Academician Wu Yiling: The theory of the context of traditional Chinese medicine opens up the "context" for the prevention and treatment of microvascular lesions

According to the China Cardiovascular Health and Disease Report 2022, the incidence and mortality of cardiovascular diseases in mainland China are still on the rise, with 2 out of every 5 disease deaths in the country being due to cardiovascular diseases. On April 28, Professor Wu Yiling, an academician of the Chinese Academy of Engineering, gave an academic report entitled "The Construction of the Theory of Traditional Chinese Medicine and Its Guidance for the Prevention and Treatment of Microvascular Diseases", systematically expounding a series of achievements in theory, mechanism, clinical and other aspects, and finding a breakthrough for the prevention and treatment of cardiovascular and cerebrovascular diseases.

Academician Wu Yiling gave an academic report entitled "Construction of the Context Theory of Traditional Chinese Medicine and Its Guidance for the Prevention and Treatment of Microvascular Lesions".

Academician Wu Yiling pointed out that after more than 40 years of unremitting efforts, the scientific research team led by him has systematically constructed a theoretical system of network disease for the first time on the basis of inheriting the research of the ancients, established a new discipline of traditional Chinese medicine network disease and established two major branches - "pulse theory" and "qi network theory", which was evaluated by Lu Zhizheng, a master of traditional Chinese medicine, as "the fourth milestone in the history of traditional Chinese medicine network disease research", laying a theoretical foundation for the establishment of the discipline of traditional Chinese medicine network disease. The project of "Construction of Context Theory of Traditional Chinese Medicine to Promote the Prevention and Treatment of Microvascular Lesions" was selected as a landmark scientific and technological achievement of traditional Chinese medicine in the new era (2012-2022), ranking first in the first category of "Formation of New Theories and New Disciplines of Traditional Chinese Medicine", and the project won the first prize of the National Science and Technology Progress Award.

The vein theory forms an original theory to guide the prevention and treatment of microangiopathy

"Microcirculation" proposes that the essence of cardiovascular disease is microcirculation disorder, which is the main cause and aggravating factor of cardiovascular disease. "Focusing on the international problem of microangiopathy, combined with major diseases such as heart, brain and sugar, we have made major innovations in the theory of traditional Chinese medicine. Academician Wu Yiling pointed out that "pulse" is called blood vein in traditional Chinese medicine, which is the channel that runs blood, and is anatomically identical with the blood vessels of Western medicine. The vein is the branch of the blood vessel, including the microvascularity and microcirculation.

Through the two 973 projects, a new theoretical doctrine - the theory of vein was constructed to guide the prevention and treatment of cardiovascular and cerebrovascular diseases and diabetic vascular complications, and the core theory of the theory of vein was put forward - the theory of camp and health, the clinical syndrome differentiation and diagnosis criteria of vascular lesions were established, and the medication rules for the treatment of vascular lesions were put forward by regulating the qi and blood of the camp and health. Under the guidance of the theory of vein, Tongxinluo Capsule for the treatment of ischemic cardiovascular and cerebrovascular diseases, Ginseng Song Yangxin Capsule for the treatment of arrhythmia, and Qili Qiangxin Capsule for the treatment of chronic heart failure have been developed. The expert group of the National 973 Program commented: "The theory of the vein theory has formed a new theory to guide the prevention and treatment of major diseases of microangiopathy, which is an original achievement of academic research in traditional Chinese medicine. ”

Protection of microvascular endothelial cells is a core mechanism in the treatment of microangiopathies

Academician Wu Yiling pointed out: "Our more than 10 research groups have been studying since 2005 and analyzed more than 33,000 research data, revealing for the first time that microvascular lesions are complex network lesions with microvascular endothelial cell damage as the core and initiating factor, blood components and neurohumoral humoral involvement, organ tissue cell structure and function damage, and multi-dimensional spatiotemporal dynamic evolution. ”

Experiments have confirmed that the protection of microvascularity is a common mechanism for the treatment of major clinical diseases of the heart, brain (sugar) and kidney, and the protection of microvascular endothelial cells is the core mechanism to solve the problem of microvascular lesions. Because of the protection of microvascularity, the tissue blood perfusion of the heart, brain, and kidney microcirculation is improved, thereby alleviating the clinical condition. The National 973 Program Acceptance Expert Group unanimously agreed that "the project has made a major breakthrough in the treatment of microvascular lesions with traditional Chinese medicine".

Evidence-based studies have confirmed that Tongluo drugs can solve major clinical problems in cardiovascular and cerebrovascular diseases

Academician Wu Yiling said: "We have carried out a lot of evidence-based research on three Chinese patent medicines for the treatment of cardiovascular and cerebrovascular diseases: Tongxinluo Capsule, Ginseng Song Yangxin Capsule, and Qili Qiangxin Capsule. The results show that a series of achievements have been made in the prevention and treatment of coronary heart disease, acute myocardial infarction, arrhythmia, chronic heart failure and other diseases, and major international medical problems in the cardiovascular field such as acute myocardial infarction without reflow, premature ventricular with cardiac insufficiency, sinus bradynia, and chronic heart failure.

The results of a randomized, double-blind, placebo-controlled clinical evidence-based study of 3,797 cases of ST-segment elevation myocardial infarction led by Professor Yang Yuejin and participated by 124 hospitals across the country showed that Tongxinluo significantly reduced the risk of major adverse cardiovascular and cerebrovascular events at 30 days by 36% and cardiovascular death by 30%, and at the first year of the study, Tongxinluo continuously reduced the risk of adverse cardiovascular and cerebrovascular events by 36%, the risk of cardiovascular death by 27%, and the risk of recurrent myocardial infarction at 1 year by 74% to provide effective therapeutic drugs to improve the long-term prognosis of acute myocardial infarction. The research paper was published in the Journal of the American Medical Association (JAMA), one of the four top medical journals in the world, and was awarded the Top Ten Academic Advances in Traditional Chinese Medicine in 2023, the Top Ten Medical Research in China, and the Top Ten Highlights in the Field of Cardiology in China, becoming a milestone breakthrough in the field of Chinese medicine going international in the past century.

Previous studies have also shown that Tongxinluo has a triple protective effect of blood, blood vessels, and ischemic tissue. A clinical study of 1,212 cases of "Tongxinluo intervention for carotid artery plaque" showed that Tongxinluo can stabilize vulnerable plaques and reduce the incidence of "cardiovascular events". The results of a 2007 clinical study of "Tongxinluo in the treatment of ischemic stroke" showed that Tongxinluo can significantly improve the self-care ability and neurological function of patients with acute cerebral infarction.

Academician Wu Yiling introduced that the theory of vein guided the treatment of arrhythmia and developed Ginseng Song Yangxin Capsule, which has the prominent feature of "fast and slow treatment, integrated regulation". A number of evidence-based medical studies have been carried out around Ginseng Song Yangxin Capsule, and good results have been obtained. Clinical evidence-based medical studies in 1476 cases confirmed that ginseng song was better than mexiletine in the treatment of premature ventricular contractions, and the efficacy of paroxysmal atrial fibrillation was comparable to that of propafenone, and the average increase in ventricular rate in the treatment of bradyarrhythmia was 7.09 beats/min. The evidence-based study of "Ginseng Song Yangxin Capsule for the treatment of ventricular premature contractions with cardiac insufficiency" showed that Ginseng Song Yangxin can significantly improve cardiac function while reducing premature contractions, which provides a new therapeutic drug for solving this international clinical problem. The evidence-based study of "Ginseng Song Yangxin Capsule in the treatment of sinus bradycardia with premature ventricular contractions" showed that it could increase the ventricular rate while reducing premature ventricular contractions and improving clinical symptoms, filling the gap in the drug treatment of "fast and slow treatment, integrated regulation". The results of the "multicenter, randomized, double-blind, placebo-controlled clinical study on the prognosis of 920 patients with atrial fibrillation after radiofrequency ablation" showed that the results of Ginsengsong Yangxin Capsule reduced the recurrence rate of atrial fibrillation by 7.9% and the risk of recurrence by 40.4% within 1 year after radiofrequency ablation, and the study caused a strong response from the international medical community after the release of the 2023 European Society of Cardiology Annual Meeting, Ge Junbo, an academician of the Chinese Academy of Sciences, commented, " It is a milestone in the field of atrial fibrillation treatment that has made breakthroughs in Chinese research and provided solutions to the world's treatment problems."

A series of scientific research results have been made in guiding the treatment of chronic heart failure. The "Evidence-based Study on the Treatment of 512 Cases of Chronic Heart Failure with Qili Qiangxin Capsule" led by Professor Li Xinli of the First Affiliated Hospital of Nanjing Medical University confirmed that the addition of Qili Qiangxin Capsule on the basis of standard drug treatment significantly improved the clinical efficacy by 16%. The findings were published in 2013 in the Journal of the American College of Cardiology (JACC), and the editorial board published a review article titled "Making a Failing Heart Stronger: Lessons from Traditional Chinese Medicine," which said: "This promising study has opened the door to how to use the latest technology to study the synergistic effects of traditional Chinese medicine in the treatment of heart failure, which is a challenge that we should warmly embrace." The study was also named JACC's Academic Highlight of the Year: "The study confirmed the reliable efficacy of the traditional Chinese medicine Qili Qiangxin Capsule, and achieved a synergistic effect with the combination of Western medicine, so that patients with heart failure can achieve significant efficacy." ”

At the 2023 Annual Meeting of the European Society of Cardiology, the results of the "Evaluation Study of the Composite Endpoint Event of Qili Qiangxin Capsule in the Treatment of Chronic Heart Failure" were announced. The study used randomized, double-blind, placebo-controlled, multi-center clinical research methods to complete the clinical evidence-based study of 3119 cases of Qili qiangxin on chronic heart failure composite endpoint events. The results showed that the risk of the main composite endpoint of chronic heart failure was reduced by 22% compared with the control group, which provided effective therapeutic drugs for improving the long-term prognosis of chronic heart failure. The study was awarded the "Top Ten Highlights in the Field of Cardiology in China in 2023", which has had a significant international impact and has been reported by domestic and foreign media.

The National 973 Program Acceptance Expert Group evaluated: This study has created a new model of TCM innovation and transformation integrating "theory + clinical + new drug + experiment + evidence-based", and the combination of traditional TCM theoretical innovation and modern science and technology has produced major original achievements and made a demonstration for the inheritance and innovative development of TCM.

Source: Huanqiu.com