Under the epidemic situation, can traditional Chinese medicine prove itself again? Interview with academician Zhang Boli

The novel coronavirus pneumonia prevention herbal tea prescription was released by the team Pneumonia one was awarded the emergency application of the Guangdong Drug Administration for clinical application within 3 days, and 4 pilot provinces were treated with Qingfei detoxification decoction, and the total effective rate was over 90% Since February, health departments at all levels have asked to ensure that patients first use traditional Chinese medicine Will novel coronavirus pneumonia become a chance for Chinese medicine to prove itself again? Zhang Boli, academician of the Chinese Academy of engineering who just led the medical team to the Dahuashan fangcang hospital in Jiangxia District, Wuhan, said in an exclusive interview with China Science Daily that the traditional Chinese medicine treatment of hospitals, isolation areas and fangcang hospitals in Wuhan has achieved good results "However, I have mentioned many times that traditional Chinese medicine treatment is symptomatic, and the purpose is to regulate the immune state of the body, not the virus itself Although some traditional Chinese medicines have been proved to have antiviral effect by in vitro experiments, there is still no evidence for clinical evaluation, so we should speed up the in-depth study, especially the clinical evidence-based evaluation " China Science Daily: Wuhan novel coronavirus pneumonia is required for all hospitals What is the current effect? Zhang Boli: at present novel coronavirus pneumonia in Wuhan is mostly accepting standardized western medicine support and symptomatic treatment About 30% of the patients in the former stage adopted the treatment method of combination of Chinese and Western medicine, which was lower than 85% of the national level Recently, the novel coronavirus pneumonia novel coronavirus control and treatment command group issued a notice on the recommendation of the Chinese medicine protocol for the treatment of pneumonia in the new coronavirus infection, which requires Wuhan to take Chinese medicine in the hospital for diagnosis and suspected patients with mild or common diseases Traditional Chinese medicine not only plays an important role in some hospitals, isolation areas and shelter hospitals, but also has unprecedented breadth and depth of participation At the same time, fever patients and people in need of home isolation in various areas of Wuhan have also taken traditional Chinese medicine Jiuzhoutong, Tianji and other pharmaceutical enterprises timely provide the decoction and Chinese patent medicine From the current feedback, taking traditional Chinese medicine has achieved better results, and the overall sensory symptoms of patients have improved Two designated hospitals of traditional Chinese medicine in Wuhan have adopted the combination of traditional Chinese medicine and Western medicine, which has achieved good results, improved symptoms significantly, and the rate of patients' recovery and conversion to severe disease is significantly better than those without traditional Chinese medicine So far, more than 100 patients have been cured and discharged The method of integration of traditional Chinese and Western medicine has achieved initial results, and has gradually become a common treatment There are 24 provinces and regions in China that have issued their own TCM Prevention and control programs Up to now, in addition to Hubei Province, other provinces and cities, TCM and the combination of Chinese and Western medicine have treated more than 10000 patients, accounting for more than 80% of the confirmed patients, and more than 1000 patients have been cured and discharged China Science Daily: novel coronavirus pneumonia patients who are concerned about what diseases, and what kind of treatment plan have been formulated? According to the different stages of the course of the disease, what are the treatment focuses? Zhang Boli: novel coronavirus pneumonia is based on the etiology, symptoms and pathogenesis It seems to be a damp toxin epidemic with less documented Chinese medicine The main syndrome elements are dampness, heat, toxin, blood stasis and Qi deficiency The pathogenic characteristics of dampness are obvious Because of the humid climate in Central China, Wuhan is in the warm winter season this year, and it is triggered by the long cold and wet weather at the end of the year, which forms the external conditions for the disease caused by the gas of the damp poison epidemic From the novel coronavirus pneumonia typical symptoms, early fever, dry cough, fatigue and other symptoms are prominent, and poor appetite, nausea, loose stools and diarrhea, and tongue is light and more often seen in the moss From the course of the disease, it also shows the characteristics of damp evil, heavy turbid, sticky and lingering Most of the patients have a slow onset, a long incubation period and mild symptoms However, in the later stage, a few patients can accelerate the development of more serious syndromes such as phlegm and blood stasis in the lung, pathogenic toxin in the lung, internal closure and external detachment In the recovery period after the virus turns negative, the common symptoms and signs of lingering evil spirit and unclear residual heat, especially the immunity of some severe patients The repair of functional and tissue damage takes a long time Traditional Chinese medicine can play a role in the whole course of the disease In the early stage of the treatment, the main symptoms can be obviously improved, such as clearing the lung and expelling pathogenic factors, aromatizing the turbid, relieving asthma and phlegm, clearing the bowels and reducing heat, etc it can calm down the fever, relieve cough, resolving phlegm and asthma, improve the digestive function, prevent the disease from deepening and developing to the severe If it has reached the critical stage, the use of clearing away heat and resolving phlegm to clear the viscera and discharge turbidity can reduce the lung exudation, improve the oxygenation level, stabilize the blood oxygen saturation, reduce the intensity of hormone and antibiotic use; the use of clearing heat and cooling the blood, and the treatment of transforming the circulation from the circulation of Yin to the circulation of Qi can control the excessive inflammatory reaction and cut off the development of critical illness On the basis of the standard treatment of Western medicine, some prescriptions of clearing the heart and opening the orifices, supplementing the Qi and strengthening the removing, cooling the blood and nourishing the Yin can be used to save the patients' lives Special attention should be paid to the treatment in the recovery period Although the nucleic acid test of the virus has turned negative, symptoms such as fatigue, cough and poor mental state still exist, and there is still residual inflammation in the lung At this time, we should continue to take the traditional Chinese medicine of Benefiting Qi and nourishing Yin, promoting blood circulation and removing stasis, and dredging and dispersing the collaterals to improve the patient's state, and at the same time, it can promote the complete repair of the immune system function and damaged organs and tissues China Science Daily: during the period of SARS, what experiences have we accumulated in the treatment of traditional Chinese medicine and can we learn from this epidemic response? ▲ Zhang Boli: in 2003, traditional Chinese medicine played an important role in SARS Our experience includes shortening the average fever time, improving the symptoms of systemic poisoning, promoting the absorption of lung inflammation, improving the immune function, reducing the amount of hormone, reducing the side effects, etc This time we have learned from the experience and lessons of SARS prevention and control in that year For example, when it comes to the use of hormones, SARS is rushed to battle It's a kind of encounter war This time, SARS is prepared, so it's prudent to use hormones But we emphasize that hormone should be used, hormone control inflammatory response, reduce lung exudation is effective Last time, traditional Chinese medicine was involved in the second half of SARS, but this time, health administration departments at all levels put more emphasis on the role of traditional Chinese medicine Traditional Chinese medicine has become a main force fighting with western medicine from past participants In the past, traditional Chinese medicine only participated in consultation, but in this early stage, it formed a system to intervene and set up a TCM ward There are a large number of designated hospitals, management of the shelter hospital, etc it has played a better role in the treatment with the combination of Chinese and Western methods China Science Daily: what are the suggestions for the patients isolated at home to use their own traditional Chinese medicine? ▲ Zhang Boli: the patients isolated at home are relatively mild Taking traditional Chinese medicine can improve symptoms and promote recovery The national health and Health Commission and the State Administration of traditional Chinese medicine have issued relevant prevention and control programs, and local programs have also been issued according to local conditions, including some national medical masters, famous old Chinese doctors and so on In particular, the national health and Health Commission and the State Administration of traditional Chinese medicine jointly recommended the "Qingfei Paidu recipe" widely used It can be said that the treatment principles are basically similar, which will have certain effect Of course, a regular lifestyle and a positive and open-minded attitude will also promote the recovery of patients China Science Daily: in this outbreak, many basic research and clinical observation experiments have been carried out in traditional Chinese medicine Have you got some preliminary results? ▲ Zhang Boli: at present, many basic and clinical researches of traditional Chinese medicine are under way The first eight emergency projects of the Ministry of science and technology include the clinical research of traditional Chinese medicine and the screening and evaluation of the listed Chinese patent medicines and components of traditional Chinese medicine Many units are actively screening and evaluating some Chinese patent medicines with antiviral effect For example, Tianjin University of traditional Chinese medicine has the State Key Laboratory of component traditional Chinese medicine, which reserves nearly 60000 components of traditional Chinese medicine At present, it is screening effective components of traditional Chinese medicine through the active components with antiviral effect in the component library, but the finished medicine may take a long time This time, TCM also undertook the national scientific and technological emergency project - clinical research on the prevention and treatment of pneumonia caused by new coronavirus by combining traditional Chinese and Western medicine, and organized eight hospitals in five provinces to carry out relevant research The units participating in the research in Hubei Province also adopt modern information means Mobile app is used to collect information in the ward and transmit it to the external platform for data processing At present, the research has been started, and is in a tense and orderly process The preliminary results have been summarized China Science Daily: before novel coronavirus pneumonia team, Rao Zihe released 30 drugs that might have therapeutic effects on new crown pneumonia, including rhubarb, Polygonum cuspidatum, Sophora Tonkin root, and shikonin But at the same time, it also raises questions about the inhibition of virus by traditional Chinese medicine What do you think? ▲ Zhang Boli: Rao Zihe and the academician team found that the active components of plant medicine, Polygonum cuspidatum glycoside and deoxyrhubarb, had a good combination with the new crown virus hydrolase, which might have an inhibitory effect on the virus The Chinese herbal medicines, such as Polygonum cuspidatum and Sophora tonkinensis root, might contain effective components against the new crown virus, which is a very significant work I hope this work can go on, after all, many new drugs are found in this way However, although some traditional Chinese medicines have been proved to have antiviral effect by in vitro experiments, there is still lack of evidence for clinical evaluation, so we should speed up in-depth research, especially for clinical evidence-based evaluation I have mentioned many times that traditional Chinese medicine has the characteristics of multi-component and multi-target The treatment is symptomatic The purpose is to regulate the immune state of the body, mobilize its own disease resistance function to resist diseases, rather than directly against the virus itself We get sick as a result of the game and struggle between the virus and human immunity If the virus wins, it will get sick Therefore, only by improving their own resistance, they are not easy to be infected, which is also a more positive preventive strategy Of course, some traditional Chinese medicine also has the effect of inhibiting virus China Science Daily: what role should Chinese medicine play in the prevention and treatment of major infectious diseases and how to cooperate with western medicine? Zhang Boli: in the novel coronavirus pneumonia, we can say that Chinese medicine played an important role in the whole process and prevention of epidemic diseases For example, for ordinary patients, it can improve symptoms, shorten the course of treatment, and promote recovery; for severe and critical patients, it can reduce lung exudation, control inflammatory overreaction, and prevent disease deterioration; for convalescent patients, it can promote the recovery process Chinese and Western medicine are two different medical systems, each with its own advantages They should complement each other, learn from each other, and work together to tackle key problems Experience shows that the curative effect of Integrated Chinese and Western medicine is more obvious Specifically, western medicine is mainly supportive therapy, including respiratory support, circulatory support, nutritional support and other life support; while traditional Chinese medicine plays a role in symptomatic treatment, improving symptoms, improving the immune function of the body, and controlling the progress of the disease The specific treatment methods include decoction, Chinese patent medicine and some physical therapy methods, and some severe patients are also commonly used traditional Chinese medicine injection For ordinary patients, traditional Chinese medicine should play a major role; for severe patients, it is necessary to support breathing and circulation, mainly with western medicine, and with the cooperation of traditional Chinese medicine Chinese medicine has more advantages in convalescence When novel coronavirus pneumonia is not effective, it is necessary to give full play to the advantages of combining Chinese and Western medicine, treat more patients and win the fight against disease (BIOON Com)