Letter to the Editor Open Access
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9961-9963
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9961
Role of traditional Chinese medicine in the initiative practice for health
Yun Li, Yi Zhong, Department of Oncology, Shanghai Traditional Chinese Medicine-Integrated Hospital Affiled to Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Shi-Ying Li, Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
ORCID number: Yi Zhong (0000-0001-5320-0725).
Author contributions: Li Y wrote the letter; Li SY designed and conducted the study; and Zhong Y revised the letter.
Supported by the 2021 Shanghai University of Traditional Chinese Medicine Postgraduate Innovation and Entrepreneurship Training Project, No. Y2021070.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Zhong, MD, Director, Doctor, Department of Oncology, Shanghai Traditional Chinese Medicine-Integrated Hospital Affiled to Shanghai University of Traditional Chinese Medicine, No. 230 Baoding Road, 6/F, Building 2, Hongkou District, Shanghai 200082, China. zhongzixian2000@163.com
Received: June 17, 2022
Peer-review started: June 17, 2022
First decision: July 29, 2022
Revised: August 11, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 26, 2022


To achieve awareness of the initiative practice for health concept in the Chinese population, traditional Chinese medicine (TCM) doctors should popularize TCM culture and knowledge among young people, people with a low level of education, in low-income populations, and in rural populations.

Key Words: Traditional Chinese medicine, Population health, Health knowledge, Attitudes, Practice, Awareness, Chinese population, Initiative practice for health

Core Tip: The Healthy China 2030 plan points out that by 2030, traditional Chinese medicine (TCM) will play a leading role in preventing diseases, a synergistic role in the treatment of major diseases and a core role in disease rehabilitation. Spleen deficiency is considered a subhealth state in TCM and is prevalent among a large number of Chinese people. To achieve awareness of the initiative practice for health in the Chinese population, TCM doctors should popularize TCM culture and knowledge among young people, people with a low level of education, in low-income populations and in rural populations.


We read with interest a questionnaire by Zhang et al[1], who reported that the Chinese population has limited knowledge of the initiative practice for health (IPFH). People with strong awareness of the IPFH are older, have higher income levels and have medical-related work experience.

We agree with the authors that young people, low-income populations, rural populations, and people with a low level of education may not be able to perform the IPFH. The finding was prospective but not practical in action. However, they used an internet survey to examine awareness about traditional Chinese medicine (TCM), which would have excluded the very same people. Although they concluded that just expanding internet access may not be enough, they did not suggest any innovative ways to improve awareness of TCM in this disadvantaged population, and it is particularly important for TCM doctors to popularize science in disease prevention and health maintenance.

As the premise of an active health practice is the promotion and stimulation of health consciousness, improving the health awareness of young people, low-income populations, rural populations, and people with a low level of education is the key to the problem. For the less literate population in India, dehyphenation campaigns, folk media and interpersonal communication have been effective[2]. In Saudi Arabia, the promotion of universal health education is restricted by religion and sex[3]. In China, which is also a developing country, nine-year compulsory education has been basically realized, there is less interference from external factors, and the unique TCM culture has existed for thousands of years throughout Chinese history. Therefore, it is a feasible strategy to fully promote the unique advantages of TCM[4].

In discussing the direction of improving levels of health awareness, we combined our oncology specialties and focused on the prevention of precancerous lesions using TCM. Most Chinese individuals have spleen deficiency syndrome. The symptoms and signs of spleen deficiency include loss of appetite, reduced diet, abdominal distension, aggravation after eating, watery stools, fatigue, disinclination to talk, pale or yellow complexion, edema, emaciation, a pale tongue that is moss white, and a slow and weak pulse. At present, the prevailing view is that spleen deficiency is the most closely related condition to the incidence of colorectal cancer. People with spleen deficiency syndrome have impaired intestinal barrier function and are more likely to have precancerous lesions such as polyps and adenomas.

In animal experiments, we found that spleen deficiency is an important factor that exacerbates the development of colorectal cancer. Spleen deficiency has a promoting effect on colorectal cancer, produced by the induction of the enteritis in the early stage. The experimental results showed that the mice with symptoms of colorectal inflammation combined with symptoms of spleen deficiency had more pronounced symptoms and earlier tumor progression than those with symptoms induced by colorectal cancer alone. The above results suggest that we should give attention to the treatment of spleen deficiency in the prevention and treatment of colorectal cancer, as it may become one of the important factors in reversing the progression of colorectal cancer.

After clarifying the pathogenesis of spleen deficiency as a precancerous lesion of colorectal cancer, we can take this opportunity to introduce the clinical symptoms of spleen deficiency in newspapers, new media platforms, radio, subway publicity boards and other media and urge people with such symptoms to go to TCM hospitals as soon as possible to undergo the relevant examinations. People’s health consciousness can be improved from the following aspects. First, the government should organize a health science popularization competition to attract the attention of young people who enjoy participating in new things by producing more health science popularization works combining animation elements and hot social issues, with mainstream media for publicity and doctors from regular hospitals with a good public image as promoters. Second, rural populations may pay more attention to the weather and climate because they have a great impact on crop yields. In TCM, the seasons and solar cycles are closely related to health. Raising the health awareness of rural individuals can start with an easy-to-understand climate and routine, which include different seasons, solar cycles for eating seasonal fruits and vegetables, and weekdays to ensure adequate sleep. Rural populations may not be able to undergo annual physical examinations on time, but they can be informed of some simple health and cancer prevention tips, such as not eating moldy and spoiled food, and the idea that aflatoxin may cause liver cancer. In addition, due to the imperfect rural health insurance system, most rural people cannot afford the high medical expenses, which is also a reason why they adopt an indifferent attitude toward health. Improving the continuity and services of rural medical insurance as soon as possible can effectively improve the health awareness of rural populations. Third, low incomes and low levels of education are correlated to some extent. In most cases, the incomes of people with low levels of education are generally not very high, but there are a few exceptions. However, raising income is a prerequisite for raising health awareness. Our city has a good program that provides free vocational training for unemployed individuals and those on subsistence allowances, including TCM caregivers. These courses can not only improve their future income but also improve their understanding of TCM health through continuing education.

In the future, we will increase the ease of screening for colorectal cancer with a convenient and fast fecal occult blood test and prevent precancerous progression with early intervention by colonoscopy. At the same time, we will maintain the purpose of health through TCM treatment and regular follow-up monitoring for outpatients. To promote this awareness among vulnerable people, we must further carry out science popularization and education in the community and different networks to strengthen the sense of belonging in TCM culture.


We thank Li SY for supporting this letter with experimental results.


Provenance and peer review: Unsolicited article; Externally peer reviewed.

Peer-review model: Single blind

Corresponding Author's Membership in Professional Societies: Shanghai TCM-Integrated Hospital.

Specialty type: Medical informatics

Country/Territory of origin: China

Peer-review report’s scientific quality classification

Grade A (Excellent): 0

Grade B (Very good): 0

Grade C (Good): C, C

Grade D (Fair): 0

Grade E (Poor): 0

P-Reviewer: Chakrabarti S, India; Chen HY, Taiwan S-Editor: Wu YXJ L-Editor: A P-Editor: Wu YXJ

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