Rong media reporter Cai Zengrui
"In terms of children's influenza treatment, parents and children in China have a very high acceptance of traditional Chinese medicine." Professor Ma Rong of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine stressed that especially with the rich evidence of evidence-based medicine and the promotion of education across the country, many clinicians have become more and more accepting of traditional Chinese medicine for the treatment of influenza, which has a very good role in promoting and promoting the wide application of traditional Chinese medicine in the treatment of influenza in children.
Recently, the annual International Conference on Network Disease was successfully held in Shanghai. As an international traditional Chinese medicine industry event that has been held for 17 consecutive years, the conference attracted nearly 20 academicians of the two academies and a number of well-known domestic experts to gather at the conference site, and nearly 100,000 domestic and foreign audiences watched the conference online. The conference focused on the application of TCM network disease theory to prevent and treat chronic diseases, and jointly sought the road of industrialization, modernization and international development of TCM.
During the meeting, the reporter of Physician Daily interviewed Professor Ma Rong, a well-known pediatric expert of traditional Chinese medicine in China, to discuss with him the current situation of influenza diagnosis and treatment in children in China and the treatment strategy of traditional Chinese medicine, and share the experience and thinking of promoting traditional Chinese medicine in the treatment of influenza.
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<h1 class="pgc-h-arrow-right" data-track="8" > characteristics of childhood influenza: high morbidity, severe symptoms, and high mortality</h1>
Influenza is an acute respiratory infectious disease caused by influenza viruses. Transmission is mainly through the respiratory route, but can also lead to indirect sexual transmission through contact with infected items. According to the World Health Organization, seasonal influenza epidemics each year can cause 3 million to 5 million severe cases and 290,000 to 650,000 respiratory disease-related deaths worldwide. Over the years, the harm of influenza and its complications has been grossly underestimated.
In China, thanks to the attention and participation of the Chinese government and the whole society, influenza prevention and control has always received great attention, especially for the prevention and treatment of key groups such as children and obesity, which has always been the key goal of prevention and control work. In the "Influenza Diagnosis and Treatment Plan (2020 Edition)" issued by the National Health Commission (hereinafter referred to as the "Plan"), the clinical manifestations, complications and other relevant contents of children's influenza have been further improved on the original basis. At the same time, the plan also clearly stipulates that children under 5 years of age, as a high-risk group of influenza cases, should be highly valued by the relevant departments, and nucleic acid testing and other necessary tests for influenza viruses should be carried out as soon as possible, and antiviral drugs should be given.
Children are listed as a high-risk group for influenza because of the high incidence, severe symptoms and high mortality rate of childhood influenza compared with adult influenza. According to statistics, the annual incidence of adult influenza is 5%-10%, and the annual incidence of influenza in children is 20%-30%, which is generally two to three times that of adults, and even up to five times in severe cases, and the incidence population is more concentrated. Professor Ma Rong stressed that "the symptoms of childhood influenza are more severe than those of adult influenza, the proportion of severe diseases is higher, and the mortality rate is higher." ”
<h1 class="pgc-h-arrow-right" data-track="8" > TCM treatment of influenza can significantly improve symptoms</h1>
Compared with the common cold, influenza does not necessarily have catarrhal symptoms (catarrhal symptoms: including cough, runny nose, sneezing, nasal congestion and other upper respiratory tract symptoms, is a common clinical symptom), but it is likely to be accompanied by high fever, body aches and other symptoms, and more contagious, so the treatment of children's influenza should focus on early treatment, rapid treatment.
Professor Ma Rong pointed out that "children are more likely to progress to severe illness after the onset of influenza, and treatment should be given as soon as possible, for example, there is a significant difference in the treatment effect compared with 1 day in advance." Therefore, for children with influenza, once treatment is delayed, the possibility of the disease progressing to severe disease will increase, and in severe cases, it will even lead to pneumonia, hepatic and renal shock, death and other consequences. ”
In terms of influenza treatment concepts, Chinese and Western medicine are different. Western medicine believes that influenza is caused by influenza virus, clinical treatment methods include general treatment, symptomatic treatment, antiviral therapy, etc., commonly used therapeutic drugs include oseltamivir, zanamivir, etc.; Chinese medicine adopts the concept of dialectical treatment, divides influenza into different types, and then gives targeted traditional Chinese medicine treatment, covering the entire course of influenza, treatment drugs such as Lianhua Qing plague, etc.
Professor Ma Rong said that chinese medicine by inhibiting the influenza virus, reducing the re-harm of influenza virus to the human body, while reducing complications, alleviating symptoms, shortening the course of the disease and other effects, especially in improving the sore throat, stool depression, cough and phlegm and other symptoms, Chinese medicine has certain advantages.
(Taking Lianhua Qingxiao as an example, evidence-based medical studies have shown that the anti-A H1N1 virus effect of Lianhua Qingpeng is no different from that of oseltamivir, and the antipyretic and alleviation of influenza symptoms such as cough, headache, fatigue, and muscle soreness is better than that of oseltamivir.) ）
It is worth noting that in the field of scientific research on the treatment of influenza in traditional Chinese medicine, most of the research currently carried out is related to adult influenza, and there is relatively little evidence-based medicine for children's influenza, which leads to very limited traditional Chinese medicine treatment options for children's influenza. For example, the plan for the traditional Chinese medicine treatment of childhood influenza states, "Children's medication can refer to the adult treatment plan and adjust the dose according to pediatric regulations." ”
In order to change the current situation of traditional Chinese medicine in the treatment of children's influenza, the random, double-blind and multi-center clinical research on the treatment of children's influenza by Lianhua Qing plague granules jointly carried out by Professor Ma Rong and jointly carried out by more than 20 hospitals across the country has been launched. He said, "In the treatment of adult influenza, the study found that Lianhua Qing plague has a good therapeutic effect, so we hope to further explore its therapeutic effect on children's influenza and provide clear proprietary Chinese medicines with children's indications for the treatment of childhood influenza." ”
<h1 class="pgc-h-arrow-right" data-track="8" > Lianhua Qing plague has a broad-spectrum antiviral effect on influenza viruses</h1>
"At present, TCM treatment of influenza is mainly based on empirical treatment. These experiences are a valuable asset handed down by the Chinese nation for thousands of years, and clinical practice has found that the therapeutic effect is very good. Professor Ma Rong pointed out that in the 21st century, it is necessary to use evidence-based medical evidence to prove the role of traditional Chinese medicine and continue to carry forward traditional medicine.
As one of the representative chinese medicines independently innovated and developed in China, the study found that Lianhua Qingpeng has a broad-spectrum antiviral effect on a series of influenza viruses. Studies by the Chinese Academy of Chinese Medical Sciences, the Chinese Academy of Military Medical Sciences, the State Key Laboratory of Respiratory Diseases of the Guangzhou Academy of Respiratory Health and other scientific research institutions have confirmed that Lianhua Qing plague has a good antagonistic effect on H1N1, H3N2, H5N1, H7N9, H9N2 virus, coronavirus, and influenza B virus. In addition, Lianhua Qing plague can also effectively inhibit a variety of bacteria, which is conducive to the treatment of mixed infections.
In 2009, during the influenza A(H1N1) pandemic, Lianhua Qingyi played a major role in the prevention and control of the epidemic and was included in the 2009 edition of the "A H1N1 Influenza Diagnosis and Treatment Plan". In recent years, it has also been continuously included in the "Influenza Diagnosis and Treatment Plan (2018/2019/2020 Edition)", which is used in traditional Chinese medicine to treat three types of diseases: wind and fever, cold fever, and heat poison attacking the lungs.
In 2011, the project of "Research on the Treatment of Influenza in the Treatment of Traditional Chinese Medicine Lianhua Qing Plague" won the second prize of the Annual National Science and Technology Progress Award - this is the first proprietary Chinese medicine for treating colds and anti-influenza in China to receive this honor.
In 2020, in the fight against the new crown epidemic, Lianhua Qingyi was successively included in the "Diagnosis and Treatment Plan for Pneumonia Infected by Novel Coronavirus" issued by the National Health commission (trial version 4/5/6/7/8), and was recommended by 20 provincial health commissions and chinese medicine administrations for the diagnosis and treatment of new crown pneumonia, becoming one of the "three drugs and three parties" of effective drugs screened by traditional Chinese medicine for the treatment of new crown pneumonia.
<h1 class="pgc-h-arrow-right" data-track="8" > Chinese medicine treatment will usher in the era of precision treatment</h1>
The concept of TCM in the treatment of influenza is to prevent before illness, prevent degeneration of existing diseases, and prevent recovery after illness. Professor Ma Rong stressed that in the prevention of diseases, the role of traditional Chinese medicine can not be underestimated.
Professor Ma Rong introduced that for patients who already have influenza, the goal of TCM treatment is to eliminate symptoms such as sore throat and fatigue, reduce the risk of progression to severe disease, and reduce mortality. For influenza patients who are in the recovery phase, the patient's immunity is often low at this time, and they are susceptible to various diseases. Therefore, Chinese medicine has developed many targeted conditioning methods such as correcting the root and replenishing the qi and fixing the table. Professor Ma Rong pointed out, "The concept of Chinese medicine believes that in order to completely cure the flu, the conditioning of patients in the post-illness recovery period is also very critical, so the stage of post-illness prevention cannot be ignored. ”
There is still huge room for development in the treatment of influenza in traditional Chinese medicine. Professor Ma Rong said that clinical practice has found that traditional Chinese medicine can effectively prevent and treat influenza, while preventing influenza recurrence, but there are still many unsolved mysteries in terms of mechanism of action, such as the specific active ingredients of traditional Chinese medicine, as well as the pathways and targets of action, which need to be proved by more basic and clinical research.
For the development prospects of traditional Chinese medicine, Professor Ma Rong sighed, "I believe that with the increasing attention of the state to the development of traditional Chinese medicine and the improvement of the level of traditional Chinese medicine talents, traditional Chinese medicine treatment will usher in the era of precision treatment." The medicine of the motherland will go to the world stage and serve patients around the world. ”
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