Ancient traditional Chinese medicine includes Chinese herbal medicine, acupuncture and moxibustion, massage, dietetic therapy and other treatments, of which Chinese herbal medicine is the most important and commonly used treatment. The theoretical basis of TCM is the theory of Yīn Yáng Wǔxíng (Yin Yang and Five Elements (metal, wood, water, fire and earth)), as well as the channel theory. The theory of Yin Yang and Five Elements holds that all things in heaven and earth are divided into Yin and Yang, and the Five Elements represent five different energy states that interact, constrain, and promote each other, forming a complex and harmonious whole. The channel theory refers to the existence of multiple channels with specific functions in the human body, and regulating these channels can achieve the goal of treating diseases.

The research and clinical application of TCM are inseparable, whether it is from the screening of medicinal materials, the formulation of prescriptions, or the treatment of medication, they are all extracted through continuous practice. TCM treatment has its unique advantages: a wide range of medicinal sources that encompass both physical and mental well-being. It can not only treat diseases, but also play a certain health role. For example, commonly used Chinese herbal medicines such as Dānɡɡuī (Angelica sinensis (Oliv.)Diels), Báisháo (Cynanchum otophyllum Schneid.), and Wūjī (Gallus gallus domesticus Brisson) have good effects in replenishing blood, nourishing blood, enhancing immunity, and have a good regulating effect on the body. TCM has been constantly developing and changing in ancient China, widely used in clinical practice, and has formed many clinically effective treatment plans. These programs include acupuncture and moxibustion, herbal medicine, decoction, application and other methods, which can treat various diseases, such as colds, dyspepsia, diabetes, hypertension, etc.

The development of TCM has undergone long and rich changes, which have a profound impact on the research and application of TCM. Although the progress and development of modern medicine have replaced some ancient TCM treatment methods, TCM is still the first choice for many people in disease treatment, because they have significant characteristics such as definite therapeutic effect, small side effects, and high safety. This review discusses the importance and case analysis of TCM in ancient clinical applications, pointing out its limitations and challenges, and providing new ideas and possibilities for promoting the development of TCM.

1 The Importance of Traditional Chinese Medicine in Ancient Clinical Applications

TCM was widely used in the treatment of diseases in ancient times. In ancient times, people's understanding and treatment methods of diseases were relatively simple, and TCM was one of the most important treatment methods. There are many ways to treat diseases with TCM, including acupuncture and moxibustion, herbal medicine, massage, Qigong and other treatments. These treatment methods were not only used in ancient times to alleviate pain and treat diseases, but also to enhance the body's immune system and enhance resistance, playing a very important role in people's physical health.

TCM was also an important method of daily health care in ancient times. In ancient times, people attached great importance to disease prevention and health preservation, and TCM became an important means of daily health care for people. For example, people often use TCM to regulate their bodies, engage in Qigong exercises, and maintain physical health. In addition, TCM also plays a very important role in diet. Ancient physicians attached great importance to the therapeutic effects of diet, believing that the nature and flavour of food had a regulating effect on the body. Therefore, the dietetic therapy of TCM was also an important part of ancient people's daily life.

Overall, TCM was an essential part of people's lives in ancient times. It was not only an important means of treating diseases, but also an important method of daily health care for people. The rich treatment methods and unique theories of TCM not only protected the physical health of ancient people, but also made important contributions to the medical industry in future generations.

2 Cases of Clinical Application of Traditional Chinese Medicine in Ancient Times

2.1 Clinical application cases of traditional Chinese medicine in different fields in ancient times

Ancient traditional Chinese medicine has a wide range of clinical applications in different fields. The application of ancient TCM in the field of internal medicine is very extensive, and it can treat various diseases, such as colds, coughs, asthma, stomach diseases, liver diseases, kidney diseases, heart diseases, etc (Li, 2017). Among them, the more famous TCM prescriptions are Sijunzi decoction, Liujunzi decoction, decoction for clearing heat and removing toxicity, Guizhi decoction, Chaihu plus Shaoyao decoction, etc. Qiānjīn Fānɡ (Important Prescriptions Worth a Thousand Gold for Emergency) is one of the ancient works of TCM, in which chaihu plus shaoyao decoction can treat stomach diseases and other diseases. The composition of Chaihu plus Shaoyao decoction includes Chinese medicinal herbs such as Chaihu (Bupleurum chinensis DC.), Shaoyao (Paeonia lactiflora Pall.), Shengjiang (Zingiber officinale Roscoe), jujube (Ziziphus jujuba Mill.), and licorice (Glycyrrhiza uralensis Fisch.), which have the functions of regulating qi and relieving depression and opening the orifices. Chaihu plus Shaoyao decoction is widely used in clinical practice and can treat stomach diseases, indigestion, spleen and stomach weakness, and other diseases (Yuan et al., 2015).

The application of ancient Chinese medicine in the field of surgery is also very extensive, which can treat diseases such as trauma, fractures, sores, scrofula, etc. In Hòuhànshū·Huá Tuó Zhuàn (Book of Later Han·Biography of Huá Tuó), Huá Tuó used wine and powder for anesthesia to perform abdominal dissection and intestinal cleansing surgery (Figure 1), which was highly skilled at the time and could be called a "divine doctor". Cháo Yuánfānɡ in the Sui Dynasty and Wēi Yìlín in the Yuan Dynasty performed the intestinal anastomosis, Wánɡ Kěntánɡ and Chén Shíɡōnɡ in the Ming Dynasty performed the ear replantation, laryngeal anastomosis and amputation, which are all successful models.

The application of ancient TCM in the field of gynecology is also quite extensive, which can treat women's menstrual disorders, dysmenorrhea, postpartum diseases, breast hyperplasia and other diseases. For example, there are many prescriptions for gynecological diseases in the Fùrén Dàquán LiánɡFānɡ (A Complete Book of Effective Prescriptions for Women), such as motherwort herb decoction, Danggui Sini decoction, etc. Shānɡhán Lùn (Treatise on Febrile Diseases) is one of the ancient works of TCM, in which Danggui Sini decoction can treat diseases such as menstrual irregularities. The composition of Danggui Sini decoction includes Chinese medicinal herbs such as Angelica sinensis, Ramulus Cinnamomi, Paeonia lactiflora and Zingiber officinale, which have the effects of warming meridians, dispersing cold, promoting blood circulation, and regulating menstruation. Danggui Sini decoction is widely used in clinical practice and can treat diseases such as menstrual irregularities, dysmenorrhea, and postpartum abdominal pain.

Ancient TCM has also been widely used in the field of pediatrics, which can treat diseases such as fever, cough, diarrhea, and convulsions of children. For example, there are many formulas for treating pediatric diseases in the Xiǎoér Yàozhènɡ Zhíjué (Key to Therapeutics of Children's Diseases), such as Xiao'er Anshen Granules and Xiao'er Xiaoshi San. Xiǎoér Yàozhènɡ Zhíjué (Key to Therapeutics of Children's Diseases) is one of the ancient works of TCM, in which the Xiao'er Anshen Granules can treat children's insomnia and other diseases. The composition of Xiao'er Anshen Granules includes Chinese medicinal herbs such as coptis (Coptis chinensis Franch.), drgonsbones (Os Draconi), oyster (Ostreae Concha), and red paeony root (Radix Paeoniae Rubra), which have the effects of clearing heat, calming the mind, and calming emotions. Xiao'er Anshen Granules are widely used in clinical practice and can treat symptoms such as insomnia, dreaminess, and panic in children.

Overall, ancient TCM has a wide range of clinical applications in different fields, with many classic formulas and treatment methods. Their therapeutic effects have been tested in long-term practice and have been widely applied and promoted in modern medicine.

2.2 Clinical application cases of ancient medical experts

2.2.1 Clinical application cases of Biǎn Què in medicine

Biǎn Què was one of the famous medical experts in ancient China, who made outstanding contributions in the field of medicine and made many important contributions to the clinical application of TCM. Using walnut kernels to treat cough, Biǎn Què believes that walnut kernels can moisten the lungs and relieve cough, and have a good relieving effect on cough symptoms. The walnut kernel is crushed and added to the honey juice for taking. It is often used to treat cough, asthma and other Respiratory disease. Biǎn Què invented Guizhi decoction , which is used to treat colds. It is a decoction made from Chinese herbal medicines such as cassia twig, peony, and licorice, mainly used to treat symptoms such as colds, fever, and headaches (Figure 2). Guizhi decoction has a wide range of clinical applications in TCM and is still widely used today (Tang et al., 2023). Ginseng and licorice decoction is used to treat frailty. Biǎn Què believes that ginseng and licorice can improve the body's immune system and anti fatigue ability, and have a good regulating effect on frailty symptoms. Making ginseng and licorice into a decoction is commonly used to treat symptoms such as weakness, illness, fatigue, and fatigue. Sanhuang gypsum can treat heatstroke. Biǎn Què believes that heatstroke is caused by excessive moisture in the body, which leads to poor circulation of qi and blood. Sanhuang gypsum can be used to clear heat, detoxify, dispel dampness, and diuresis. He made Sanhuang gypsum from traditional Chinese herbs such as gypsum (Gypsum Fibrosum), baikal skullcap root (Scutellaria baicalensis Georgi), and golden thread (Rhizoma Coptidis), which is commonly used to treat symptoms such as heatstroke and fever.

2.2.2 Clinical application cases of Sūn Sīmiǎo in medicine

Sūn Sīmiǎo was one of the famous medical experts in ancient China. His academic achievements in the field of medicine were extremely outstanding, and he made many important contributions to the clinical application of TCM. Liver fire invading lung, causing coughing and phlegm. Sūn Sīmiǎo believed that an increase in liver fire can affect the lungs, leading to symptoms such as coughing and phlegm. He can treat it with formulas that clear heat, clear the liver, nourish yin, and moisten the lungs. His commonly used formulas include Radix Rehmanniae deccotion, Ophiopogon deccotion, etc. For wind-heat colds, Sūn Sīmiǎo believes that wind-heat colds are common in the summer and autumn seasons, and can be treated with formulas that clear heat, detoxify, and promote lung and cold dissipation. His commonly used formulas include Yinqiao powder, Sangju drink, etc. Sūn Sīmiǎo also has deep research on the treatment of gynecological diseases. He believes that symptoms such as irregular menstruation and dysmenorrhea can be treated with formulas that promote blood circulation and regulate menstruation. Commonly used formulas include Danggui Sini deccotion, Taohua deccotion, etc. He also invented a gynecological surgery, cervical resection, which made an important contribution to the treatment of gynecological diseases. For skin diseases, Sūn Sīmiǎo believes that skin diseases are often related to dampness and heat in the body, and can be treated with formulas that clear heat and detoxify. His commonly used formulas include Shigao deccotion, Baihu deccotion, etc. Sūn Sīmiǎo also has deep research on the treatment of liver diseases. He believes that liver diseases can be treated with formulas that clear the liver, promote gallbladder function, detoxify and reduce fire. His commonly used formulas include Yinchenhao decoction, Chaihu plus Mangxiao decoction, etc.

2.2.3 Clinical application cases of Huá Tuó in medicine

Huá Tuó was one of the famous medical experts in ancient China (Figure 3), who made many important contributions to the clinical application of TCM and is known as the "ancestor of surgery". Huá Tuó is skilled in surgical procedures and has deep research in the treatment of trauma. He believes that after a wound, it is necessary to first clear the wound and remove pus, and then apply medication to the wound surface to promote wound healing. His commonly used drugs include golden thread (Rhizoma Coptidis), amur cork-tree (Phellodendri Chinensis Cortex), etc. Huá Tuó also has deep research on the treatment of digestive system diseases. He believes that digestive system diseases are often related to improper diet and emotional disharmony, and can be treated with formulas that clear heat and detoxify, eliminate food accumulation, and regulate qi and relieve pain. His commonly used formulas include Erchen deccotion, Linggui Zhugan deccotion, Xiangsha Liujunzi deccotion, etc. Huá Tuó believes that gynecological diseases are often related to qi stagnation and blood stasis, and can be treated with formulas for promoting blood circulation and resolving blood stasis. His commonly used formulas include Taoren Chengqi deccotion, Danggui Sini deccotion, etc. Huá Tuó believed that respiratory disease were often related to wind cold and wind heat, and could be treated with prescriptions for clearing heat, detoxifying, and dispersing lung and cold. His commonly used formulas include Mahuang deccotion, Yinqiao powder, etc. As for nervous system disease, Huá Tuó believed that Nervous system disease were often related to emotional disharmony and poor qi and blood flow, and could be treated with prescriptions that calmed the nerves, replenished qi, and promoted blood circulation. His commonly used prescriptions include Chaihu plus Longgu Muli deccotion, Bazhen deccotion, etc. (Figure 4).

3 Limitations and Challenges of Traditional Chinese Medicine in Clinical Application

Although the clinical application of TCM has advantages in certain aspects, it still faces some problems and challenges in modern medicine. Firstly, there is a lack of scientific evidence to support the clinical application of ancient TCM, which mostly relies on experience and practice, and lacks support from scientific experiments and clinical research. Therefore, the reliability and effectiveness of its clinical application have been questioned to some extent. Secondly, there are significant individual differences, and TCM emphasizes differentiation of symptoms and signs for treatment. Therefore, treatment plans and drug compositions may vary among different patients, resulting in significant individual differences and difficulty in standardized clinical applications. Thirdly, the quality of drugs is unstable. The quality of TCM is related to the place of origin, climate, harvest season, processing methods, etc. Therefore, its quality stability is poor, which may lead to unstable component content and efficacy of drugs. The fourth is side effects and toxicity. Although TCM is a natural drug, there are also some side effects and toxicity, such as certain herbs causing adverse reactions such as liver damage and kidney damage (Tan and Shui, 2023). Fifthly, synergy is difficult to explain the complex combination of drugs in TCM prescriptions, and the synergy is difficult to explain and study, so the mechanism and Mode of action of the efficacy are lack of scientific explanation and proof. Sixth, the treatment effect is difficult to quantify. The treatment effect of TCM is usually based on non quantitative indicators such as symptom relief and physical improvement, which is difficult to quantitatively evaluate. This also limits the promotion and application of its clinical application (Li, 2002).

In summary, the clinical application of TCM still faces some problems and challenges in modern medicine. Therefore, modern medicine needs to combine the theory and practice of TCM, develop scientific research methods and standards of TCM, in order to better achieve the integration of traditional Chinese and Western medicine, and promote the modernization and internationalization of TCM.

4 Summary and Outlook

In the long process of development, humanity has created a rich and colorful world civilization, and Chinese civilization is an important component of the diversity and diversity of world civilization. TCM, as an outstanding representative of Chinese civilization, is a medical science that has been gradually formed and continuously enriched and developed by the people of all ethnic groups in China through thousands of years of production, life practice, and struggle against diseases. It has not only made outstanding contributions to the prosperity of the Chinese nation, but also had a positive impact on the progress of world civilization.

TCM is the wisdom crystallization of China for thousands of years, enduring for thousands of years. Its advantages in preventing and treating diseases are evident, and it can and should play its due role in the development of contemporary Chinese medical industry. Developing TCM is not only an affirmation of TCM's protection of people's health, but also a means of promoting traditional Chinese culture. With the continuous improvement of living standards, people are paying more and more attention to health. Meanwhile, due to the development of China's medical system, a TCM medical system with TCM hospitals as the main body has been established and continuously improved.

China has a long history of TCM research, and ancient medical experts discovered the medicinal properties of a large number of Chinese herbal medicines through long-term practice, and used them for clinical treatment. These Chinese materia medica have the advantages of precise efficacy, safety, and low price in treating various diseases, which enabled the rapid development of ancient TCM and have had an impact to this day.

TCM has rich clinical application experience and a complete theoretical system in ancient times, making important contributions to the development and prosperity of ancient medicine. The clinical application methods and experiences of TCM are worth learning from and inheriting, which is of great significance for the development and inheritance of TCM.

Authors’ contributions

HQK was responsible for the relevant literature and material researching, organizing, and the writing for the first draft of this review; JLF participated in discussions and paper revisions; JLF was the person in charge of this review, guiding the writing and revision of the paper. Both authors read and approved the final manuscript.

Acknowledgments

Sincerely thank Ms. Xuan Jia for her thoughtful assistance from the initial draft to the final draft of my paper, which enabled me to successfully complete it.

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