Compared with traditional randomized controlled trials

response adaptive randomization（RAR） could not only balance between scientific inference and research ethics

but also maximize the benefits of the subjects. Through systematically reviewing the publications which ever used or will use RAR

and considering the characteristics of clinical trials in traditional Chinese medicine（TCM）

this study discussed the application conditions

implementation key elements

advantages

and limitations of RAR. The many advantages of using RAR in TCM clinical trials are mainly reflected as screening of different TCM prescriptions for the same disease and syndrome; screening of the superior dosage（s） for the same prescription; selecting the most promising treatment from potential drug candidates when confronted with the outbreak of new diseases. Simultaneously

challenges such as higher technical difficulty

increasing research cost

determination of the main outcome（s） and the representativeness of the subjects are faced by RAR to be dealt with.