Zhang Boli： We have the ability to achieve ＂dynamic zero clearing＂
Xinhua News Agency, Shanghai, April 25th: Zhang Boli: We have the ability to achieve "dynamic zero clearing".
Xinhua news agency reporter
Where is the confidence to achieve "dynamic zero clearing", what are the characteristics of the current epidemic in Shanghai, and what important role does traditional Chinese medicine play for Covid-19 infected people, especially severe patients? In response to social concerns, Zhang Boli, an academician of China Academy of Engineering and honorary president of Tianjin University of Traditional Chinese Medicine, responded in an interview with reporters in Shanghai recently.
Q: What do you think of "dynamic zero clearing"? Where is the confidence for China to realize "dynamic zero clearing"?
A: "Dynamic zero clearing" and "absolute zero clearing" are completely different concepts. "Dynamic zero clearing" means taking active measures to find and put out the epidemic together, not to say that the epidemic situation will never happen. The core connotation is to quickly find the epidemic situation and take measures to stop the continuous community spread of the epidemic situation.
According to the population density and population structure of China, once the epidemic control is relaxed, it will face the consequences of widespread virus transmission, severe illness and huge number of deaths.
The epidemic in Shanghai is precisely because many teams have come to support it, which has prevented the medical resources from being run. If it is completely liberalized, a large number of critically ill patients will appear. How many medical resources will be needed to deal with it? If that happens, it is hard to imagine how economic development and social communication will be carried out. Everyone is worried about whether they will be infected or not, and how can they live with peace of mind?
The practice of dealing with dozens of local cluster epidemics in China after Wuhan proves that we have the ability to achieve "dynamic zero clearing", which has achieved good results at a small cost and ensured people’s health and steady social and economic growth.
Q: From the perspective of Chinese medicine, what are the characteristics of Omicron mutant and the current epidemic in Shanghai?
A: The mutant strains in Omicron spread quickly and are concealed. Recently, the local clustering epidemic has been characterized by many spots, wide areas and frequent occurrences.
From the perspective of traditional Chinese medicine, the core etiology and pathogenesis of Omicron mutant strain COVID-19 has not changed significantly compared with before, and it still belongs to the category of "epidemic disease" in traditional Chinese medicine. Only due to the differences in regions, climate, eating habits and other factors, there are slight differences in syndrome characteristics, such as dryness in northwest China, and dampness with wind-heat in Shanghai.
Q: What role does Chinese medicine play in asymptomatic infected people and mild cases?
A: The large number and high proportion of asymptomatic infected people are the obvious characteristics of this round of epidemic in Shanghai. On the one hand, it is related to the characteristics of Omicron mutant, on the other hand, it is related to timely screening and early detection of infected people in China, as well as extensive vaccination.
For the treatment of asymptomatic infected people, western medicine has no symptoms and Chinese medicine has syndromes. For example, some asymptomatic infected people, although they don’t have COVID-19’s symptoms, may have symptoms of traditional Chinese medicine, such as fatigue, greasy tongue coating, abdominal distension, etc. At this stage, timely intervention with traditional Chinese medicine plays a role in regulating immune function, which can often achieve better curative effect, so that they don’t become diagnosed, and also promote the rapid turn of nucleic acid into negative.
According to the principle of "novel coronavirus Diagnosis and Treatment Plan (Trial Ninth Edition)", using "three drugs and three parties" and the agreed prescription formulated by Shanghai, from the early use situation, asymptomatic infected patients and mild patients in Covid-19 showed a good curative trend in reducing the weight transfer rate and reducing the time of leaving the cabin after intervention with traditional Chinese medicine.
Q: Shanghai’s population is aging. What treatment plan does Chinese medicine take for the elderly infected people, and what is the effect?
A: Among the confirmed cases, 30% are elderly people over 60 years old, and most of them suffer from basic diseases, including hypertension, diabetes, coronary heart disease, stroke, dementia, tumor and uremia. These factors, combined with COVID-19, will lead to a serious illness, and the disease progresses rapidly, and it is easy to turn into severe and critical illness, which needs special attention.
In order to improve the treatment effect of the elderly infected persons, according to the symptoms of Omicron mutant, combined with the characteristics of the elderly and previous treatment experience, on the basis of "novel coronavirus Diagnosis and Treatment Plan (Trial Ninth Edition)", the treatment of the elderly infected persons aims at accelerating the nucleic acid negative conversion, reducing the aggravation of the disease and reducing the death rate, and under the guidance of the national expert group, an expert consensus on the treatment of the elderly novel coronavirus infected patients in Shanghai with traditional Chinese medicine has been formed.
Generally speaking, it is necessary to distinguish high-risk groups, pay attention to the changes of basic diseases, combine multiple disciplines, intervene early, treat according to syndrome differentiation, and make a policy for one person, and grasp the main symptoms and core pathogenesis to determine the clinical treatment plan and strategy of integrated traditional Chinese and western medicine. It is early and fast in the timing of medication, clear and clear in the treatment strategy, and pays attention to regulating the overall state of the body, avoiding the elderly patients from developing into severe diseases, cutting off the disease and reducing death.
Q: What is the treatment plan of Chinese medicine for severe and critical patients?
A: For the treatment of severe and critically ill patients, we should first emphasize multi-disciplinary cooperation, including intensive medicine, respiratory medicine, nutritional support, nursing, traditional Chinese medicine, etc. Each discipline gives full play to its own advantages and collective efforts, and combines Chinese and Western medicine, so as to control the disease, reverse the disease and reduce the death rate.
According to the basic diseases and other factors, Chinese medicine takes dialectical methods and targeted treatment strategies for each patient’s most dangerous factors at present. Specifically, it is "early" and "accurate", early detection, early warning, early judgment and early intervention; Take targeted and precise treatment, "one person, one policy, one person, one side, one day" method to treat.
In order to strengthen the ability of TCM treatment of critically ill patients, we set up a multi-disciplinary TCM expert group at the municipal level. Besides participating in the joint rounds and consultations of Chinese and Western medicine experts at the municipal level, we hold consultations and discussions on critically ill cases in designated hospitals at the municipal and district levels every night, make daily statistics on TCM treatment of critically ill cases, and conduct consultations on cases with serious illness or complicated basic diseases one by one.
Q: What role does Chinese medicine play in the follow-up rehabilitation of discharged patients?
A: Since the emergence of the COVID-19 epidemic, people have been concerned about whether there are sequelae, and they have different names for it, and some have called it post-COVID-19 state and persistent symptoms. Patients can be discharged from the hospital after the nucleic acid turns negative and meets the requirements of relevant indicators, but some people have not fully recovered their immune function, and others have damaged their heart, liver and kidney due to Covid-19, and their functional indicators are not normal.
Therefore, patients discharged from COVID-19 need a rehabilitation process. Summarize the rehabilitation situation of patients with epidemic diseases in Wuhan and beyond. Some patients have fatigue, muscle aches, palpitations, asthma, anxiety, insomnia, hair loss, etc. For this, we put forward the concept of "early rehabilitation, self-rehabilitation and comprehensive rehabilitation", which generally adopts the method of combining traditional Chinese and western medicine, with western medicine doing health assessment and Chinese medicine promoting rehabilitation.
After active rehabilitation, most people’s symptoms are gradually eliminated within three months to six months, and some people need longer rehabilitation. Some patients can cooperate with medication, and some patients can actively promote rehabilitation through physical exercise, such as playing Tai Ji Chuan and Baduanjin.
Because the Omicron mutant appeared late, more observation is needed on its possible sequelae. (Reporter Gong Wen, Li Shu, Li Hengyi, Li He)