Current Situation and Progress in Integrative Medicine in China
                                  LU Ai-ping , DING Xiao-rong , and CHEN Ke-ji 
    
 

Integrative Medicine in China

ABSTRACT  In the past 50 years, integration of traditional Chinese medicine and Western medicine, known as the Chinese version of integrative medicine (IM), has achieved significant developments. In this article, the present situation and progress in IM development in China are summarized from the aspects of IM application, policy making, scientific research, education, academic exchanges, and its future development. With continuous support from the Chinese government and successful scientific achievements in the past 50 years, the authors believe that IM will be moving forwards to a full globalization.
KEY WORDS  current situation and progress, integrative medicine, China
     
Integrative medicine (IM) is a new term that emphasizes the combination of both conventional and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness. It emphasizes respect for the human capacity to heal, the importance of the relationship between the practitioner and the patient, the collaborative approach to patient care among practitioners, and the practice of conventional, complementary, and alternative health care that is evidence-based. In the 1950s, some doctors of Western medicine (WM) in China were systematically trained in traditional Chinese medicine (TCM), while some TCM scientists were systematically trained in WM. At that time, a new discipline called integrated TCM and WM was primarily formed in China. This primary discipline would be the Chinese version of IM. In 1981, the Chinese Association of Integrated TCM and WM (now renamed as Chinese Association of Integrative Medicine,CALM) was established. In 1983, the first issue of the Chinese Journal of Integrated Traditional and Western Medicine was published. The journal has been published monthly since then. At present, IM has become a mature and independent academic discipline, and there are about 300 IM hospitals, 30 IM departments in medical universities, and more than 100 IM-specific institutes across the nation. Many IM projects have been funded by the government, and great progress in IM research has been made(1).

IM in China
Public recognition of IM and the number of patients and/or doctors who accept IM are important for the development of IM. A national survey in China was conducted through questionnaires in 2004 by CAlM with the support of the State Administration of Traditional Chinese Medicine of the People's Republic of China (SATCM)(2). Various divisions of CAlM in each province participated in this arduous task, including 56 IM hospitals and 12 IM research institutes. All together, 19 824 medical professionals were investigated. The results showed that 91.21% and 93.52% respondents favored IM as the best diagnostic method and therapeutic method, respectively. Of all the patients who had once gone through TCM, WM and IM therapies, 68.85%, 65.45% and 71.20% respondents most appreciated IM, IM hospitals and IM therapeutic treatments, respectively. Most of the 6 595 respondents held that the optimal scientific research strategy in TCM should be done by integrating modern medical research methods (2 380 cases) or modern scientific methods (2 920 cases).These results indicate that IM reflects patients' social needs and doctors' aspirations in China.
      
CLinical practice in TCM hospitals usually includes IM approaches. Regarding disease diagnosis in TCM hospitals, patients obtain both WM diagnosis and TCM syndrome differentiation. For treatment, patients mainly obtain herbal medicine. However, they may also receive some WM treatment depending on their condition.

In general, TCM practice could be considered as IM practice. Clinical practice in the WM hospital usually follows a biomedical model. There is a department of TCM in most WM hospitals in China, and TCM doctors are asked to participate in the treatment for some patients (as requested by patients or by WM doctors). In China, IM approaches are included in clinical practice in many WM hospitals.
     
Clinicians in IM hospitals definitely focus on IM approaches in clinical practice. More importantly, a number of ongoing IM clinical studies are aimed to set up guidelines for IM clinical practice and to show the advantages of IM approaches.

IM Policies in China
For a long time, Chinese governmental authorities have been doing their best to create a positive environment for the development of IM. "The Regulations of the People's Republic of China on Traditional Chinese Medicine" (Abbr. as Regulations) was adopted at the Third Session of the State Council on April 2, 2003 and carried out on October 1, 2003. "Regulations" indicates clearly that the nation must protect and support TCM development, pay equal attention to TCM and WM, and encourage TCM and WM doctors to learn from each other and complement each other for IM development. Following the "Regulations", SATCM issued a document called "Suggestions on Strengthening the Work on Integrated Traditional and Western Medicine" on December 5, 2003 to address the policies more clearly for IM development in China. Premier WEN Jia-bao proposed to develop TCM actively in the Government Work Report at the Second Session of the 10th National People's Congress at 2004. He also wrote down "Performing IM and Developing TCM" for the 50th anniversary of the Journal of Traditional Chinese Medicine. In 2006, a total of 16 ministries in China together issued a guideline for TCM modernization, in which the creation of new medicine (the combination of TCM and WM) was listed as the key aim for TCM modernization. Dr. CHEN Zhu, the Minister of the Ministry of Health, emphasized at the Senior Pacific Forum for Health in 2007 that scientists should break the obstruction between TCM and WM gradually. He pre