Academician Wu Yiling: The theory of preventing “micro” and “changing” veins has found a new breakthrough for the prevention and treatment of cardiovascular and cerebrovascular diseases

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At present, chronic non-communicable diseases represented by cardiovascular and cerebrovascular diseases and metabolic diseases have become an important public health problem that seriously endangers people’s health. Both Chinese and Western medicine have unique advantages in treating these diseases, and promote the complementary and synergistic advantages of Chinese and Western medicine. Innovation is of great significance to accelerate the construction of a national major disease prevention and treatment system integrating traditional Chinese and Western medicine.

On April 16, the 10th Angiology Congress of Integrated Traditional and Western Medicine hosted by the Chinese Society of Integrative Medicine was held in Xi’an. In the keynote report of the conference, Professor Wu Yiling, an academician of the Chinese Academy of Engineering, gave an academic report entitled “Construction of TCM choroidal theory and its guidance on the prevention and treatment of microvascular lesions”, introducing the first prize project of the National Science and Technology Progress Award “Construction of TCM choroidal theory and its guidance on the prevention and treatment of microvascular lesions” Significant academic achievements in the treatment of cardiovascular diseases.

Professor Wu Yiling, academician of the Chinese Academy of Engineering, made an academic report at the meeting

Microvascular disease is the key factor that makes it difficult to improve the clinical efficacy of cardiovascular, cerebral (diabetic) and renal vascular diseases

Major diseases such as cardiovascular and cerebrovascular diseases and diabetic nephropathy seriously endanger human health. Statistics show that the incidence of cardiovascular disease in China remains high, with 330 million people suffering from it, and 2 out of every 5 deaths due to disease are due to cardiovascular disease. The United States “Microcirculation” (Microcirculation) magazine pointed out that the essence of cardiovascular disease is microvascular circulation disorder, which is the main cause and aggravating factor of cardiovascular disease. Academician Wu Yiling pointed out that the microvessel is the most important organ that determines the health of the human body. It not only undertakes the transport function of blood, but also is the most important link to truly transport blood to various tissues and organs, and is also the main place for material exchange between blood and tissues and organs. The normal structure and function of the human body play an important role in maintaining the functions of the heart, brain, kidney and other organs. Microvascular disease is a systemic disease of the whole body, which is a difficult problem in the international medical community. It is not only an important factor in the occurrence and development of major diseases such as cardiovascular and cerebrovascular diseases and diabetes, but also a key factor that is difficult to improve the current clinical efficacy.

Facing this disease that poses the greatest threat to human health, academician Wu Yiling led a scientific research team to systematically carry out research on the construction of TCM vein theory and its guidance on the prevention and treatment of microvascular lesions from three aspects: theory, mechanism and clinical practice since 2005.

Theory – the first systematic construction of the vein theory to guide the prevention and treatment of microvascular diseases is a major theoretical original

Academician Wu Yiling’s team traced the origin and explored the flow, and systematically constructed the context theory. The “vessels” of Chinese medicine and the blood vessels of Western medicine are anatomically identical, spreading all over the body and mainly responsible for the circulation of blood. The choroid is the branch of blood vessels, including microvessels and microcirculation; the choroid theory is constructed, and the core theory of the choroid theory—Yingwei theory is proposed, which systematically reveals the occurrence, development and treatment of vascular lesions, and establishes the clinical syndrome differentiation and diagnosis system. Standards, medication rules, put forward “Sunluo-microvessel” is the theoretical combination point and treatment breakthrough of Chinese and Western medicine in the study of microvascular diseases, and formed a system theory to guide the prevention and treatment of cardiovascular and cerebrovascular diseases and diabetic vascular complications; and under the guidance of this theory Analyzed 2,487 first prescriptions for the treatment of vascular diseases over the past 2,000 years, and developed innovative traditional Chinese medicine Tongxinluo Capsules for ischemic cardiovascular and cerebrovascular diseases, Shensong Yangxin Capsules for arrhythmia, and Qili Qiangxin Capsules for heart failure , opened up a new way to effectively prevent and treat cardiovascular and cerebrovascular diseases. The national “973” plan expert group commented: “The theory of veins, camp and health has formed a new theory to guide the prevention and treatment of major diseases of microvascular disease, and belongs to the original achievement of academic research on traditional Chinese medicine.”

Mechanism—Protection of microvessels is a common mechanism for the treatment of major clinical diseases of the heart, brain (sugar) and kidney with dredging drugs

Academician Wu Yiling said, “Our more than ten research groups started research in 2005, and analyzed more than 33,000 research data, revealing that microvascular disease is the core and triggering factor of microvascular endothelial cell damage, blood components and neurohumoral regulation. Participate in the complex network pathology of the multi-dimensional space-time dynamic evolution of the heart, brain, and kidney cell structure and function damage. Collateral dredging intervention makes the complex network associated nodes tend to be normal, and has more obvious advantages in protecting microvessels than the control group.”

Academician Wu Yiling emphasized that dredging collaterals, protecting microvessels and improving blood perfusion is a common mechanism for the treatment of major diseases of the heart, brain, and (sugar) kidney: in the experiment of acute myocardial infarction, Tongxinluo Capsules protected microvessels and myocardial Perfusion unit, thereby reducing infarct no-reflow and infarct size. In the arrhythmia experiment after myocardial infarction, it was found that Shensong Yangxin Capsules can effectively treat arrhythmia by improving myocardial microvascular blood perfusion, and the effect of reversing electrical remodeling is equivalent to that of amiodarone, inhibiting structural remodeling, reversing neural remodeling, improving Cardiac function is better than amiodarone. In the heart failure experiment after myocardial infarction, Qili Qiangxin Capsules can inhibit ventricular remodeling and improve heart function by protecting microvessels and cardiomyocytes. In the experiment of acute cerebral infarction, Tongxinluo Capsule protects the microvessels in the ischemic area, thereby protecting the blood-brain barrier and nerve cells, reducing the volume of cerebral infarction, and improving neurological function. In the experiment of diabetic nephropathy, Tongxinluo Capsules protected microvessels and nephrons, inhibited renal fibrosis, and improved renal function.

Protecting microvascular endothelial cells is the core mechanism for treating microvascular diseases and the key to preventing and treating major diseases such as cardiovascular and cerebrovascular diseases and diabetes. A large number of basic studies have confirmed that the meridian dredging drugs developed under the guidance of the choroid theory have the function of protecting microvessels, protecting vascular endothelial cells, inhibiting their apoptosis, promoting their proliferation, and making the vascular endothelial cells tightly connected, thereby improving the endothelial barrier function; It can prolong the survival time of microvascular endothelial cells in an ischemic and hypoxic environment, protect the morphological and functional integrity of microvessels, and can promote the regeneration of microvessels in the infarcted area, and realize the protection of ischemic tissues. Key mechanisms of microvascular disease. Therefore, the national “973” plan project acceptance expert group agreed that the project “has made a major breakthrough in the treatment of microvascular diseases with traditional Chinese medicine”.

Clinical—Evidence-based medical research to solve international medical problems in the cardiovascular field

According to Academician Wu Yiling, relying on two national “973 projects”, four evidence-based medical studies have been carried out, which have solved major problems such as acute myocardial infarction without reflow, premature ventricular contraction with cardiac insufficiency, sinus bradycardia with premature beats, and chronic heart failure. International medical problems.

The results of a randomized, double-blind, placebo-controlled, multi-center clinical study of 1212 cases of Tongxinluo intervention in carotid plaque showed that the application of Tongxinluo capsule can delay the average carotid intima-media thickness, plaque area and vascular The progress of the refactoring index reduces the incidence of first cardiovascular events, and the safety is good. An evidence-based study of 219 cases of acute myocardial infarction with no reflow treated by Tongxinluo Capsules showed that, compared with conventional western medicine, the addition of Tongxinluo can significantly reduce the size of myocardial infarction, improve heart function, and increase the curative effect by 20%. Significant progress has been made on this difficult problem in the vascular community. Tongxinluo Capsule has been included in the “Chinese Expert Consensus on the Diagnosis and Treatment of Coronary Arteries as Microvascular Diseases”, “Chinese Expert Consensus on the Diagnosis and Treatment of Coronary Artery Spasm Syndrome”, “Expert Consensus on the Diagnosis and Treatment of Acute Myocardial Infarction Integrated Traditional Chinese and Western Medicine”, “Chronic Brain Insufficiency”. Authoritative expert consensus issued by the Chinese Medical Association, China Society of Integrative Medicine, etc.

The evidence-based study of Shensong Yangxin Capsules in the treatment of 465 cases of ventricular premature beats with cardiac insufficiency has confirmed that Shensong Yangxin Capsules can reduce ventricular premature beats while improving heart function, providing a new drug for this international clinical problem. An evidence-based study of Shensong Yangxin Capsules in the treatment of 333 cases of sinus bradycardia with premature ventricular beats found that it can effectively reduce premature ventricular beats, increase ventricular rate, and fill the gap in the treatment of both fast and slow, and integrated rhythm-regulating drugs. Shensong Yangxin Capsule has been included in the “Chinese Expert Consensus on Ventricular Arrhythmia”, “Atrial Fibrillation: Current Understanding and Treatment Recommendations”, “Guidelines for Rational Drug Use of Arrhythmia” and “Thirteen “Five” planning textbook “Internal Medicine”.

An evidence-based study of Qili Qiangxin Capsules in the treatment of 512 cases of chronic heart failure found that the drug can significantly reduce the level of NT-proBNP (a marker of heart failure), improve heart function, increase left ventricular ejection fraction, and increase the 6-minute walking distance of patients with heart failure , reduce the incidence of composite endpoint events, and significantly improve the clinical efficacy by 16% on the basis of international standardized treatment of western medicine. The study was published in the authoritative international circulation journal “American Journal of Cardiology” (JACC), and the editorial department issued a review article “Making the Failing Heart Stronger-Inspiration from Traditional Chinese Medicine”, saying: “This promising research has already It opens the door to how to use the latest technology to study the synergy of traditional Chinese medicine in the treatment of heart failure, which is a challenge that we should warmly embrace.” Professor Anthony, deputy editor-in-chief of The New England Journal of Nature, commented: “The clinical study of Qili strengthening heart is very exciting, it is a high-quality double-blind, placebo-controlled study, and the results are very encouraging. result of the heart”. The evidence-based study of Qili Qiangxin Capsules was rated as the annual academic highlight of the American College of Cardiology JACC: “This study confirmed the reliable curative effect of the traditional Chinese medicine Qili Qiangxin Capsules, and obtained a synergistic effect with the combined treatment of Western medicine, so that patients with heart failure obtained significant curative effects “. Qili Qiangxin Capsule has been included in the Chinese Medical Association’s “Chinese Guidelines for the Diagnosis and Treatment of Heart Failure” and “Chinese Guidelines for the Diagnosis and Treatment of Dilated Cardiomyopathy”.

The national “973” plan project acceptance expert group commented that the above research “created a new model of TCM academic innovation and transformation integrating ‘theory + clinical + new drug + experiment + evidence-based’, combining traditional TCM theoretical innovation with modern science and technology, resulting in The major original achievements have set an example for the inheritance and innovative development of traditional Chinese medicine.”

Experts participating in the meeting said that to adhere to the equal emphasis on traditional Chinese and Western medicine, and to strengthen the integration of Chinese and Western medicine, it is necessary to use the great wisdom of “harmony but difference”, to understand each other deeply, to constantly explore, and to constantly seek evidence. Make greater contributions to China’s construction and the health and well-being of people around the world, and protect people’s health.

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