Artemisinin may open the door of "modern Chinese medicine"

Business News Agency October 17 October 3, the Nobel Committee announced the first Nobel Prize in 2011 - the Nobel Prize in physiology or medicine As she just won the Lasker prize for medicine in September, which is known as "the vane of Nobel Prize", many people have high expectations for Tu youyou and her artemisinin to win the Nobel Prize Although it did not win the Nobel Prize, artemisinin was awarded the international medical award, which still made a lot of writing in the history of traditional Chinese medicine After the news that Tu Youyou, the common goal behind the controversy, won the Lasker prize, there was a controversy in the society immediately Whether the success of artemisinin can reflect the value of traditional Chinese medicine has become the focus of debate Professor Chang cunku of Heilongjiang University of traditional Chinese medicine also said in an interview with our reporter that the research of artemisinin is only based on a kind of efficacy record of traditional Chinese medicine, and does not touch the core academic connotation of traditional Chinese medicine Therefore, "artemisinin has limited significance in promoting the overall progress of Chinese medicine" Li Lianda, academician of the Chinese Academy of engineering and chief researcher of the Chinese Academy of traditional Chinese medicine, thinks that artemisinin has the characteristics of chemical medicine after purification, extraction and artificial synthesis But it comes from traditional Chinese medicine and develops in traditional Chinese medicine "The research and development of Western medicine is characterized by high-throughput screening Every kind of Western medicine should be selected blindly from hundreds of thousands of compounds If you meet the right one, you should study it in depth, just like grasping lottery tickets Traditional Chinese medicine is not blind, but based on the experience of ancient and modern people, it is targeted to optimize Different sources are the biggest difference between traditional Chinese medicine and Western medicine " Li Lianda told our reporter This view coincides with Chen Keji, another expert on traditional Chinese medicine, academician of the Chinese Academy of Sciences and chief researcher of the Chinese Academy of traditional Chinese medicine: "artemisinin should be regarded as a traditional Chinese medicine, and it should be called modern Chinese medicine." "Today, the development of traditional Chinese medicine has come to a time of scientization and modernization Using modern scientific and technological means to analyze the effective ingredients in traditional Chinese medicine has become the duty of traditional Chinese medicine research " Chen Keji pointed out in an interview with our reporter that one of the topics of modern Chinese medicine is to understand the clinical use of Chinese medicine, what problems can be solved and what its material basis is In fact, in Li Lianda's view, the debate about whether artemisinin is a traditional Chinese medicine is not of great value in itself "The core goal of eastern and Western medicine is the same, that is, to cure diseases and save people We should pay more attention to this goal " Li Lianda stressed The long way of standardization of traditional Chinese medicine is often stored in the storehouse It is pointed out that the core issue in the dispute of traditional Chinese medicine is that although traditional Chinese medicine has value, it has not achieved scientific form, and its theory cannot explain the truth of clinical effect "As far as traditional Chinese medicine is concerned, only the efficacy records can be used for empirical research, but there are substantive dislocation and logical mismatch between its theory and efficacy, such as sexual taste, meridian tropism, ups and downs, function and so on, so empirical research cannot be carried out." However, the artemisinin case seems to bring light to the empirical study of traditional Chinese medicine The scientific and standardization of modern medicine will become the core work of the future development of traditional Chinese medicine At the same time, it will be a huge project Li Lianda introduced that there are about 12800 kinds of raw materials and 10000 kinds of proprietary Chinese medicines "To achieve the standardization of the efficacy of traditional Chinese medicine, we should do everything from crude drugs, APIs, extracts, semi-finished products to finished products, not in three or five years." Chen Keji pointed out that according to the requirements of science, many drugs need to be studied in drug metabolism For example, if you take a medicine and excrete it in 24 hours, you need to supplement it every 24 hours; if you excrete it in 8 hours, you need to supplement it every 8 hours Drug metabolism involves many aspects such as efficacy and toxicology At the same time, the most characteristic and widely used compound prescription in traditional Chinese medicine, due to the interaction between drugs, the standardization of each drug is far away when the standardization of each drug has not been completed Li Lianda suggested that in the initial stage, the standardization of traditional Chinese medicine should first screen out some new drugs, or focus on some of the most effective drugs among the old ones "We need to promote the modernization of traditional Chinese medicine in a selective and focused way." Chen Keji also pointed out that the standardization of traditional Chinese medicine has not been completed The follow-up study of drug resistance is also an important part of modern Chinese medicine research Tu youyou said when she received the Lasker medical award in New York, the United States, that she hoped to draw attention to the issue of artemisinin drug resistance through the award Find out the way to prevent the drug resistance of artemisinin and its derivatives as soon as possible She pointed out that the original search for new artemisinin drugs was to deal with drug-resistant malaria treatment If artemisinin drugs are misused or used as unreasonable preventive use, it is likely to accelerate the emergence of artemisinin resistant malaria Now some countries in Africa and Asia use therapeutic drugs as preventive drugs Once artemisinin resistant malaria appears and breaks out, human beings will face another disaster In the future, the main keynote is cooperation: "to study Chinese medicine compound prescription, we need pharmacognosy first, and we need botanists; to analyze the ingredients, we need chemists; to find the target of action, we need pharmacologists; to carry out toxicology research, we need toxicologists; to verify the clinical effect, we need clinicians." Chen Keji pointed out that interdisciplinary cooperation has become an inevitable choice for modern Chinese medicine research Li Lianda gave a more vivid metaphor: "like a war, all kinds of arms, land and air, can go up." In addition to interdisciplinary cooperation, strengthening exchanges with western countries and actively learning from western advanced technologies are also the necessary path for the development of traditional Chinese medicine in the future "Chairman Mao said that the past serves the present and the foreign serves China Only by combining the two can we promote the development of traditional Chinese medicine healthily and dig out good achievements of traditional Chinese medicine " Li Lianda said After all, influenced by culture, there are differences in the history of traditional Chinese medicine and Western medicine Western medicine has attached great importance to experiment, anatomy and analysis since ancient Rome, while traditional Chinese medicine, influenced by Confucianism, Buddhism and Taoism, has attached great importance to integration "Some people always say that traditional Chinese medicine cannot learn western medicine, or it will be westernized Then why don't we wear long coats now? In fact, traditional Chinese medicine and Western medicine have their own advantages and disadvantages In clinical treatment, I advocate the combination of traditional Chinese and Western medicine, which should complement each other's advantages " Chen Keji has been trying to promote the integration of traditional Chinese and Western medicine Tu youyou also said that China has the foundation of TCM research, but cooperation with international research will supplement our shortcomings Through the establishment of a reasonable incentive mechanism to promote continuous innovation in Chinese medicine research, to remove the dross and extract the essence, Chinese medicine can do better "I would like to call on China and the International Medical Association to cooperate in the research of traditional Chinese medicine." In recent years, the research system of traditional Chinese medicine needs to be "customized" In China, the overall research environment tends to write articles and produce results The research of traditional Chinese medicine has been deeply affected, which Li Lianda does not agree with "Treating and rescuing talents is the ultimate goal of medical research, especially the research of traditional Chinese medicine The value of research work that is far away from this goal cannot be reflected." Li Lianda pointed out that western medicine has some pure mechanism and pure discipline research, which is far from the goal of curing diseases and saving people in the short term, and may take ten or twenty years to play its role On the contrary, the main research direction of traditional Chinese medicine should be on the treatment of diseases and saving people "The evaluation system of TCM research should be tailored according to the characteristics of TCM." Li Lianda stressed He further pointed out that the current system and mechanism of scientific research and management of traditional Chinese medicine also had defects To some extent, it restricts the development of scientific research of traditional Chinese medicine, especially is not conducive to mobilize the enthusiasm and innovation ability of front-line scientific and technological workers On the one hand, the popularity of examination oriented scientific research, that is, a very small number of people come up with questions and work together across the country, reflects the will of the chief and the ideas of a very small number of experts, so that the expertise of more scientific researchers is not easy to play On the other hand, there are many "foreman" projects in the field of science and technology A "everybody" monopolizes a large number of major projects, occupies several hundred million scientific research funds, and then subcontracts them to other units layer by layer Finally, all the achievements made by everyone belong to them Chang cunku also believes that at present, the development of traditional Chinese medicine has a great momentum, a lot of money, a prevailing trade, and few achievements, lacking scientific spirit, scientific attitude and scientific methods We should further reform the system of subject and achievement evaluation to make the application of subject and achievement transparent and fair "The development of TCM industry depends on the scientific research progress of TCM, and to ensure the scientific research progress of TCM, we must have correct policies, to ensure the effective use of funds and funds, and to take more strict and feasible measures for subject examination and approval, achievement appraisal, etc." The repository said At present, the momentum of China's support for traditional Chinese medicine has not decreased A series of documents have been issued to promote the development of traditional Chinese medicine, and the funding for scientific research has increased dozens or even hundreds of times than in the past However, in the face of the vast standardization project of traditional Chinese medicine, the current investment is still insufficient At the same time, from the policy level to support the development of traditional Chinese medicine, medical reform must also have greater action "For example, setting up community general practitioners, traditional Chinese medicine is very promising." Chen Kaixian, academician of the Chinese Academy of Sciences and President of Shanghai University of traditional Chinese medicine, believes that community residents often have some minor diseases that are not serious, and general practitioners of traditional Chinese medicine can play a role in "treating the disease before it occurs" and disease prevention "If researchers can produce more achievements like artemisinin that can reflect the value of traditional Chinese medicine, the influence of traditional Chinese medicine will be greater, and more people will support traditional Chinese medicine, so as to achieve the success of" modernization "of traditional Chinese medicine," Chen said