scalp acupuncture; ② body acupuncture(2) TCM soaking(3) Moxibustion(4) ManipulationDiseases of the nervous system30Parkinson disease (with bladder dysfunction)G20.028A00.Y(1) Acupuncture(2) Moxibustion(3) TCM compress(4) TCM psychotherapy(5) Low-frequency pulse electrical stimulationDiseases of the nervous system31Alzheimer diseaseG30.98A20(1) Sensory irritation(2) Cognitive stimulation(3) Emotional interventionDiseases of the nervous system32Neuromyelitis opticaG36.0018A43.Z(1) AcupunctureDiseases of the nervous system33Cervical headacheG44.8018A84.Y(1) Acupuncture(2) Manipulation(3) Traction treatment (4) MoxibustionDiseases of the nervous system34Posterior circulation ischemiaG45.08B10.Y(1) TCM compress(2) AcupunctureDiseases of the nervous system35Carpal tunnel syndromeG56.0018C10.0(1) Manipulation(2) Electroacupuncture(3) TCM hot compress(4) TCM soakingDiseases of the nervous system36Ankle canal syndromeG57.5028C1Z(1) Manipulation(2) Acupuncture(3) Electroacupuncture(4) TCM hot compress(5) TCM soaking; 6)MoxibustionDiseases of the nervous system37Chronic inflammatory demyelinating polyneuropathyG61.8018C01.3(1) Acupuncture(2) Moxibustion(3) Manipulation(4) TCM soakingDiseases of the nervous system38Myasthenia gravisG70.0008C60.Z(1) Acupoint injection(2) Cutaneous needle(3) TCM soaking(4) Manipulation(5) Acupoint applicationDiseases of the nervous system39Muscular dystrophy (progressive)G71.0018C70(1) External TCM(2) Acupoint injection(3) TCM enemaDiseases of the nervous system40Retinal artery occlusion (branch)H34.2029B74.0(1) Acupuncture(2) Moxibustion(3) Ear pressure beans(4) Acupoint injectionDiseases of the eye and adnexa41Senile macular degeneration (atrophic) (exudative)H35.3119B75.0Y(1) Acupuncture(2) MoxibustionDiseases of the eye and adnexa42Vitreous hemorrhageH43.1009B83(1) Acupoint injection(2) Ocular iontophoresis(3) Acupuncture(4) MoxibustionDiseases of the eye and adnexa43External ophthalmoplegiaH49.8079C82.Z(1) AcupunctureDiseases of the eye and adnexa44Ménière’s diseaseH81.000AB31.0(1) Acupuncture: ① body acupuncture; ② ear acupuncture; ③ scalp acupuncture(2) Moxibustion(3) Acupoint injection(4) Ear pressure beansDiseases of the ear and mastoid process45Viral myocarditis (children)I40.001\I41.1BC42.1(1) Acupuncture(2) Manipulation(3) Acupoint application(4) Acupoint injectionDiseases of the circulatory system46Diabetic peripheral angiopathyI79.202BD53.Y(1) Acupuncture(2) Moxibustion(3) TCM fumigationDiseases of the circulatory system47ThrombophlebitisI80.902BD70.Z(1) TCM compressDiseases of the circulatory system48VaricoceleI86.1015A81.1(1) Acupuncture(2) Moxibustion(3) Needle-picking(4) Acupoint application(5) Acupoint injectionDiseases of the circulatory system49Mesenteric lymphadenitis (children)I88.002BD90.1(1) Acupoint application(2) Manipulation(3) Moxibustion(4) TCM ion introduction(5) TCM hot iron(6) TCM soaking(7) Acupuncture(8) Ear pressure beans(9) CuppingDiseases of the circulatory system50Acute tonsillitis (children)J03.900CA03.Z(1) Acupoint application(2) Acupuncture(3) MoxibustionDiseases of the respiratory system51Mycoplasma pneumoniaJ15.702CA40.04(1) TCM chest compress(2) Acupoint application(3) Cupping(4) TCM ion introduction(5) Umbilical therapyDiseases of the respiratory system52Severe community-acquired pneumoniaJ15.903CA40.Z(1) TCM ion introduction(2) TCM enemaDiseases of the respiratory system53Hospital-acquired pneumoniaJ18.8CA40.Z(1) Acupuncture(2) TCM atomization inhalation(3) TCM enema(4) TCM compress(5) Skin scraping therapyDiseases of the respiratory system54Acute tracheitis/bronchitisJ20.902CA42.Z(1) Acupoint application(2) Moxibustion(3) Acupuncture(4) Cupping(5) Stone needle therapyDiseases of the respiratory system55BronchiolitisJ21.902CA40.Z(1) Infantile tuina(2) TCM ion introduction(3) Acupoint application(4) TCM chest compress(5) TCM enema(6) Acupuncture(7) Ear pressure beans(8) Chiropractic therapyDiseases of the respiratory system56Pharyngeal abscessJ36.X00; J39.001; J39.003; J05.100CA0K.0(1) Acupuncture: ① body acupuncture; ② Bloodletting therapy(2) TCM external therapy: ① Insufflating medicinal powder, gargle, dissolving in the mouth, nebulization, compress, and evacuation of pus(3) Lifting and scraping therapyDiseases of the respiratory system57BronchiectasisJ47.x00CA24(1) Acupuncture(2) Moxibustion(3) Acupoint application(4) Acupoint injectionDiseases of the respiratory system58Gastritis (Helicobacter pylori-associated) (refractory)A49809 + （……）∗DA42.1(1) Acupuncture(2) Moxibustion(3) Abdominal paste massage(4) Acupoint applicationDiseases of the digestive system59Cryptitis(anal)K62.801DB70.Z(1) TCM fumigation(2) TCM compress(3) TurundaDiseases of the digestive system60Hypertrophy of anal papillaK62.806DB71.2(1) TCM fumigation(2) Turunda(3) TCM enemaDiseases of the digestive system61Alcoholic cirrhosis of liverK70.301DB94.2(1) Acupoint applicationDiseases of the digestive system62Hepatic failure (hepatitis B related) (early stage)K72.004DB99.7and1E51.0Z(1) TCM enema(2) TCM rectal instillationDiseases of the digestive system63Chronic hepatic failureK72.101DB99.8(1) TCM enema(2) TCM compressDiseases of the digestive system64Ascites (hepatitis B related) (hepatic sclerosis)K74 ＋ R181E51.0Z/DB93.1 + ME04.0(1) TCM umbilical therapy(2) Acupuncture(3) TCM enemaDiseases of the digestive system65Cholestatic hepatitisK75.802DB97.Y(1) TCM enema(2) Liver disease therapeutic apparatus(3) Acupuncture(4) MoxibustionDiseases of the digestive system66GallstoneK80.203DC11(1) Acupuncture(2) Moxibustion(3) Ear pressure beans(4) TCM enema(5) TCM applicationDiseases of the digestive system67Cholangitis (primary) (sclerosing)K83.0DB96.2Z(1) TCM fumigation(2) Liver disease therapeutic apparatusDiseases of the digestive system68ImpetigoL01.0001B72.Z(1) TCM external therapy(2) Acupuncture(3) MoxibustionDiseases of the skin and subcutaneous tissue69Pilonidal cyst (sacrococcygeal)L05.900EG63.0(1) TCM compress(2) TCM fumigationDiseases of the skin and subcutaneous tissue70Pustular psoriasisL40.100EA90.4(1) Acupuncture(2) Triangular needle quick puncture(3) Cupping and exsanguinationDiseases of the skin and subcutaneous tissue71PemphigusL10EB40.Z(1) TCM collapse stains(2) TCM scrub treatment(3) Moxibustion(4) TCM bath(5) Acupoint injection(6) AcupunctureDiseases of the skin and subcutaneous tissue72Erythroderma psoriasisL40.801EA90.3(1) TCM wet compress(2) TCM bath(3) TCM ointment or oil(4) Acupoint application(5) Acupuncture(6) Moxibustion(7) CuppingDiseases of the skin and subcutaneous tissue73Chronic actinic dermatitisL57.801EJ30.1(1) TCM external therapy(2) Acupuncture(3) Moxibustion(4) Ear pressure beansDiseases of the skin and subcutaneous tissue74Allergic cutaneous vasculitisL95.8024A44.BZ(1) TCM collapse stains(2) TCM scrub treatment(3) Acupuncture(4) Moxibustion(5) Ear acupuncture(6) TCM hydronium spray(7) Acupoint applicationDiseases of the skin and subcutaneous tissue75Lupus nephritisM32.101+4A40.0Y(1) Acupuncture(2) MoxibustionDiseases of the musculoskeletal system and connective tissue76Juvenile idiopathic scoliosisM41.992FA70.1(1) Tendon-soothing manipulation(2) TCM hot compress(3) TCM fumigation(4) Acupuncture(5) Manipulation(6) Chiropractic treatment(7) Needle knife treatment(8) Positive ridge(9) Traction(10) MoxibustionDiseases of the musculoskeletal system and connective tissue77Spondylolisthesis (lumbar)M43.162FA81.Z&XA0D60(1) Tendon-soothing manipulation(2) TCM hot compress(3) TCM fumigation(4) Acupuncture(5) Manipulation(6) Needle knife treatment(7) Positive ridge(8) Traction(9) MoxibustionDiseases of the musculoskeletal system and connective tissue78Contracture of muscle (gluteal)M62.405FB32.4&XA48F2(1) Manipulation(2) Acupuncture(3) Moxibustion(4) TCM hot compress(5) TCM soakingDiseases of the musculoskeletal system and connective tissue79MetatarsalgiaM77.401FB54.4(1) Body acupuncture(2) Ear acupuncture(3) Acupoint application(4) Moxibustion(5) TCM hot compressDiseases of the musculoskeletal system and connective tissue80FibromyalgiaM79.792MG30.01(1) TCM health exercises(2) Acupoint application(3) Acupuncture(4) TCM bath(5) TCM fumigation(6) TCM ion introduction(7) Musical therapy(8) MoxibustionDiseases of the musculoskeletal system and connective tissue81Degenerative lumbar spinal stenosisM48.061FA82(1) Tendon-soothing manipulation(2) TCM hot compress(3) Acupuncture(4) Manipulation(5) Needle knife treatment(6) Positive ridge(7) Traction(8) MoxibustionDiseases of the musculoskeletal system and connective tissue82Acute glomerulonephritisN00 + B95.5GB40(1) Acupuncture: ① body acupuncture② Ear acupunctureDiseases of the genitourinary system83Primary nephrotic syndrome (primary) (children)N04.900GB41(1) Moxibustion(2) Acupuncture(3) TCM compressDiseases of the genitourinary system84Idiopathic membranous nephropathyN05.201GB41(1) Medicated diet and dietotherapy(2) TCM soaking(3) Acupoint applicationDiseases of the genitourinary system85Acute pyelonephritisN10.X01GB51(1) AcupunctureDiseases of the genitourinary system86UrolithiasisN20.951GB70.Z(1) Acupuncture(2) MoxibustionDiseases of the genitourinary system87Hyperplasia of prostate (benign)N40GA90(1) Acupuncture(2) TCM umbilical therapy(3) TCM enema(4) TCM enemaDiseases of the genitourinary system88Orchitis/epididymitis (acute/chronic)N45.903; N45.902GB02.Y(1) TCM external therapy(2) Acupuncture(3) MoxibustionDiseases of the genitourinary system89Vesiculitis (seminal)N49.001GB07.0(1) TCM enema(2) Acupuncture(3) MoxibustionDiseases of the genitourinary system90Mastitis (plasma cell)N61.X02GB20.0(1) TCM application(2) Acupoint application(3) TCM ion introductionDiseases of the genitourinary system91Granulomatous lobular mastitis (abscess)N61.x07GB21.Y(1) TCM compress(2) Ironing therapy(3) TCM external Washing/TCM fumigation(4) Moxibustion(5) Collateral prickingcupping(6) TCM ion introduction(7) Catheter perfusion(8) TCM external therapyDiseases of the genitourinary system92Pelvic congestion syndromeN94.803GA34.Y(1) Rectal administration(2) Ironing therapy(3) TCM compress(4) Acupuncture(5) MoxibustionDiseases of the genitourinary system93Minimal change nephropathy (adult)NO5.004GB40(1) TCM soaking(2) Moxibustion(3) T CM fumigationDiseases of the genitourinary system94Hyperemesis gravidarumQ21.951JA60.Z(1) Acupuncture(2) Moxibustion(3) Cupping(4) Ear pressure beansDiseases of the genitourinary system95Polyuria (neurogenic)R35.X51MF50.0(1) Acupuncture(2) Ear pressure beans(3) Acupoint application(4) ManipulationDiseases of the genitourinary system


## 4. Discussion

Our study found that the 95 TCM dominant diseases covered multiple systems, mainly the genitourinary, nervous, and digestive systems. However, the diseases’ code of TCM was incomplete and remained to be revised and improved. The length of hospital stay was mainly ≤14 days. Each disease has its own Chinese herbal decoction pieces and Chinese patent drugs. Although therapeutically effective [13–15], Chinese medical injections have not been widely used, which may be because of the controversy on their safety [16]. For the 95 TCM dominant diseases, there were many alternative external treatments of TCM. Therapies such as acupuncture and moxibustion have been widely recognized for their efficacy, easy operation, and low cost and played an important role in the therapy process of many diseases [17–19].For thousands of years, TCM has been widely used in clinical practice in China. How to inherit and develop the advantages of TCM in the diagnosis and treatment of diseases and health maintenance is still a hot topic [20]. Some scholars have proposed that strategy should, with clinical efficacy at the core, be developed based on a single disease. A study conducted in a TCM hospital indicated that, in health economics, the TCM dominant diseases are characterized by difficulties in treatment, a longer length of hospital stay, and higher hospitalization costs [21]. But evidence from other research suggested that because of the long-term therapeutic effect of TCM, the number of readmissions and total expenses of treatment reduced with the participant of Chinese medical treatment [22]. For example, in the TCM treatment of acute myocardial infarction, the readmission rate due to angina during the 6-month follow-up in the treatment group (2.96%) was significantly lower than that in the control group (7.88%) [23]. Therefore, TCM dominant diseases are ubiquitous and need us to excavate through research.The evaluation criterion of TCM dominant diseases exactly follows the principle of focusing on a single disease and with clinical efficacy at the core. Under the guidelines of these evaluation criteria, the potential TCM dominant diseases can be evaluated one by one, and the scope of TCM dominant diseases can be continuously expanded and enriched according to the criteria of the evidence grade of evidence-based medicine. Currently, the level of evidence from TCM trials is generally low [24]. Moreover, a large number of diseases were considered TCM dominant diseases by experts but lacked high-quality evidence. Therefore, it is important to establish mature evaluation criteria for TCM dominant diseases as soon as possible. With the guidance of evaluation criteria of TCM dominant diseases, finding the direction of the topic of high-quality original clinical research will also be easier [25, 26].However, the concept of TCM dominant diseases has been put forward for decades and a large number of clinical trials have also demonstrated the superiority of TCM in the treatment process of some diseases. There have been no clear regulations to elucidate which diseases belong to the dominant diseases of TCM until the list of dominant diseases of TCM issued by the Chinese State Administration of Traditional Chinese Medicine in 2019, which systematically summarized the dominant diseases of TCM on a national scale for the first time and described their diagnosis and treatment protocols and clinical pathways in detail, providing important references for clinical practice. As the list is derived from the collective views of experts, there is a level of subjectivity in the process of developing the list.Future studies could start with diseases in which TCM was widely used with clear therapeutic effect and an accepted TCM treatment to unearth more TCM dominant diseases. On the other hand, high-quality original research is also warranted to reinforce its theoretical basis.


## 5. Conclusion

For all the 95 TCM dominant diseases, there were definite TCM treatment protocols, clinical pathways, length of hospital stay, specific Chinese herbal decoction pieces, and Chinese patent drugs. Various characteristic TCM external therapies were widely applied in these diseases. This study may offer some reference for the establishment of the evaluation criterion of TCM dominant diseases.



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*Source: 6972663-2022-06-06.xml*