Guangming Daily reporter Jin Haotian Su Yan Tang Yige
editorial comment/note
A few days ago, the last severe case of COVID-19 in the East Hospital of Wuhan University People’s Hospital was cured, and the severe cases in Hubei Province and Wuhan COVID-19 were cleared. Since the outbreak of the COVID-19 epidemic, many affiliated hospitals of Wuhan University have become important battlefields of the epidemic, and made painstaking efforts for the cure of severe patients in COVID-19.
In the course of COVID-19’s treatment, Chinese medicine has become a sharp weapon against the epidemic. According to the data of National Health Commission, the total effective rate of Chinese medicine treatment is over 90%. Early intervention of traditional Chinese medicine in mild treatment and recovery treatment, and combination of traditional Chinese and western medicine in severe and critical cases can effectively alleviate the development of the disease. The development of TCM disciplines and the cultivation of TCM talents have also become a topic of social concern.
In this issue, Bright Vision invited the relevant leaders of Wuhan University, Beijing University of Chinese Medicine and Nanjing University of Chinese Medicine to discuss the medical construction and the development of Chinese medicine.
Guest of this issue
Party Secretary of Beijing University of Chinese Medicine?Gu Xiaohong
Secretary of the Party Committee of Nanjing University of Chinese Medicine?Cheng chun
Vice President of Wuhan University, Director of Medical Department of Wuhan University?Tang Qizhu
On February 25th, in Wuhan Jiangxia Fangcang Hospital, Zhu Ying (left), vice president of the First Affiliated Hospital of Hunan University of Chinese Medicine, and Dai Feiyue (middle), a doctor of the First Affiliated Hospital of Hunan University of Chinese Medicine, felt the pulse of a COVID-19 patient. Xinhua news agency
On March 19th, in pulmonary hospital, members of Inner Mongolia Medical Team massaged acupoints for patients with COVID-19. Xinhua news agency
Promoting the cultivation of compound talents with "TCM+"
Gu Xiaohong
Since the outbreak of the COVID-19 epidemic, a large number of medical personnel have been fighting in the front line to fight the epidemic and become the main force in this campaign. The epidemic situation has intensively tested China’s medical education, and also highlighted the unique advantage of China’s medicine-the synergy of Chinese and Western medicine. The war against the COVID-19 epidemic without smoke has brought us many new thoughts on the construction of Chinese medicine and the cultivation of Chinese medicine talents.
On April 21st, the medical staff of Hubei Provincial Hospital of Traditional Chinese Medicine treated COVID-19’s cured patients with acupuncture. Xinhua news agency
The therapeutic potential of integrated traditional Chinese and western medicine still needs to be tapped
While affirming the achievements of medical education, we also notice that medical staff have insufficient knowledge reserves in public health, infectious disease prevention and other aspects, and the treatment ability of integrated traditional Chinese and western medicine is not enough. Mainly manifested in several aspects: First, in the current medical education system, whether in clinical medicine, nursing or traditional Chinese medicine, the training of public health and preventive medicine accounts for a relatively small proportion. Second, the first line of defense that general practitioners should play is not enough. Third, in the face of new diseases, Chinese medicine has obvious advantages, but western medical staff have less knowledge about Chinese medicine in the education stage, and their ability to use Chinese medicine has not reached a familiar level. Fourth, the participation of Chinese medicine in critical and severe treatment is not high enough and the intervention is not early enough. This is related to the lack of ability of Chinese medical staff in first aid. In addition, the new clinical instruments and equipment of traditional Chinese and western medicine have not been fully applied to the whole process of prevention, treatment and rehabilitation.
Give full play to the unique advantages of syndrome differentiation and treatment of traditional Chinese medicine
Looking back on history, Chinese medicine has been playing an important role in the fight against infectious diseases, accumulating rich and effective prevention and treatment experience and forming a unique theoretical and clinical comprehensive system. In the treatment of COVID-19, the curative effect of traditional Chinese medicine once again reflects its important value as a precious wealth of the Chinese nation. The comprehensive intervention of traditional Chinese medicine has obvious advantages over the clinical efficacy without comprehensive intervention of traditional Chinese medicine. In particular, the cure rate of patients over 60 years old is high, which can be attributed to the "one person, one party" TCM treatment based on syndrome differentiation, and TCM has played the therapeutic advantage of multi-target intervention. In addition, after the patient was discharged from the hospital, the nucleic acid test was negative, but continuous Chinese medicine intervention and psychological rehabilitation were needed. In addition to traditional Chinese medicine prescriptions and appropriate techniques, there are also dietary guidance and emotional therapy. Traditional Chinese medicine has systematic advantages in prevention before illness, treatment during illness, rehabilitation after illness, etc., which is very consistent with the concept of "serving the health of human life cycle" in the healthy China strategy.
China has made great achievements in the fight against COVID-19 epidemic, which can not be separated from the cooperation of preventive medicine and clinical treatment of traditional Chinese and western medicine, and also from the cooperation of multidisciplinary and multi-system Qi Xin, such as health management. The development of medical disciplines requires both independence and refinement, as well as cross-integration.
Looking back on the anti-epidemic process, at the beginning of the epidemic, people’s understanding still stayed at the level that Chinese medicine was good at prevention and treatment of mild diseases, while western medicine was good at treatment of severe and critical diseases. Later, in the process of clinical diagnosis and treatment, the national Chinese medicine medical team applied Chinese medicine to the treatment of severe and critically ill patients, and achieved remarkable results. In the face of patients, Chinese and Western medicine seek only the fastest and best way to relieve patients’ pain, complement each other’s advantages and cooperate in treatment. After the epidemic, medical science, as a major discipline, is related to people’s livelihood and grand strategy. The top-level design and construction of medical science should be coordinated and coordinated.
Reform the curriculum system and cultivate compound talents.
At present, in China’s medical colleges, there are still obvious boundaries between disciplines and courses, and there is a lack of effective cross-integration. For Chinese and western medicine, due to different ways of thinking, the subject system is not completely interlinked, and there are still barriers. In fact, regardless of Chinese medicine or western medicine, the goals and purposes are the same, both for human health. The direction of medical development should be "future medicine" that does not distinguish between Chinese and western medicine. Taking infectious diseases as an example, it is necessary to carry out scientific research, personnel training and clinical application around the prevention, early warning, diagnosis, syndrome differentiation, treatment and rehabilitation of infectious diseases with the guiding ideology of "keeping integrity and innovation". Under the guidance of classical theoretical thinking of traditional Chinese medicine such as febrile diseases and typhoid fever, combined with clinical departments such as respiration, emergency, digestion and critical illness, modern scientific theories and methods such as evidence-based medicine and precision medicine should be used to prevent the spread of infectious diseases. On the basis of interdisciplinary, innovation is the driving force to promote cross-border integration and build an innovative academic platform of "medicine-teaching-research-production". Break the barriers of traditional disciplines and promote the cross-integration and innovation of multi-disciplines.
In the field of medical education, the biggest difficulty in cultivating compound talents lies in how to achieve high-standard talent training goals within a limited number of years. This requires starting from the top-level design and strengthening the integration of curriculum systems in different training stages. At the same time, change the teaching mode, guide students to learn actively and independently, and provide a platform for students to develop into talents in a diversified way.
In addition, it is necessary to actively carry out the training projects of leading talents of "Chinese medicine plus" and "Chinese medicine plus" and "combination of Chinese and Western medicine", explore the cross-integration of Chinese and Western medicine, science and engineering and other disciplines to form an integrated education system, pursue the talent training goal of keeping the thinking of Chinese medicine correct, standardizing clinical diagnosis and treatment skills and integrating innovation ability, and provide talent protection for healthy China.
Internationalization of traditional Chinese medicine still has a long way to go
As the epidemic spread around the world, many countries began to learn from China’s experience, including the use of Chinese medicine to treat COVID-19. Chinese medicine represents "China Wisdom" and goes abroad, which provides an opportunity for Chinese medicine to better serve the life and health of all mankind. We have made initial achievements in the internationalization of traditional Chinese medicine, but there are still many shortcomings that need to be made up.
In the next step, we should strengthen the international communication and personnel training of Chinese medicine, enhance the cross-cultural communication ability of Chinese medicine talents, and fully tap the communication potential of new media technology in the "internet plus" era, so as to fully support the internationalization of Chinese medicine and better serve the health needs of all mankind.
Reconstruct the discipline system and improve people’s overall health quality
Tang Qizhu
At present, the COVID-19 epidemic is raging all over the world. This epidemic has a profound impact on the global economy, society, politics, culture, education and health, and it also makes us realize that health is the foundation of people’s all-round development and the greatest wealth of individuals, while medical development and medical education are related to national development and the rise and fall of nations. Summarizing the experience of fighting the epidemic, I would like to talk about a few points.
On April 15th, the staff of Rugao Hospital of Traditional Chinese Medicine in Jiangsu Province showed the sachets of traditional Chinese medicine. Xu Hui photo/bright picture
Take into account the prevention and control of major epidemics and chronic non-communicable diseases.
At present, the attention of the whole people is focused on the COVID-19 epidemic. However, as medical people, we must clearly realize that human beings are threatened by frequent outbreaks of major infectious diseases and major chronic non-infectious diseases at the same time. In the face of sudden major epidemic, we must go all out, strictly prevent and control, put life safety first, and do our best to save lives. However, in the process of epidemic prevention and control, the threat of major chronic non-communicable diseases to our lives has not diminished. On the one hand, the mortality rate of people with severe chronic non-communicable diseases increased significantly after being infected with Covid-19; On the other hand, the risk of infection and the mobilization of medical resources for epidemic prevention and control lead to the weakening of routine medical functions and the increase of mortality of major chronic non-communicable diseases, that is, "secondary disasters".
The medical discipline is facing unprecedented challenges, so it is necessary to break through the traditional thinking and make new adjustments. The future medical construction must take into account the prevention and control of major epidemics, the prevention and control of major chronic non-communicable diseases, the overall health quality of people and the improvement of life expectancy.
Strengthen multidisciplinary cross-integration and promote medical technology innovation
Medicine is a comprehensive and practical discipline, and its development itself has a strong dependence on multidisciplinary development and technological innovation. To a certain extent, a modern medical history is also a history of the integration of multi-disciplines and new technologies. From the introduction of anatomy and ligation and hemostasis reform surgery in Paré in the 16th century to the clinical application of CT, magnetic resonance, endoscopy, robotic surgery, proton heavy ion and high-throughput sequencing today, it shows that the development of multidisciplinary and new technologies has promoted medicine.
At present, the development of artificial intelligence will bring subversive changes to medicine. Therefore, the development strategy of medical science must further strengthen the cross-integration with multi-disciplines. Widely absorb and apply relevant theories such as life science, mathematics, physics, humanities and social sciences, and accelerate medical development and medical technology progress.
Focus on people’s life safety and health, and make up the shortcomings.
Compared with the current classification methods and standards of disciplines in China, it will be found that these classification methods and standards can not fully cover the new major challenges and requirements faced by the medical discipline system. We should build a new medical discipline system around the core issue of "human life safety and health", covering all aspects from individual to group, from group to all mankind, from treatment to prevention, from frequent occurrence to sudden occurrence, from survival to life, from long-term to longevity.
The future medical discipline system should be based on the previous discipline system, expanding and extending some fields, shrinking and discarding others. For example, biosafety and emergency medicine have attracted much attention in the prevention and control of this epidemic, and their research and service targets are people, but they are also directly related to the survival of individuals and even human beings. We must expand and dig deep, and make up for shortcomings and strengths and weaknesses to become an important part of the discipline system of "new medicine". Another example is psycho-social oncology, which involves many disciplines such as medicine and sociology. At present, a large number of patients live with tumors and need long-term care and psychological care, which should be regarded as an extension of the medical discipline system.
Discipline construction is an important strategic task of colleges and universities, and it is the key and core of university development. In this epidemic prevention and control, I deeply feel that the fundamental way of discipline construction lies in scientific practice and in solving major scientific problems required by the country and society. We determined the whole genome sequence of Covid-19 within one week and isolated the virus strain, which was shared with the whole world in time. Introduce a variety of detection reagent products in stages; Quickly screen effective drugs and treatment programs … This fully shows the important discipline value of medicine in epidemic prevention and control, and effectively promotes and promotes the level of discipline construction. Therefore, the construction of "new medicine" needs to constantly stimulate the innovation potential in practice and continuously promote the development of disciplines.
Broaden students’ knowledge and make persistent progress for medical career.
The fundamental task of medical construction is to cultivate top-notch medical talents with broad and solid basic theories, master basic skills and dare to take on the responsibility of building a healthy China. In this epidemic prevention and control, I deeply feel that persistence in medical career and broad knowledge are extremely important for the growth of an outstanding medical talent. Throughout the history of medical development, many doctors who have made outstanding achievements have persisted in conquering diseases, not afraid of difficulties, working quietly, being modest and virtuous, and being kind and benevolent, and finally succeeded. In this epidemic, after the early normal medical order was disrupted, many doctors who were not in respiratory medicine or infectious diseases also participated in the treatment. Their broad knowledge enabled them to quickly change the roles and skills of specialists and quickly become competent for new missions.
Anti-epidemic experience promotes the innovation of traditional Chinese medicine education
Cheng chun
In the war of preventing and controlling the epidemic in COVID-19, Chinese medicine made a brilliant report card: among the confirmed cases in COVID-19, the coverage rate of Chinese medicine reached 91.5%, and the observation of clinical efficacy showed that the total effective rate of Chinese medicine was over 90%.
Chinese medicine participated in the whole process and was deeply involved in the prevention and treatment of COVID-19, which generally showed the following characteristics: First, it paid equal attention to both Chinese and Western medicine in terms of strength, organized early intervention on a large scale for the first time in the history of modern anti-epidemic in China, took over a hospital in an all-round way for the first time, took over the ward in an integrated system for the first time, made joint rounds of Chinese and Western medicine for the first time, and deeply intervened in the treatment of critically ill patients for the first time; Second, adhere to the combination of traditional Chinese and western medicine in the way of prevention and control, and Chinese medicine, western medicine and combination of traditional Chinese and western medicine work together to play a beautiful combination boxing; Third, the combination of Chinese and western medicine is reflected in the prevention and treatment methods. The main drugs with obvious curative effects, including chloroquine phosphate, farpiravir and "three drugs and three parties" of traditional Chinese medicine, have played an important role in clinical treatment.
In this global public health crisis, China pays equal attention to Chinese and Western medicine, combines Chinese and Western medicine, and uses both Chinese and Western medicine, which shows the "wisdom of China" and contributes to the "experience of China". The answer sheet handed over by Chinese medicine in this epidemic examination has brought us profound enlightenment in strengthening the construction of "new medicine" and promoting the reform and innovation of Chinese medicine higher education in the new era.
The medical staff of Zhongnan Hospital of Wuhan University are doing tests in the experimental cabin. Xinhua news agency
Follow the law of development and grasp the general orientation of higher education reform of traditional Chinese medicine
To strengthen the construction of "new medicine" in higher education of traditional Chinese medicine, we must achieve three innovations: first, the development concept is new. Chinese medicine higher education must adapt to the needs of the great health era and the change from treating diseases as the center to people’s health as the center, and improve the discipline system and personnel training system covering the whole life cycle and health process in view of the interweaving of various health influencing factors, the change of disease spectrum and people’s health needs, and the threat of major infectious diseases.
Second, the professional layout is new. Focusing on giving full play to the leading role of traditional Chinese medicine in the prevention of diseases, the synergistic role in the treatment of major diseases, and the core role in disease rehabilitation, we will make a forward-looking layout and extend the professional upstream and downstream. In the prevention and control of COVID-19, the theory and experience of traditional Chinese medicine in the prevention and control of epidemic diseases for thousands of years have been sorted out, applied and tested, and the specialty setting should be further expanded in the future. At the same time, it should be further explored in the fields of basic and clinical integration of traditional Chinese and western medicine and "artificial intelligence+traditional Chinese medicine".
Third, the training scheme is new. The most fundamental task of inheriting Chinese medicine is to highlight the original thinking of Chinese medicine and cultivate Chinese medicine talents with self-confidence in Chinese medicine culture and good use of Chinese medicine methods to solve clinical problems. Inheriting the "cultural gene" of traditional Chinese medicine is fundamental, and integrating modern life science knowledge and building a compound and innovative talent training system of traditional Chinese medicine is the way. We must vigorously strengthen the study of classic Chinese medicine and accelerate the live transmission of traditional Chinese medicine.
Sticking to the principle of curative effect and improving the ability of serving the clinic
Facts speak louder than words, and the scientific nature and charm of traditional Chinese medicine are fully reflected in clinical efficacy. In the prevention and control of epidemic situation, from "retrogression" in the front line to "wisdom" in the rear, Chinese medicine colleges and universities give full play to their disciplinary characteristics and resource advantages, and medical and Industry-University-Research departments are linked together. Zhou Zhongying, the 93-year-old first master of traditional Chinese medicine and former president of Nanjing University of Traditional Chinese Medicine, personally led a team to carry out emergency special research on COVID-19’s etiology, pathogenesis and prescription selection, which provided reference for the formulation of the Chinese medicine part of the national "novel coronavirus Diagnosis and Treatment Plan" and authoritative guidance for the anti-epidemic of traditional Chinese medicine in Jiangsu Province. The "Suliu Ward" undertaken by 11 affiliated hospitals of Nanjing University of Traditional Chinese Medicine has the largest number of patients, the most complicated diseases, the shortest treatment course, zero death and zero weight loss, and zero infection among medical staff in Jiangxia Fangcang Hospital. The eye-catching transcripts handed over by Chinese medicine in the fight against epidemic have won recognition and respect for Chinese medicine academics.
The construction of "new medicine" should take the improvement of service clinical ability as the main direction, explore and construct an interdisciplinary innovative research mechanism in which scientific questions are put forward by clinic, scientific research design is carried out by clinic, data samples are provided by clinic and research results are tested in clinic, and carry out integrated joint research around major diseases. The application of traditional Chinese medicine in this anti-epidemic suggests that more attention should be paid to evidence-based medical evidence in future clinical research of traditional Chinese medicine.
Adhere to innovative development and form an open and coordinated development pattern.
Adhere to both Chinese and western medicine, promote the complementary and coordinated development of Chinese medicine and western medicine, and strive to realize the creative transformation and innovative development of Chinese medicine health culture. In order to adapt to the development of higher education of traditional Chinese medicine in the new era, we must have the concept of opening schools, the method of integration and coordination, the openness to modern science and the international community, the collaboration between medical teaching and research, and the collaboration between government and Industry-University-Research.
In the modern context, to inherit and carry forward the extensive and profound Chinese medicine needs to profoundly expound its scientific connotation and mechanism of action. For example, the "Qingfei Paidu Decoction" which is suitable for light, ordinary and severe patients in COVID-19 is made up of four classic prescriptions of Chinese medicine, Treatise on Febrile Diseases. In the process of its development and use, experts have studied its material basis, chemical composition, potential target and mechanism of action, which proves that it can effectively inhibit the production of endotoxin and avoid or delay the occurrence of inflammatory storm. This case inspires us that it is the key task of the construction of "new medicine" to integrate interdisciplinary research and modern scientific and technological means.
In the prevention and control of epidemic situation in COVID-19, we should further enhance our cultural confidence and road confidence in revitalizing and developing Chinese medicine, further enhance our awareness of benchmarking and responsibility, and strive to promote the reform and innovation of Chinese medicine higher education in the new era.
Guangming Daily (May 7, 2020, 07 edition)
