TCM phenomics 2.0: The integration with digital medicine
The integrated innovation and practical exploration of Digital Chinese Medicine
image: TCM phenomics 2.0 integrates phenomics with digital medicine to investigate the lifespan phenome longditudinal cohorts defined by the integrated criteria of TCM and western medicine. Clinical data from the healthy constitutional phenomes, clinical phenomes and herb/pharmacophenomes as the sources of the best evidence for clinical medicine and biomedical research through top-down or bottom-up phenomics will build a new knowledge network of life science and precision medicine, which will be used as the basis for new taxonomy and classification of disease with phenome codes. The more accurate holistic diagnosis and targeted treatment of disease at the phenomic level will lead to improved health outcomes.
Credit: X.U. Min
Published in Digital Chinese Medicine in 2025, this paper from Dr. Dayue Darrel Duan’s team of Nanjing University of Chinese Medicine and Hunan University of Chinese Medicine systematically elaborates on the theoretical foundation, technical pathways, and development prospects of integrating digital medicine with traditional Chinese medicine (TCM) phenomics under the framework of "TCM Phenomics 2.0".
TCM phenomics was first introduced in 2008 as an emerging discipline studying the integrated and dynamic changes of human clinical phenomes under TCM theories. TCM Phenomics 1.0 initially established a clinical phenomic system centered on "Zhenghou" (the TCM definition of clinical phenome) but faced bottlenecks in data standardization, mechanistic interpretation, and precision intervention. To address these issues, TCM Phenomics 2.0 emerges with digital medicine technologies—including artificial intelligence (AI), wearable devices, medical digital twins (MDTs), and multi-omics integration—as its core support.
The core goal of this framework is to construct a closed-loop system of "Zhenghou–Phenome–Mechanism–Intervention", realizing the digitization, standardization, and precision of disease diagnosis and treatment. In practice, digital tools enable comprehensive collection and standardization of multi-source clinical data, covering clinical symptoms, imaging examinations (CT, MRI, PET), laboratory tests, and multi-omics data (genomics, proteomics, metabolomics， metagenomics etc.). AI and big data algorithms further reveal correlations between clinical Zhenghou phenomes and molecular mechanisms, enhancing the scientific rigor of diagnosis, efficacy evaluation, and personalized intervention. Specific technical applications include data preprocessing (cleaning, filling missing values), AI-driven analysis (Bayesian networks, graph neural networks for Zhenghou prediction), feature selection (e.g., FRL algorithm for biomarker screening), model building (support vector machines, random forests), and simulation prediction via medical digital twins.
The integration and development of TCM Phenomics 2.0 and digital medicine hold multiple core significances. It not only aligns with the core needs of the modernization of TCM but also provides a new path for innovative breakthroughs in the medical field.
1) TCM has long faced the predicament that its theories are difficult to quantify and its practices lack standardization, and the integration of digital medicine has precisely solved this problem. Through technologies such as AI and multi-omics integration, TCM's Zhenghou (clinical phenome), four diagnostic data (tongue appearance, pulse condition, etc.) can be digitally collected and analyzed in a standardized manner, enabling TCM theories and practices to break away from reliance on traditional experience and conform to the research paradigm of modern science. This quantification and standardization not only enhance the scientific connotation and credibility of TCM but also break down the cognitive barriers in international communication, helping TCM go global. At the same time, the mechanism under the integration framework provides a modern biological basis for the scientific connotation of TCM, promoting its transformation from traditional empirical medicine to precise evidence-based medicine.
2) The "Zhenghou-phenome-mechanism-intervention" closed-loop system constructed by the integrated development provides technical support for personalized diagnosis and treatment. Digital tools (wearable devices, medical imaging, multi-omics testing) can comprehensively collect multi-source data such as patients' physiological parameters, living habits, and molecular characteristics, and AI algorithms can deeply explore the potential associations between these data and TCM syndromes, accurately identifying syndrome subtypes and pathogenesis. On this basis, clinical practice can formulate targeted treatment plans, avoiding the limitation of "one formula for all" in traditional diagnosis and treatment, and significantly improving the accuracy and clinical efficacy of treatment. In addition, through digital twin and simulation prediction technologies, the treatment effect and potential risks can be predicted in advance, further optimizing diagnosis and treatment decisions to meet patients' personalized health needs.
3) It builds a bridge for the integration of Chinese and Western medicine and expands new paradigms of precision medicine. The core difference between Chinese and Western medicine lies in the diagnostic and treatment logic of "local symptom orientation" vs. "holistic phenome orientation", and the integration of phenome data from both provides a key entry point to break this barrier. As a neutral technical carrier, digital medicine can integrate Western medicine's anatomical and molecular detection data with TCM's Zhenghou and constitution data, revealing the commonalities and differences in the understanding of diseases between Chinese and Western medicine through multi-dimensional analysis, and promoting the complementary advantages of the two. At the same time, this integration also injects new connotations into precision medicine: the integration of TCM's "holistic view" and "dynamic balance" concepts with the personalized and dynamic monitoring capabilities of digital medicine has constructed a new disease identification and classification system that takes into account both macro-level wholes and micro-level molecules. This not only enriches the theoretical framework of precision medicine but also provides new ideas for the diagnosis and treatment of complex diseases (such as chronic diseases and multi-system diseases).
Ultimately, this integration aims to build a new disease identification and classification system centered on phenomes, achieving the inheritance, innovation, and modernization of TCM diagnostic and therapeutic patterns while offering new paradigms for precision medicine.
The complete study is accessible via DOI: 10.1016/j.dcmed.2025.09.002