Major scientific questions, engineering challenges, and industrial technology issues in traditional Chinese medicine in 2025

Abstract Objectives: To anticipate future trends in science and technology related to traditional Chinese medicine (TCM) and guide cutting-edge research directions, the China Association of Chinese Medicine (CACM) organized experts to deliberate and propose pivotal scientific questions, engineering challenges, and industrial technology issues in the TCM field for 2025. The aim is to address core bottlenecks impeding the high-quality development of TCM through original scientific research, thereby providing strategic technological support for improving the consistency of clinical efficacy, ensuring the sustainable utilization of resources, advancing intelligent industrial upgrading, and enhancing international influence. Methods: In accordance with the targeted commission requirements of the China Association for Science and Technology (CAST) and considering the disciplinary distribution characteristics, the CACM established an expert panel comprising five strategic scientists. Drawing on the major scientific questions selected by CAST and the CACM in previous years, the panel carried out a systematic process of deliberation and discussion, collation and review, evaluation and screening, as well as validation and refinement. Ultimately, two frontier scientific questions, one engineering challenge, and two industrial technology issues were identified and submitted to CAST. Results: This report focuses on key bottlenecks in transforming TCM from empirical inheritance to precision-driven science. It systematically elaborates on five core issues: the two frontier scientific questions aim to uncover the modern scientific underpinnings of classical TCM theories (e.g., the spleen deficiency theory) and the core efficacy of Daodi Herbs; the engineering challenge is dedicated to constructing intelligent reasoning AI models capable of clarifying the scientific principles underlying TCM-based prevention and treatment of complex diseases (e.g., gastric cancer); the two industrial technology issues address pressing industrial demands, namely, key technologies for the stable production of “three-excellence” medicinal materials based on molecular pharmacognosy, and the establishment of a quality homogenization technology system for TCM solid preparations based on multimodal data fusion. Conclusions: The five major scientific questions and engineering challenges selected and reported herein systematically target the core bottlenecks and frontier directions in TCM modernization, exhibiting distinct strategic, interdisciplinary, and forward-looking attributes. The development of TCM in the new era must be driven by cutting-edge multidisciplinary technologies to thoroughly elucidate the scientific core of traditional wisdom, thereby achieving comprehensive modernization covering basic research, industrial technology, and clinical application. This will lay a solid foundation for gaining strategic advantages in the global competition of traditional medicine science and technology.