Foundation and practice of digital traditional Chinese medicine platforms in enhanced recovery after surgery

Postoperative recovery is a critical phase in the perioperative period, focusing on minimizing complications and enhancing functional restoration. Enhanced Recovery After Surgery (ERAS) protocols have been highly effective in improving patient outcomes, integrating practices like multimodal analgesia and early mobilization. However, challenges such as stress imbalances and delayed gastrointestinal function persist. Traditional Chinese Medicine (TCM), with its holistic principles, offers unique solutions to postoperative care by focusing on the body's circulation of Qi and blood. TCM’s theories are being integrated with modern digital technologies, forming digital TCM platforms aimed at enhancing perioperative care. These platforms use digital tools to optimize the integration of TCM with ERAS protocols, enhancing precision and individualized care.

Biological Holography and Chaos-Fractal Theory: Foundations for a Perioperative Digital TCM Platform

Biological Holography

TCM’s fundamental principles, including "holistic thinking" and "syndrome differentiation," align with the concept of biological holography, introduced by Professor Yingqing Zhang. According to this theory, each part of an organism reflects the whole, demonstrating the deep interconnections within the body. For instance, the auricle's structure is reminiscent of the human embryo, and pulse divisions correspond to the overall health of vital organs and circulation. This concept of “whole and part” mirrors the body’s overall functional status and is foundational for developing diagnostic platforms that use localized signs, such as tongue characteristics and pulse conditions, as indicators of the body’s overall balance.

Chaos-Fractal Theory

Chaos and fractal theories, central to complexity science, describe the nonlinear and self-similar characteristics of complex systems. In TCM, the concept of “chaos” is reflected in the dynamic balance of Yin and Yang. Just as small changes in chaotic systems can lead to significant shifts, the balance of Yin and Yang in the body determines health outcomes. By applying chaos-fractal theory, TCM practitioners can observe and predict recovery trajectories through patterns that emerge in the body’s dynamic systems, such as heart rate variability (HRV). This approach allows for a more structured understanding of the complex physiological changes occurring during recovery and provides a new way to monitor and optimize postoperative rehabilitation.

Establishment of a Perioperative Digital Chinese Medicine Diagnosis and Treatment Platform

Digital technologies, including AI and wearable devices, are being used to develop a perioperative TCM diagnosis and treatment platform. This platform integrates TCM's holistic concepts with modern digital tools, enabling dynamic monitoring of the body’s internal states and improving individualized care. The platform's primary objective is to maintain homeostasis during the perioperative period, ensuring that even minor fluctuations in patient condition are promptly addressed. By utilizing technologies such as mobile healthcare devices, AI-driven data analytics, and real-time monitoring, the platform facilitates a deeper convergence of TCM with Western medical practices, enhancing postoperative recovery outcomes.

Theoretical Construction of the Perioperative Digital TCM Diagnosis and Treatment Platform

The development of the perioperative digital TCM platform is rooted in complexity science. Surgical trauma, anesthetic intervention, and individual patient responses create a nonlinear system that influences recovery. The integration of biological holography and chaos-fractal theory provides a framework for mapping localized signs, such as tongue and pulse conditions, to the overall health of the patient. Digital tools, such as tongue image analysis and pulse wave signal acquisition, can track changes in physiological states, offering predictive insights into recovery and enabling timely interventions.

Construction of Methodology

The digitalization of TCM’s four diagnostic techniques (inspection, auscultation and olfaction, inquiry, and palpation) forms the backbone of this platform. Modern AI technologies, combined with bioinformatics, are used to analyze large datasets of clinical diagnostic information, enabling real-time, precise monitoring of postoperative recovery. The platform supports the objectives of preventing disease, halting disease progression, and preventing recurrence by continuously monitoring patient health through wearable devices and AI-driven diagnostic tools. This integration allows for comprehensive, data-driven decision-making, moving beyond traditional, experience-based TCM practices.

Visualization of Perioperative Yin-Yang Status

The complexity of assessing Yin and Yang status during the perioperative period is addressed through digital tools that objectively measure autonomic function, such as HRV. HRV data can be used to track the balance between the sympathetic and parasympathetic nervous systems, reflecting the dynamic shifts between Yin and Yang. The use of these tools helps overcome the uncertainty inherent in traditional TCM diagnostic methods and provides a clearer, evidence-based framework for postoperative care.

Application of AI Biomarkers

The integration of AI biomarkers into the perioperative TCM platform represents a significant advancement in personalized medicine. These biomarkers, collected through wearable devices, provide continuous, non-invasive monitoring of a patient’s physiological states, reflecting the balance of Yin and Yang. AI biomarkers offer a cost-effective, modular approach to disease prevention, diagnosis, and treatment, enabling the detection of subtle changes in the body’s condition and facilitating more precise interventions.

Conclusions

The integration of TCM with modern digital technologies offers a promising pathway for optimizing postoperative recovery through a personalized, data-driven approach. By incorporating complexity science theories such as biological holography and chaos-fractal theory, the digital TCM platform provides a scientific basis for monitoring and adjusting perioperative care. AI-driven tools, wearable devices, and the quantification of Yin-Yang balance allow for precise management of postoperative recovery, improving patient outcomes and contributing to the evolution of integrated medicine. Moving forward, continued advancements in digital TCM platforms will help bridge the gap between traditional Chinese medicine and Western medical practices, creating a more holistic and effective approach to perioperative care.

 

Full text:

https://www.xiahepublishing.com/2835-6357/FIM-2025-00011

 

The study was recently published in the Future Integrative Medicine.

Future Integrative Medicine (FIM) publishes both basic and clinical research, including but not limited to randomized controlled trials, intervention studies, cohort studies, observational studies, qualitative and mixed method studies, animal studies, and systematic reviews.

 

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