Liao Shurong (Beijing Tibetan Hospital, Beijing, 100029)
Abstract Objective: The integration of traditional Chinese and western medicine combines the knowledge and methods of traditional Chinese medicine with the knowledge and methods of modern western medicine, clarifies the mechanism and obtains new medical understanding for the purpose of improving clinical effectiveness. The integration of traditional Chinese and western medicine is the blending of the fields of traditional Chinese and western medicine. Precision medicine is the principle and practice of integrating modern scientific and technological means with traditional medical methods, scientifically recognizing human function and pathology, and systematically optimizing the principles and practice of disease prevention and health promotion into a new health medical service paradigm that maximizes individual and social health benefits with efficient, safe and economical health care ser- vices. In clinical practice, precision medicine pursues the correct selection and accurate application of appropriate diagnosis and treatment methods for each patient, so as to minimize iatrogenic damage and cost, and maximize patient benefits. In the prevention and treatment of COVID- 19 infection, the effect of integrated traditional Chinese and western medicine is significantly better than that of simple traditional Chinese medicine or simple western medicine.The combination of traditional Chinese and western medicine in the prevention and treatment Covid- 19 has truly achieved precision and maximized individual benefits.
The combination of Chinese and Western medicine is the combination of traditional medical knowledge and methods with Western medical knowledge and methods to improve clinical efficacy, elucidate the disease mechanisms and gain new medical understanding. Integrating Chinese and Western medicine is a cross disciplinary field of both Chinese and Western medicine which was developed in clinical practice and gradually evolved into an aca- demic system with clear goals and methodologies.
Keywords Integrative medicine, precision medicine; Prevention and treatment of COVID- 19 infection;
In the 21st century, the development of modern technology and biomedicine has brought about comprehensive technological advances in clinical medicine, allowing physicians to no longer rely on intuition and experience for disease diagnosis and treatment, leading to the novel concepts in clinical practice and improvements for medical standards. Internationally, on November 1, 2011, the American Academy of Sciences, the American Academy of Engineering, the National Institutes of Health, and the American Council on Science jointly launched the “Toward Precision Medicine” initiative [1], the main point of which is the “symptomatic medicine” based on the reclassification of diseases. This is the origin of the concept of precision medicine. This is the origin of the concept of precision medicine.
Precision medicine is a new health care service paradigm that integrates modern technology and traditional medical methods to scientifically recognize the nature of human body functions and diseases, systematically optimize the principles and practices of disease prevention and treatment and health promotion, and obtain the maximum health benefits for individuals and society with efficient, safe and economical health care services. In clinical practice, precision medicine pursues the correct selection and precise application of appropriate treatment methods for each patient to achieve minimal side effects and costs and maximum patient benefits. Under the guiding principle of precision medicine, the trans- formation of medical paradigm and the return of medical humanism are leading modern medicine from “technology first” and “market worship” back to the value of human-centeredness and the ultimate goal of maximizing the benefits to patients.
When combined, Chinese and Western medicine have their own characteristics.The theory of Chinese medicine comes from the summary of medical experience and the ancient Chinese idea of yin and yang and the five elements. Its content includes the doctrine of essence, the doctrine of yin and yang and the five elements, qi, blood, fluids, visceral manifestation, channels, physique, etiology, pathogenesis, disease mechanism, treatment rules, and health maintenance. The Yellow Emperor’s Classic of Internal Medicine, a monograph on Chinese medicine, was published more than two thousand years ago, laying the foundation of Chinese medicine. Chinese medicine takes the five elements of yin and yang as its theoretical basis, and regards the human body as a unified body of qi, form and spirit. Through the method of “looking, smelling, asking and inspection of the pulse”, the four diagnoses are combined to explore the cause, nature and location of the disease, analyze the disease mechanism and the changes of the five internal organs, meridians, joints, qi, blood and fluids in the human body, determine the evolution of pernicious and upright qi, and then derive the name of the disease and summarize the evidence. Chinese medicine focuses on the holistic concept, that is, unity and integrity. The holistic concept is the embodiment of ancient Chinese materialism and dialectical thinking in Chinese medicine; it is integrated into all aspects of Chinese medicine, including physiology, pathology, diagnosis, identification and treatment. Guided by the holistic concept, TCM believes that the normal physiological activities of the human body rely on the functional role of each internal organ on the one hand, and on the other hand, it depends on the comple- mentary synergistic and opposite restraining effects between the internal organs to maintain its physiological balance. Each internal organ has its own function, but it is a division of labor and an organic cooperation within the overall activity of the body, which is the unity that underlies Chinese medicine’s view of the human body’s local and overall functional nature.
Compound therapy is a characteristic and an advantage of TCM treatment. Compound therapy refers to the combination of two or more medicinals in accordance with the principles of four diagnoses, the eight principles, and evidence-based treatment in TCM, which is different from the western medical approach of using a single medication. This characteristic of Chinese medicine is an advantage in clinical use, and also the beginning and end point of Chinese medicine research. More than two thousand years of clinical practice has provided a thorough screening of many Chinese medicinal prescriptions. Many classical and famous prescriptions are safe and effective, and their use has endured for a long time. In recent years, the WHO’s biomedicine experts have advocated for a more individualized and specific approach to treatment, and consider this individualized treatment approach as the highest level of clinical treatment. Chinese medicine compound prescriptions often have multi-vectored efficacy and wide indications, and can play a comprehensive role in regulating, modifying and recuperating from illness. Chinese medicine has flexible treatment principles and abundant treatment options, which are not only effective but also have few side effects. The symptoms of most diseases are in line with the nature of the disease, and the maxim “treat the cold with heat, treat the hot with cold, treat deficiency with supplementation, treat repletion with dispersion”, a thing is treated with its opposite. Chinese medicine is based on the principle of diagnosis and treatment, and the treatment principles are “sweating, vomiting, downward draining, harmonizing, warming, clearing, supplementing, and eliminating”, using various methods such as herbal medicine, acupuncture, massage, cupping, qigong, and dietary therapy to make the body achieve harmony between yin and yang and recover from illness.
Western medicine as modern medicine is characterized by more than 100 years of Western culturally intuitive thinking, linear thinking, reductionism, logical analysis of the respiratory, circulatory, digestive, urinary, endocrine, neurological and other systems, cellular, genetic, molecular, and even the quantum aspects of human diseases. Western medicine’s perception of the human body is that the various components are structurally inseparable, physio- logically interconnected, mutually supportive, and yet mutually constraining, and pathologically interacting with each other. However, the treatments offered byWestern medicine are mostly allopathic and localized, often criticized as “treating the head when it hurts, and treating the foot when it hurts”, with symptoms and signs as the guide, instrumentation, laboratory tests, chemical drug treatment and surgery as the main means of treatment, repairing the deficiency and removing the excess.
“The advantages of combined Chinese and Western medical treatment services are in the prevention of the disease and chronic dis-ease management, while also having the ability to respond to major public health emergencies. ” [2] The discipline of integrated medicine combines the systematic functions of prevention, diagnosis and treatment, internal medicine and surgery from Western and Chinese medicine, clinical research, research and translation, teaching and personnel training, etc., and has a systematic ability to prevent and treat the whole disease process, from the early preventative stage, to the end stage. Much of the research on evidence-based medicine shows that the effect of combining Chinese and Western medicine is significantly better than that of Chinese medi- cine or Western medicine on their own, and that combining Chinese and Western medicine is the only way to develop Chinese medicine. “Today, the world of modern medicine is moving from micro to macro, while Chinese medicine is moving from macro to micro. Chinese and Western medicine are moving in opposite directions and converging with one another, not as a simple fusion reflecting the increased use of technology, but also the bi directional exchange of original thinking from the positions of Chinese medicine and modern technology.” [3]
During the 3-year epidemic, in terms of the prevention and control of the novel coronavirus infection, the combination of Chinese and Western medicine has played an important role. Western medicine defines COVID as an epidemic infectious viral disease which is principally characterized by damage to the respiratory tract, and causing inflammatory responses in the respiratory system. This, in turn, can cause multiorgan damage in severe cases. Symptomatic treatment such as antipyretic, cough suppressants, bronchodilators, and oxygenation are the main therapeutic measures. In Chinese medicine, the etiology and pathogenesis of the coronavirus infection have not changed in the past few years. The disease is defined as an epidemic toxin which is located in the lung, with the pathogenesis of damp-heat accumulation in the lung or damp toxins depressing the lung. Diagnosis is based on the appearance of the tongue, the pulse image, divided into various syndromes: damp toxin depressing the lung, cold dampness blocking the lung. Pestiliential toxin combined with dryness, pestilential toxin blocking the lung. Qi and ying burning, and vacuous and feeble yang qi. [4]
Three years of clinical practice against this epidemic has proved the combination of Chinese and Western medicine and individualized treatment is fully reflected in the prevention and treatment of coronavirus infection. In western medicine the prevention of epidemic and infectious diseases is to find the source of infection, cut off transmission routes, and protect the susceptible population; however, in the case of such a large surface of coronavirus infection, it is difficult to rely solely on cutting off the transmission routes and protecting the susceptible population. Chinese herbal medicine can provide prophylactic decoctions, with 10 traditional Chinese medicines, which can be drunk as tea [5], which is simple, cheap and effective. In the treatment of patients with coronavirus infection, fever can be controlled with ibuprofen, oxygen supplementation for hypoxia, and intravenous fluid rehydration for patients who have difficulty eating, can all help to support and stabilize.
This is a manifestation of the saying “in an emergency treat the symptoms” in traditional Chinese medicine. And western medicine was used to treat the acute symptoms, while Chinese medicine preparations were added, particularly during the recovery period from coronavirus infection. During the recovery period, Chinese medicine complements the deficits of western medicine, by supporting the right qi, it helps to gradually restore the body’s resources, and slowly but steadily strengthens the immunity.
In a more general way, the combination of Chinese and Western medicine has changed the routine practice of Western medicine and formed a novel therapy with Chinese characteristics, which not only improves the effectiveness, and reduces mortality, but also helps some patients avoid surgery and reduces the comorbidities and side effects of medical treat- ment. In elucidating the essence of the theories of yin and yang, internal organs, qi and blood, exploring the norms of various symptoms, and studying the mechanisms of treatment methods such as activating blood circulation and removing blood stasis, acupuncture and analgesia, all of them can more fully reflect the combination of traditional Chinese medicine academic and modern scientific experimental methods. The combination of Chinese and Western medicine will certainly become a medicine for the future, to better benefit human health.
References:
1. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. National Research Council (US) Committee on A Framework for Developing a New Taxonomy of Disease. Washington (DC): National Academies Press (US); 2011.2. [China Youth Daily] At the unveiling ceremony of the China National Center for Integrative Traditional Chinese and Western Medicine, Zhou Jun, the president of the China-Japan Friend- ship Hospital, gave a speech. October 25, 2022
3. [China Youth Daily] Speech with Academician Xiaolin at the unveiling ceremony of China National Center for Integrative Traditional Chi- nese and Western Medicine. October 25, 2022
4. [Chinese Traditional Medicine] Diagnosis and Treatment Program for Novel Coronavirus Infection (Trial Version 10), Chinese Medicine Treatment Part, published in Beijing on January 8, 2023
5. The Beijing Municipal Administration of Traditional Chinese Medicine’s Urgent Notice on Adjusting the Preventive Prescriptions of Traditional Chinese Medicine for the Novel Coronavirus at the Current Stage, December 8, 2022
