Due to the side effects of the drugs [6, 7], poor medication compliance and the problem of development of drug-resist- ant TB, global investment in TB research is needed . Among the first-line anti-TB drugs, side effects of hepato- toxicity have been reported to be associated with isoniazid, rifampin and pyrazinamide; cutaneous reactions with isonia- zid, pyrazinamide and ethambutol; gastrointestinal intoler- ance with rifampin; retrobulbar neuritis with ethambutol; and ototoxicity with streptomycin [9–11]. Long-term re- spiratory symptoms and impairment of pulmonary function affect patients’ quality of life after completing TB treatment. The respiratory comorbidities were identified in more than half of microbiologically cured TB patients . Despite suc- cessful treatment of TB, residual impairments persist, and chronic complications or sequelaes can arise from structural or vascular alterations at disease sites [13, 14]. Many patients with chronic illness may seek complementary therapies , especially ChineseMedicine (CM) in Asian countries [16, 17]. CM, which originated in ancient China, is defined as comprehensive healthcare skills and practice for the main- tenance of health and treatment of disease based on the be- liefs of holism  and experiences of pattern identification/ syndrome differentiation handed down from generation to generation . In Taiwan, CM is important and popular among different categories of complementary therapies, and is regarded as one of the mainstream therapies with cover- age of the National Health Insurance (NHI) program . “CM” usually refers to the overall treatment modalities, and services of CM covered by the NHI program, which in- cludes Chinese medicines, acupuncture, moxibustion and Chinese traumatology therapy . “Chinese medicines” usually refers to herbs or herbal products which can be classified into single-herb products and herbal formulas (multi-herb products) . In Taiwan, herbal products (con- centrated scientific herbal granules) covered by the NHI program are manufactured by GMP-certified pharmaceut- ical companies .
In the last century, more than 40 major drug disasters happened in the world. Such incidents alerted people of all levels about the importance of drug safety. For exam- ple, the “thalidomide” event that occurred in the 1960s of the last century might be the most tragic and dramatic drug disaster. Thalidomide was used to treat ailments of pregnant women. Teratogenicity of thalidomide was not considered important. The result was 8000 to 10,000 babies were born with congenital malformations [1-3]. Such disas- ters caused by chemical drugs made clinicians and authori- ties realize the importance of drug safety before promo- tion. In the situations of traditional Chinesemedicine, although the history has been over 3000 years, and has been generally considered safe; the safety data derived from scientific tests remain very limited. We do not have es- sential data of many commonly used traditional Chinese medications such as maximum safe dose and duration of treatment that is considered safe.
Adverse effects of some Chinese herbal medicine have been reported [11,43-49]. Perharic et al. received reports of 11 cases of liver damage following the use of Chinese herbal medicine for skin conditions . There were two confirmed cases in which recovery after dechallenge and recurrence of hepatitis after rechallenge were observed. The time-course relationship, recovery after ceasing Chinese herbal medicine, and absence of alter- native causes of liver damage two further symptomatic cases following a single period of exposure. Herbal material was available for analysis in seven cases. The plant mixtures varied and no single ingredient accounted for the liver injury in this case series. The mechanism of toxicity was unclear; effects did not appear dose-related and are probably idiosyncratic. Fer- guson et al. reported that a patient with eczema devel- oped a severe cardiomyopathy after a 2-week course of Chinese herbal medicine . The connection between cardiomyopathy and usage of Chinese herbal medicine was not established until when the patient was specifi- cally asked if she had ingested any unusual substances. The authors cautioned that patients might not consider medicinal herbs worth mentioning during a standard medical history. The indiscriminate usage of herbs by parents in treating children for prolonged durations is especially alarming. This concern is increased by the fact that there is no standardized treatment; it is the choice of the individual practitioner how much any one herb is prescribed . Chinesemedicine practitioners have another concern that standardisation of herbal mixtures may contradict Chinesemedicine theories .
Both the quantity and quality of publications were measured to evaluate the contributions of different countries and regions. A total of 4152 articles from 1995 to 2018 met the search criteria. After screening, a total of 4005 articles are available for analysis. We can see that TCM-Immune related articles have increased rapidly in recent years from Figure 1 A. Figure 1 B shows the trend of publications in five countries with the largest number of articles on TCM-Immune in recent years. China has the fastest growth and the largest number of papers since 2011. Although the number of papers issued by the United States, South Korea, India, and Japan has increased, there is still a big gap with China in this field, which may be related to national history, the cultural background and so on. The above-detailed information is shown in Table 1. People R China had the first place when ranking for the number of publications (1408, 35.16%), followed by USA (763, 19.05%) and the South Korea (313, 7.82%). The USA had the most citations with a number of 25158. People R China ranked 2nd with the citation number of 19154.
Xue-Fu-Zhu-Yu decoction (XFZYD) is a famous TCM formula for treating cardiovascular diseases (CVDs) with a history of several centuries. 21 The formulation of XFZYD consists of eleven plants material. The therapeutic effects of this XFZYD were validated, especially atherosclerosis and hyperlipidemia. 22 Recently, Gao also reported that this decoction can induce endothelial progenitor cell angiogenesis and hasten tube formation, especially in capillary vessels. Jie- Jen Lee reported for the first time that oral treatment with XFZYD suppressed thromboembolic stroke, and it also potentiated rt-PA mediated neuroprotection in rats. In the past, many different animal stroke models were described in the literature such as photochemically induced MCAO, surgical occlusion, and vessel occlusion by electrical cauterization or the thread occlusion model which only simulated the aspect of vessel occlusion Krueger of thrombolytic agents. In the present study, the thromboembolic stroke model mimics human strokes more closely than do other models of cerebral ischemia. 23 Furthermore, animal thromboembolic strokes induced by blood clots facilitate the investigation of the effects of thrombolytic therapy, which is currently the only available stroke treatment in humans. Cerebral ischemia restricted to the distribution of the thromboembolic occlusion gives rise to focal metabolic disturbances that result in infarction, neuronal necrosis, and brainedema. 24 Thromboembolic occlusion reperfusion injury induces HIF-1, iNOS, TNF, and active caspase-3 expressions, which may represent the response of neurons suffering from ischemic insult.
TCMeSH thesaurus is China's first specialized controlled vocabulary of TCM. Since 1987, the TCMeSH thesaurus has been published and revised continually by the Institute of Information on TCM, China Academy of Chinese Medical Sciences . This vocabulary was developed specifically to enable indexing, cataloguing, and searching for TCM interventions. The third version of the TCMeSH thesaurus contains a total of 13 905 items, including 8307 headings and 5598 entry terms. 7 Each heading has a definition, code, English translation, annotation (labelling, history, searching), and entry terms. The latest online fourth version has been available since December 2015. 8
Presenting history and symptoms: The patient had suffered from psoriasis for four years with erythema, papules and scales on his scalp, back, arms, hands and right thigh which were aggravated by heat and stress. He also had a sensation of itching and soreness. Steroid cream had been used on occasions in the past with very little and short-lived success. The tongue was red with a yellow coating, the pulse was taut and forceful.
Compared with the research and development (R&D) of TCM, there are some problems in R&D of chemical medi- cine. First, the process of chemical drug discovery is long and arduous that it begins from the search of a poten- tial candidate to the development of a marketable drug. The course could be as long as more than a decade . Second, the R&D cost for a new drug can be, in average, more than 800 million USD in the United States (US) . Third, the development of new chemical drugs remains very a low rate of success. Among thousands chemical compounds only a few candidates could reach their first markets as new drugs in recent years. Finally, synthetic chemical drugs are often associated with undesirable side effects in patients. It is now clear that the need of thera- peutic intervention in many clinical conditions cannot be satisfactorily met by synthetic chemical drugs. Since the research and development of new chemical drugs remain time-consuming, capital-intensive, safety issues, and undesired side effects, much effort has been put in the search for alternative routes for drug discovery in China . TCM has a long history of use, with extensive litera- ture and clinical applications covering thousands of years. Such as berberine, an active ingredient from Coptis chin- ensis Franch, is widely used for the treatment of infectious diseases in China . As TCM has the advantages of treatment of special diseases safety, and so on, there are many countries and regions begin to study it. At present, more than 150 countries and regions  have established natural botanical institutions, and pharmaceutical com- panies are increasingly focusing on research and develop- ment of botanicals, paying attention to the construction of traditional botanical studies and development teams, and focusing on the search for effective natural medicines to replace chemical treatments. Furthermore, there are over 1300 medicinal plants used in Europe . As safe and healthy treatments are associated with a return to nature, TCM can make up for the shortcomings of West- ern medicine in many areas. We can find the solutions to different kinds of diseases that are hard to cure by using the innovations and developments of TCM. TCM displays a distinctive curative effect for different diseases that are hard to cure and for technological difficulties that are rec- ognized worldwide, such as tumours , chronic liver disease  and chronic kidney disease .
Given the long history of CM, most of the CM docu- ments were written in Chinese. While the Web is multi- lingual, a simple literal translation, however, is not sufficient in terms of making the CM knowledge acces- sible by Western researchers. An example is the transla- tion of signs and symptoms between CM and WM. For example, the term Re (which literally means “ Heat ” ) in CM may be referred to as high fever and irritability in WM. The theories behind WM and various CM can be fundamentally different, leading to the difficulty to make alignments among their domain ontologies. For exam- ple, CM practitioners interpret human body and organs based on Chinese philosophical ideas of “yin-yang” and “five-elements”. They are aware of the efficacy of the herb, Huperzia serrata (HS), in aging disorders, and interpret the action mechanism of this herb as strength- ening the Shen (kidney). Biomedical scientists analyze some experimental evidence, and deduce that a com- pound of the herb HS acting on the brain can serve as a potential therapy for the Alzheimer ’ s disease. In this case, HS targets the brain (WM) instead of the Shen (kidney).
Motivation to use and the perceived effectiveness of Chinesemedicine modalities were reported in three stu- dies [11,15,17]. Xu et al.  highlighted four important reasons for Chinesemedicine usage among 28 Chinese cancer patients: (1) Chinesemedicine as a popular and culturally acceptable process of self-help, (2) fear of che- motherapy damaging the vital essence, (3) importance of individualised prescriptions and (4) empowerment with self-help. Almost all participants used Chinesemedicine to avoid or reduce adverse effects from cancer treat- ment. Overall, health benefits, quality of life and ability to function were significantly improved with Chinesemedicine. Benefits attributed to Chinesemedicine Table 2 Prevalence of CAM and ChineseMedicine usage
DOI: 10.4236/chnstd.2019.82004 43 Chinese Studies tion given in the inspection from the perspective of phenomenology philosophy and the aspect of the structure of consciousness rather than study the behavior of consciousness from the material level of the natural science. Phenomenology, a popular philosophical trend of thought in the West in the 20th century, which was founded by Husserl, the German philosopher, is a strict philosophical me- thod based on direct intuition and essential understanding (Ni, 2000). Phenom- enology founded by Husserl, as a philosophical method based on intuition and essential knowledge, adheres to the motto of “returning to things themselves”, which guides us back to the objective object of intention. This article aims to discuss a CMP’s course of thinking and consciousness during the inspection us- ing some methods and conclusions of “phenomenology of occurrence” in the late stage of his academic career.
artery disease and renal insuf ﬁ ciency. 1 2 However, many hypertensive patients are unre- sponsive to standard antihypertensive care. 3 4 Since the publication of a scienti ﬁ c statement from the American Heart Association (AHA) on the evaluation and treatment of resistant hypertension in 2008, there has been growing clinical and research interest in the epidemi- ology, pathophysiology and management of resistant hypertension. 5 Resistant hypertension is de ﬁ ned as a failure to achieve a BP goal of <140/90 mm Hg, despite treatment with a diur- etic and ≥ three different antihypertensive medication classes at maximally tolerated dosages. 6 Resistant hypertension is currently a devastating medical, social and economic problem. Despite knowledge about the man- agement of resistant hypertension and the avail- ability of numerous effective antihypertensive drugs and combinations of drugs, it remains a concern for both primary care clinicians and specialists. 7 8 Therefore, some patients choose non-conventional therapy to prevent and manage resistant hypertension. 9 There is robust evidence of the BP-lowering effects of complementary therapies, including aerobic exercise, 10 tai chi, 11 qigong, 12 yoga, 13 acupunc- ture, 14 moxibustion, 15 cupping, 16 massage, 17 dietary Fments 18 and herbal medicine. 19 20
From the percentage distribution of diagnoses by age in our study, we found that for patients over the age of 20, conditions of major organ systems such as the muscu- loskeletal, nervous, circulatory and endocrine systems, as well as mental disorders, appeared more and more fre- quently in TCM visits, which might be a consequence of the aging process and the natural course of diseases. Evi- dently, respiratory conditions accounted for almost half of TCM visits in young people (aged under 20). Whether TCM has better efficacy and fewer side effects than West- ern medicine in treating conditions such as upper airway infection, asthma or allergy rhinitis deserves further eval- uation [58,59]. We also found that TCM practitioners in clinics treated more injury conditions and symptoms, signs and ill-defined conditions than those in hospitals, while TCM practitioners in hospitals treated internal organ problems more than those in clinics . Since the NHI program in Taiwan only covers outpatients, TCM practitioners in Chinesemedicine sections in both Chi- nese and Western medical hospitals can deal with most ambulatory subjects, as in the clinics. However, in the hospitals, TCM doctors have to be trained strictly in either Chinese or Western medical school, unlike those in pri-
It is an active ingredient of Radix puerariae which is a traditional Chinese herbal medicine that used to treat kidney diseases such as acute kidney injury, nephrotoxicity and nephropathy. Apart from prov- ing that it has the function to reduce oxidative stress and suppress matrix metalloprotectinase 9(MMP-9), it is showed that Puerarin could attenu- ate podocyte injury and proteinuria in diabetic rats (ZHONG, Yifei, et al.,2014). In similar study, it is demonstrated that Puerarin could attenuate eNOs expression in glomerular endothelial cells and tubular cells and improve renal function of diabetic mice (ZHANG, Yong, et al.,2015). Particularly, it has been shown in a study that Puerarin exerted anti-oxidative effects through activating SIRT1- mediated NF-κB deacetylation. As a result, Puerarin attenuated early diabetic kidney injury through down-regulating MMP-9(LI, Xueling, et al., 2017).
be validated in order to provide an accurate and reliable assessment of the TCM? In addition, it is of interest to determine how an observed difference obtained from the Chinese diagnostic procedure can be translated to the clinical endpoint commonly used in similar WM clinical trials with the same indication. These two questions can be addressed statistically by the calibration and validation of the Chinese diagnostic procedure with respect to some well- established clinical endpoints for evaluation of Western medicines. If the TCM clinical trial is to be conducted by Western clinicians or Western clinicians who have some background of Chinese herbal medicine, the standards and consistency of clinical results as compared to those WM clinical trials are ensured. However, the good characteristics of TCM may be lost during the process of the conduct of the TCM clinical trials. On the other hand, if the TCM clinical trial is to be conducted by both Chinese doctors and Western clinicians, difference in medical practice and/or possible disagreement regarding the diagnosis, treatment, and evaluation are major concerns. For the third question, if the TCM is intended for use of Chinese doctors but it is conducted by Western clinicians, difference in perception regarding how to prescribe the TCM is of great concern. The preparation of a package insert based on the clinical data could be a major issue, not only to the sponsor but also to regulatory authorities. Similar comments apply to the situation where the TCM is intended for use of Western clinicians, but the trial is conducted by Chinese doctors.