More than two years ago, on the plane to Wuhan, Zhang Boli filled in the words: "Xiao Fei jiang city disease, the epidemic is accompanied by a heart." Isolation and prevention win the cure, and the East and the West complement each other. "After two years of fighting the epidemic, the advantages and characteristics of Traditional Chinese medicine have been well known to more people. The combination of traditional Chinese medicine and Western medicine and the simultaneous use of Traditional Chinese medicine have become a major feature of the prevention and control of the new crown epidemic in mainland China.
The curtain has begun on the two sessions of the National People's Congress in 2022, and the surging news "two sessions and one line" program has a special interview with Zhang Boli, deputy to the National People's Congress, academician of the Chinese Academy of Engineering, and honorary president of Tianjin University of Traditional Chinese Medicine. At this year's Two Sessions, what suggestions will he bring to promote the development of Chinese medicine? After the Wuhan Defense War and the Tianjin Aomi Kerong Encounter, what improvements have been made to the prevention and treatment plan of traditional Chinese medicine? How should we sort out and summarize the hard-won anti-epidemic experience over the past two years?
In this regard, the surging news exclusive conversation with Zhang Boli, the following is the interview transcript:
Zhang Boli was a guest of the surging news "two sessions and one line" program.
The Paper: What suggestions will you bring about the development of Chinese medicine at this year's two sessions? Is there a summary of the experience from the treatment of the new crown? Could you please tell us about it?
Chamberlain: Okay, thanks. At this year's two sessions, I put forward a total of ten suggestions and proposals, mainly on traditional Chinese medicine, for example, I hope that the major projects of key technologies and equipment of traditional Chinese medicine can be started as soon as possible; there are also some suggestions for the approval of the rationality of the production process of ancient classic chinese medicine preparations; also include the proposal to speed up the formulation of strengthening the quality standards of traditional Chinese medicine formula granules and ensuring the healthy development of the formula granule industry; and also, it is suggested that authentic medicinal materials can be monopolized by local governments, with high quality and good price, and quality assurance Of course, there are also suggestions to speed up the re-evaluation and acceptance of Chinese medicine injections; it also includes suggestions on the negative list of medicinal and food dual-use items, and so on.
Regarding the anti-epidemic proposal, I did make two suggestions. First, it is hoped that the state will organize various departments to summarize the relevant experience of the fight against the epidemic. In the more than two years since the fight against the epidemic, we have a lot of good experience to be summarized in terms of the establishment of emergency system mechanisms, the deployment of teams, or the management organization of prevention and control, including transportation, safety, and material supply. Not to mention how we divide the "three areas" from the perspective of medicine and health () - sealing and control areas, control areas, prevention areas, etc., as well as how to prevent, treat, and recover, there are many good experiences. These experiences come from more than two years of practice across the country, which is particularly difficult. We first rushed to the battle and fought a difficult encounter, but then we turned to organized normalization prevention and control, and then developed to today, we have been "precise prevention and control, dynamic clearance".
There have been many good experiences in the three phases of the past two years, including the recent prevention and control of the epidemic in Olmi kerong. I think these experiences should be carefully sorted out and summed up, some should revise the current laws and regulations, and some should institutionalize the experience gained, so that we can encounter the same situation in the future, and we can fight more actively, more consciously, and better. Everyone is very hard, we must seriously sum up, can not just go over. No mistakes and setbacks can be repeated, and we must learn from experience, constantly do it better, and at the same time establish it as a system for long-term needs.
In addition, I also put forward some opinions and suggestions on prevention and control in the post-epidemic era, mainly these.
The Paper: As far as the current situation is concerned, Aomi Kerong has become a dominant strain, what role has traditional Chinese medicine played in the prevention and treatment of the local Aomi Kerong epidemic? Can you please talk about the experience of treating the epidemic in Tianjin, especially compared with the previous Delta strain and the original strain, how will chinese medicine be different from the prevention and treatment of Aomi Kerong?
Zhang Boli: Since January this year, Tianjin has experienced an epidemic of Omicron, until more than a week ago, the new crown patients of this epidemic were basically "cleared". This time, we treated more than 430 infected people, which is also the first large-scale response to the new crown epidemic caused by the Omiljung variant strain in China.
If compared with the previous Delta strain, including the previous first-generation strain, when I was in Wuhan, I said a word, Western medicine is concerned about the virus, while Chinese medicine is concerned about the symptoms, symptoms, is the virus invaded the human body, the human body's reaction to it, the performance of these reactions is our focus.
Chinese medicine is "dialectical treatment", we analyze, this time the core mechanism of the Aomi Kerong strain has not changed much from the past, the core is still wet poison. We call it "wet poison containing lungs, and clamping disease", "concurrently clamping disease" is a clinical feature, and "wet poison containing lungs" is its core pathogenesis.
In the past two years, we have summarized several mutations of the new crown virus, the basic point has not changed, but there have been small changes in symptoms, and this time there are relatively fewer patients with inflammation in the lungs than before. This time it was "wet poison wind", the symptoms of wind and fever were more obvious, sore throat, dry throat, cough was more severe, but it was lighter than Delta's infection. At the same time, Omi Kerong was infected to the middle of the disease, the appearance of evil heat into the body, wet poison into the lungs, cough, coughing sputum, which is similar to the past, but its digestive tract symptoms are not obvious. In the later stages of the disease, it is manifested as residual heat, qi and yin, fatigue, fatigue, and panic, which are similar to the past. Therefore, from the overall point of view, the core characteristics of traditional Chinese medicine of new crown pneumonia have not changed, but the clinical manifestations have changed, that is, wet poison and wind fever, upper respiratory tract symptoms are more manifested, mainly dry throat and sore throat, at the same time, digestive tract symptoms are not too obvious.
Regarding traditional Chinese medicine treatment, the situation in Tianjin is a bit special this time, that is, there are more children's infections, there are more than a hundred cases of children's patients, so many pediatric patients, it is our first treatment, so we have also formulated a combination of traditional Chinese medicine and Western medicine treatment program for children for pediatric patients, and achieved good results.
For the elderly with underlying diseases, we summed up an experience this time - first evidence and treatment, that is, do not wait for the symptoms of this patient to be complete, and then correctly treat, but in the prediction of where the disease will develop, give him a medication in advance, cut off the development of the disease, which has also achieved good results. We have nearly ten elderly patients over the age of 80, all of whom have underlying diseases, heart failure, and even tumor foci and new crown pneumonia, malnutrition, diabetes, hypertension and other basic diseases, and finally they are also cured and discharged from the hospital, and have achieved good curative effect.
The Paper: Virus mutations are constantly changing the trend of the epidemic. However, from the perspective of TCM theory, its core pathogenesis has not changed much, and TCM seems to be more "calm" in the face of the mutation of the new crown virus. From the perspective of the traditional "epidemic disease" theory of Chinese medicine, is Chinese medicine more advantageous in dealing with virus mutations?
Chamberlain: Exactly. The accessibility of TCM is the biggest advantage of TCM in the treatment of COVID-19 and the treatment of epidemic diseases. Some new acute infectious diseases, often pathogens or viruses are not clear, there is no specific drug, there is no related vaccine, in this case, Chinese medicine is "unchanged to cope with changes", it is "dialectical treatment", the virus invades the human body, what performance is the key to treatment, I want to adjust the state of discomfort, called "dialectical treatment".
In the process of adjustment, Chinese medicine actually helps the human body activate immune function, or mobilizes the body's own ability to resist the virus. Essentially, this is the therapeutic mechanism. Therefore, no matter what kind of virus caused the disease, Chinese medicine can be the first to get started. Over the past few thousand years, Chinese medicine has accumulated a lot of experience, and the "pre-evidence treatment" and "truncation of the disease" that we summarized this time (Tianjin epidemic) are also an experience. In addition, the integration of treatment and rehabilitation that we summarized this time is seamless docking - the morning is treatment, the afternoon can be transferred to the rehabilitation hospital, directly into the rehabilitation stage, etc., there are many good experiences.
Moreover, chinese medicine is convenient and accessible, as long as the prescription is prescribed, the medicine is caught and boiled, and the patient can drink the medicine immediately. Now we are faster, with the formula granules, take out the formula and adjust the medicine in a few minutes, convenient and accessible. At the same time, we prescribe these drugs, because the effect on the patient's symptoms is very clear, the effect is immediate, so that the patient can get psychological comfort while curing the disease. This kind of panic is very harmful to people, if you can take medicine, the symptoms are alleviated, the patient has confidence, this panic will be greatly alleviated.
The timeliness, convenience and accessibility of Traditional Chinese medicine, and good compliance (of the patient), are very valuable, giving treatment an opportunity. So I always say that when I publicize the efficacy of Chinese medicine, I do not compete for fame and profit for Chinese medicine, but let this good treatment method be taken out when necessary, save people from danger, and win the opportunity for treatment. Save your life first, grab the time, we study vaccines, research special drugs. Traditional Chinese medicine has its own unique advantages in the treatment of infectious diseases, especially its accessibility has important clinical application value, which is very precious.
The Paper: In the past two years of war and epidemic, the effect of traditional Chinese medicine has been obvious to all, and related research has also blown up. So what roles does existing research summarize in TCM?
Zhang Boli: Since the fight against the epidemic in Wuhan, including the later (local) multi-point distribution, until now the Omicron multi-point outbreak. Traditional Chinese medicine has been involved in treatment, accumulated a lot of good experience, published some papers in journals at home and abroad, and done a lot of research, especially the Ministry of Science and Technology of the People's Republic of China and the National Natural Science Foundation of China have also set up special projects to carry out this related research. Recently, the State Administration of Traditional Chinese Medicine also organized experts to review and summarize the previous information.
It should be said that traditional Chinese medicine treatment is very clear for improving symptoms, especially for fever, cough, chest tightness, breath holding, fatigue, fatigue these symptoms, especially in the recovery period, the patient's hot flashes, sweating, palpitations and other symptoms, have a clear effect. These are confirmed by a large amount of data.
The second is to control the weight conversion rate. Many patients after taking traditional Chinese medicine, quickly control, will not turn into severe disease, this advantage is also obvious. Previously, when I was in Wuhan, Jiangxia Fangchang Hospital treated more than 500 patients, and none of them became seriously ill after treatment. After the general use of traditional Chinese medicine, the weight transfer rate is relatively low, basically 2% to 5%, while the international report is generally 15% to 20%, the domestic report is generally 10% to 15%, and the Chinese medicine treatment is only 2% to 5% of the weight conversion rate, which is the experience of Wuhan. Later, whether it was from the epidemic reports of Xinfadi in Beijing, Xinjiang, Dalian, Tonghua, or later in Shijiazhuang, Nanjing, Yangzhou and other places, (traditional Chinese medicine) was able to control the weight transfer rate as a whole. Multiple studies have shown this, controlling the weight transfer rate, and this role is very clear.
In addition, for convalescent treatment, TCM is able to improve symptoms during convalescence. After two negative nucleic acids, the patient can be transferred to rehabilitation, but his disease is not completely better, some lungs still have inflammation, some immune function is still relatively low, some organ damage has palpitations, liver enzymes are higher symptoms, the symptoms of these injuries are gradually recovering. Traditional Chinese medicine also plays an important role in controlling Fuyang. The difference between eating Chinese medicine and not eating Chinese medicine is very obvious, so Chinese medicine also has a certain effect on preventing Fuyang.
The Paper: How does the existing research explain the mechanism of the role of traditional Chinese medicine?
Chamberlain: The understanding of the mechanism is gradually deepening. When we first started treatment in Wuhan, we said macroscopically and generally that traditional Chinese medicine treatment improved symptoms and regulated immune function, because the virus came to the body and induced an inflammatory response of the body. Moderate inflammatory response is necessary, the body can rely on inflammatory mediators to kill the virus, but excessive release will cause an inflammatory storm, resulting in a change from mild to severe. So controlling the immune response and not overdoing it is a key part of treatment.
At that time, when I was in Wuhan, some overseas media asked me, "Chinese medicine pays attention to the symptoms, how to treat diseases?" "At that time, I explained that there was some garbage in a room, and the garbage attracted bugs, and the passage of Western medicine studied how insecticides kill insects. Chinese medicine does not study insecticides, nor does it study insects, we study this pile of garbage, clean up the garbage, the house is clean, there are no insects, and there is no need for pesticides. This is a popular metaphor.
After returning from Wuhan, we have been carrying out mechanism research for more than a year. It is now confirmed that Chinese medicine is a comprehensive role through multi-target integration and exerts comprehensive benefits. First, Chinese medicine is mainly to regulate immunity, mainly to regulate interleukin-6, so that the inflammatory storm should not be excessive. I have seen more than a dozen related experiments, including TCM units, including Western medicine units, and even some comprehensive research institutes and universities, the results are also the same, analyzing the main role of TCM is immunomodulation.
Secondly, (traditional Chinese medicine) also has an inhibitory effect on the virus itself, including Mr. Zhong Nanshan's team has also done research on Lianhua Qing plague, which has a certain inhibitory effect on the coronavirus. It also includes the repair, protection, and promotion of inflammation and absorption of organs. Therefore, Chinese medicine still plays a comprehensive role through multiple pharmacodynamic substances, and the mechanism is roughly the same.
These studies have also published some papers, such as the Journal of the Chinese Academy of Engineering, "Engineering", which has published such content, and the research is still deepening.
The Paper: You also mentioned that many teams are committed to the study of the mechanism of Chinese medicine. Why is it so important to open the "black box" of Chinese medicine and explain the principles clearly?
Zhang Boli: Now everyone has basically determined the efficacy of traditional Chinese medicine. If we make the mechanism clear, I think people will have a better understanding of why it works, and they will apply it more consciously. For something that is understood, it can be felt more deeply and applied more consciously, and in this regard, it is very important to do mechanism research. So the general secretary asked us to explain and explain the mechanism of action of traditional Chinese medicine, and we are implementing this.
The Paper: The combination of traditional Chinese medicine and Western medicine and the combination of Traditional Chinese medicine and Western medicine are a major feature of the prevention and control of the new crown epidemic in mainland China. After two years of practical testing, what effective methods have we explored for the model of integrated Traditional Chinese and Western medicine?
Zhang Boli: The combination of traditional Chinese medicine and Western medicine and the simultaneous use of Traditional Chinese medicine are a major feature of this fight against the epidemic, and it is also a vivid practice of inheriting the essence of traditional Chinese medicine and keeping integrity and innovation. In fact, our treatment from beginning to end is a combination of Chinese and Western, during the Wuhan period, although it was a cabin hospital with traditional Chinese medicine, I asked that all Western medicines in the standardized treatment plan and some emergency Western medicines must be fully prepared, so that patients can be guaranteed and we have confidence. I can't use these, but I can't afford to do so.
At the same time, I also had the ambulance ready, and an ambulance was on standby twenty-four hours. If this is a serious patient, you can always transfer to the hospital by ambulance. I also contacted the hospital in advance, and I wanted to keep beds, as well as ventilators, mobile CT, etc. I made full preparations.
The diagnosis of Western medicine, the treatment of Western medicine, especially respiratory support and circulatory support, still play a very important role, especially for patients with severe diseases, we must combine Traditional Chinese medicine and Western medicine, and use the circulation support of Western medicine to save the patient's life, and Chinese medicine to help solve some tricky pathological stages or links.
For example, some patients are on the ventilator, and the flow of oxygen is also very high, but the blood oxygen saturation is not going up, and the long-term blood oxygen saturation is relatively low, and it also fluctuates. In this case, the doctor is very anxious, and the long-term hypoxia state can cause many complications. The treatment of this situation in Chinese medicine is to use raw pulse drink, single ginseng soup, after administration, the patient's blood pressure first does not fluctuate, and then slowly two or three days of blood oxygen saturation can reach the standard, and then consolidate for two or three days can be offline, which is a good example. In addition, like patients with inflammation in the lungs, when the control of antibiotics and a small amount of hormones is not ideal, adding a little antipyretic and detoxification of traditional Chinese medicine injections, such as hot poisoning and sputum heat clearing, will also be effective.
The Paper: Your suggestions this year also paid attention to the conversion of classic celebrities. What do you think we can do in this regard?
Zhang Boli: This is a new series of research on new Chinese medicine drugs jointly launched by the State Food and Drug Administration and the State Administration of Traditional Chinese Medicine, and the secondary development and transformation of classic recipes is of great significance. In fact, the experience of Chinese medicine in human medicine for thousands of years is the most valuable, which is very envious of foreigners. When they discover a new thing, they often have to study from scratch, and they have to study from the laboratory first, then animal experiments, and finally to the clinic, which takes a long time. Chinese medicine has thousands of years of experience in medication, and the literature is vast, and these experiences are very valuable.
On this basis, combined with modern science and technology to conduct research, it is called Shouzheng innovation. The drugs developed in this way are often more reliable and safer. It can also be used for some new conditions without drugs, and drugs will be introduced soon. The secondary development of the classic formula is very important, but in terms of approval regulations, in terms of quality quality control, especially in the conversion from Traditional Chinese Medicine Decoction to Granules, there are still many technical standards that need to be studied. This research cannot be "brain-tapping", nor can it be based on a variety alone, but it must continue to progress and constantly improve.
The Paper: In our review and approval mechanism for new Chinese medicine drugs, how to better introduce human experience?
Zhang Boli: People's experience in medicine is vast, and it is necessary to take its essence and remove its dross. Some of these written things are relatively reliable, and some may have their limitations. How to analyze and summarize these, there is a set of methodology, there is also a set of experience, there is a lot of scientific and technological content. As an important part of the overall review, how to evaluate the experience of human medication is very important. Therefore, the State Food and Drug Administration has set up an expert group, and with the support of the State Administration of Traditional Chinese Medicine, published a directory of classic recipes, recommended famous parties one by one, and also underwent very serious and serious review by experts to do a good job in the development of high-quality classic recipes.
