中华中医药学会
中医药学是形成于中国古代的研究人体生命、健康、疾病和养生、保健、防病治病的一门自然科学。她具有独特的理论体系、丰富的临床经验和科学的思维方法,是以自然科学知识为主体,与人文社会科学知识相交融的科学体系。中医药学以其独特的理论和现实的疗效生存并发展至今,保障了中华民族几千年繁衍昌盛。近年来,我国中医药学科取得了重要进展,为我国人民健康和社会主义现代化建设作出了应有的贡献。2006年8月1日,国家中医药管理局制定了《中医药事业发展“十一五”规划》,并确立了重点发展的10个项目,为中医药改革与发展描绘了新的蓝图。2006年10月11日,中国共产党第十六届中央委员会通过了“中共中央关于构建社会主义和谐社会若干重大问题的决定” 第六次全体会议,明确提出了“大力扶持中医药和民族医药发展”的重要战略,为中医药事业在新历史时期的全面、协调和可持续发展奠定了比较坚实的基础。
1中医药学科现状与发展趋势
中医药学科以继承创新为主线,全面推动了学科的发展。2004年,国家财政支出中医事业费绝对数为37.52亿元,而2005年上升到41.42亿元。“十五”期间,国家发改委、财政部、科技部、自然基金委与国家中医药管理局共投入中医药研究开发资金14亿元,有力地促进了科技与临床、生产相结合的中医药学术发展和技术创新,共有22项科技成果获得国家科技进步奖,其中“血瘀证与活血化瘀研究”在继承传统中医理论的基础上,对血瘀证及其活血化瘀治法进行了深入、系统的现代研究,取得了重大进展,获得了2003年国家科技进步一等奖。2003年,国家中医药管理局启动的“中西医结合治疗SARS方案优化与多中心数据处理”研究项目及其组织实施的国家863计划重大项目“中西医结合治疗SARS临床研究”,使中西医结合方法治疗SARS的成功经验和研究成果,得到了世界卫生组织的肯定。截至2005年底,我国开展的中医药治疗艾滋病试点项目由5省扩大到11个省,中医药治疗艾滋病在改善部分症状、体征方面取得初步成效。2005年10月,国家中医药管理局紧急启动中医药防控人感染高致病性禽流感专项研究,中医药参与重大疾病研究翻开新的一页。此外,在中药学及民族医药方面也取得了重大进展。
针灸学是中医学走向世界的先导,并越来越被世界科学界所关注。世界卫生组织(WHO)文件指出,“针灸是被世界各国率先接受的传统医学方法”。WHO在亚洲设立的15个“世界卫生组织传统医学合作中心”中有13个与中医药有关,其中7个设立在中国。2003年,WHO制定的《全球传统医学发展战略》中采纳了我国政府提出的建议,明确指出我国的针灸、中药等传统医药正在全球获得广泛重视,在人类保健中发挥着日益重要的作用。此外,中医药的国际交流合作日益活跃,到2005年底,我国已与70多个国家签订了含有中医药条款的卫生合作协议,另外还签订了专门的中医药合作协议达到16个。
1999年正式启动了国家重点基础研究发展计划(“973”计划),2005年7月在该计划中首次设立了中医基础理论专项,拟投资五千万元的研究经费,使基础研究得到了前所未有的强有力支持。国家自然科学基金委员会2002~2003年安排了262项中医药基础研究项目,并启动了重大研究计划项目“中医药关键问题的基础研究”。2002~2004年国家中医药管理局重点支持了中医理论、中药质量、方法学、资源保护与利用、种子种苗、动物药等360余项研究。自2003年以来,中医药共有一个项目七个专项遴选入973计划。2004年,启动并组织实施国家科技攻关项目“中医药疗效及安全性基本问题研究”、“中医临床疗效关键技术研究”、“中医药疗效及安全性基本问题研究”、“中医临床疗效关键技术研究”等研究。国家高技术研究发展计划(“863”计划)重大科技专项“创新药物与中药现代化”于2001年正式启动,2005年12月通过了国家科学技术部的验收。
2005年,共有4项中医药研究获得国家科技进步二等奖。分别为:“益气升陷法在病毒性心肌炎中的应用与研究”、“抗药性恶性疟防治药青蒿素复方的研发与应用”、“中西医结合治疗SARS临床研究”及“四部医典的整理和推广应用”。2005年11月4日,7项科研成果获得了2005年度中华中医药学会科学技术一等奖,包括“络病理论及其应用研究”;“超临界二氧化碳萃取中药有效成分产业化研究”等项目。2006年1月17日,“活血化瘀中药干预冠心病介入治疗后再狭窄的多中心临床及机理研究”及“著名古方生脉散的基础研究”等六项科研成果获得了首届中国中西医结合学会科学技术进步一等奖。
据全国中医药科技成果统计数据显示:2005年全国中医药学科发表论文3000篇、出版科技著作154种、专利申请受理43件、专利授权数31件、拥有发明专利总数93件。2005年全国中医药课题总数为1584个、其中基础研究143个、应用研究371个、试验发展593个、研究与试验发展成果应用349个、推广示范与科技服务126个、生产性活动2个。目前国家已经建立了3个中药安全性评价中心和4个规范化中药临床试验中心、启动了3个“国家中药药理规范化实验室”和4个“国家中药工程技术研究中心”的建设;国家中医药管理局在全国各地引导建立了135个中药示范三级实验室。我国已成功完成了艾滋病、心脑血管、肿瘤等一批新的中药治疗品种开发,以及六味地黄丸、藿香正气丸等传统名优中成药品种的二次开发,有7个中药品种通过美国食品药品管理局(FDA)临床研究许可,并申请了国际专利。
2中医药学科发展需求、战略及目标
随着人们生活水平的普遍提高,老龄化社会逐步到来,疾病谱已经发生了变化;人类对于生活质量和健康水平的需求日益增高;药源性疾患则不断增多;医学模式已从生物医学向“生物-社会-心理-生态环境”模式转化;在世界范围内,回归自然、重视植物药和自然疗法已成为发展趋势,中医药学具有系统的理论体系和显著的临床疗效,面临着前所未有的良好发展机遇。
根据我国中医药学科发展现状及趋势,在未来五年,中医药学科总体发展战略为:大力强化对中医药传统知识和技术体系的继承、整理和挖掘;对中医药传统知识进行系统整理和现代诠释,深入挖掘中医药科学文献和古典医籍,构建中医药知识库系统;建立中医药个体化诊疗体系,对名老中医的学术思想、临床经验和用药方法进行系统研究和挖掘,构建中医药现代传承技术体系;建设现代中医诊疗体系;建立中医药疗效、安全性评价方法与标准;开展中医药防治重大疾病的研究;提高中药产品的质量标准和技术水平;建立符合中医药特点的国际化标准规范及其研发技术平台,研究建立中医药国际标准,加强符合国际市场需求的医疗、保健产品研究开发与注册;继承、研究传统制药技术和经验,转化为中药工程化技术和工艺规程;积极推进中医药医疗、教学、科研、生产合作与学术、技术交流;推进中医药立法;使中药作为治疗性药物进入医院、药房和医疗保险系统;通过联合办医、办学、合办研究机构等,使中医药知识与文化得到有效的传播;推进中医药人才战略,构建中医药终身教育体系,加强中医药人才培养,开展中医药教育学研究,探索建立符合中医药教育自身规律的教育模式。
未来五年我国中医药学科发展的目标为:开展中医药理论概念内涵的系统深入整理及规范化研究,逐步形成专业术语统一,概念内涵清楚,理论层次明确,表述严密的规范化中医理论;以藏象、经络、气血为核心,进行中医生理、病理理论的深入研究,揭示其科学内涵;开展证候规范化研究,探索有代表性证候的细胞分子生物学机制,初步形成中医证候科学评价系统;规范和完善以四诊为主的诊查方法,在整体观念指导下的个体化的中医药诊疗体系;初步探明部分疗效确切的中药和有代表性的名方的药效物质基础,并探索其作用机理;初步建立适用于药效物质和作用机理研究的比较系统的方法技术;建立和完善中药质量评价与保障体系;初步揭示部分中药药性和方剂配伍理论的科学内涵,重点开展中药药性、中药炮制原理等方面研究。对针灸疗法调整作用的现代生物学机制进行深入的研究,为建立现代的针灸治疗学奠定理论基础。在提高中医药防治常见病、多发病、疑难危重症的临床疗效的基础上,加强对心脑血管疾病、糖尿病、肿瘤、痴呆、帕金森病等重大疾病的研究;加强对艾滋病、病毒性肝炎、非典型性肺炎、人感染高致病性禽流感等重点传染病的中医药防治研究;力争在防治重大疾病和疑难病方面有所突破。
3中医药学科重点领域与发展方向
在今后的五年里,我国中医药学研究可优先发展以下领域并在这些领域中设置相应的重点研究方向:
3.1中医基础理论研究
(1)500种中医药古籍文献整理研究;
(2)中医五脏相关理论继承与创新研究;
(3)创新病因学说研究;
(4)方剂配伍规律研究;
(5)中医辨证论治疗效评价方法的基础理论研究;
(6)中医防治老年病、慢性病的系统生物学研究;
(7)中医药学术传承新模式研究;
(8)名老中医药专家学术思想和临床诊疗经验研究;
(9)中医体质理论基础研究;
(10)中医药特色疗法和单验方研究;
(11)民族医药文献整理研究;
3.2证候研究
(1)证候规范与辨证论治体系研究;
(2)病证结合的诊断标准与疗效评价体系研究;
(3)证候的生物学基础研究;
(4)证候的信息处理方法与复杂系统模型研究;
3.3经络研究
(1)针灸效应与经络功能的科学基础;
(2)穴位效应规律的研究;
(3)基于临床的经穴特异性基础研究;
(4)经络文献整理研究;
3.4重大疑难疾病的中医药防治研究
(1)心脑血管病、糖尿病防治及疗效评价体系研究;
(2)神经变性病防治及疗效评价体系研究;
(3)恶性肿瘤防治及疗效评价体系研究;
(4)艾滋病、病毒性肝炎防治及疗效评价体系研究;
(5)风湿病及肾病防治及疗效评价体系研究;
3.5中药研究
(1)中药药性理论研究;
(2)濒危、道地中药的关键问题研究;
(3)中药炮制原理研究;
(4)中医药制剂关键技术及复方释药系统研究;
(5)中药材种植种源的保护与利用研究;
(6)中药质量技术标准、疗效评价方法和评价体系研究;
(7)中药安全性问题研究;
4中医药学科存在的问题与对策
近年来,虽然中医药学科的发展取得了较大进展,但仍存在不少问题。主要体现在:中医药的科技创新能力还有待进一步提高,一些重大理论和关键技术虽取得了一定成绩,但尚未取得突破性进展;人才队伍素质亟待提高;一些保护和扶持中医药发展的政策措施没有得到贯彻落实;中医药特色优势尚未得到充分发挥;中医药标准化、规范化研究急需完善;中药新药研发水平有待提高;中医药的投入长期不足,基础差、底子薄的现状仍没有得到根本改善等。因此,进一步落实中医药学术主体发展战略,提高中医药科技创新能力,加强中医药人才培养,加强中医药政策法规贯彻落实,突出中医临床诊疗的特色优势等是解决目前学科发展存在问题的根本措施。
在未来五年,中医药学科应紧紧围绕中医基础理论继承和创新研究、证候研究、经络研究以及重大疾病的防治研究等瓶颈问题,优先发展瓶颈问题的相关领域,从而推动中医药学科的飞速发展。“十一五”时期是我国全面建设小康社会的关键时期,中医药学科发展要紧紧抓住我国发展的重要战略机遇,进一步贯彻落实科学发展观,按照构建社会主义和谐社会的要求,推进中医药学科全面协调可持续发展,不断提高人民群众健康水平,为全面实现建设小康社会的宏伟目标而努力奋斗。
Report on Discipline Development of TCM and Chinese Materia Medica
(outline)
On August 1, 2006, State Administration of Traditional Chinese Medicine (SATCM) issued the 11th Five-Year Plan of TCM Industry Development to determine 10 projects of key development and describe new blueprint of TCM reform and development. On October 11, 2006, the 6th plenary session of 16th Central Committee of Chinese Communist Party passed the Decision of Central Committee of Chinese Communist Party on Several Major Problems during Constructing Socialist Harmonious Society to specify the important strategy of greatly supporting the development TCM and minority medicine development and lay more solid foundation for overall, harmonious, and sustainable development of TCM industry in new historical period.
In 2005, China spent a national fiscal expenditure of ¥4,142 million on TCM industry. During the period of 10th Five-Year Plan, State Development and Reform Commission, Ministry of Finance, Ministry of Science & Technology, Natural Science Foundation of China, and SATCM jointly input a TCM R&D fund of ¥1,400 million to thus greatly promote the academic development and technical innovation of TCM by combining its technology, clinical practice, and production, and to regard 22 technological achievements as National Award of Technological Progress. By the end of 2005, China pilot project of TCM therapy in AIDS expanded from 5 provinces to 11 provinces, and TCM therapy in AIDS made preliminary achievements in improving some symptoms and signs of AIDS. In October 2005, SATCM urgently initiated the special research on TCM prevention & control of highly-pathogenic human avian influenza. Moreover, TCM and minority medicine also made major progress. There was increasingly more and more international exchange and cooperation of TCM: by the end of 2005, China had signed various health cooperation agreements (including TCM clause) and 16 special TCM cooperation agreements with over 70 countries.
In July 2005, National 973 Program (China Development Plan of Key Basic Research) first established the special project of TCM basic theory, invested a research fund of ¥50 million, and granted unprecedented powerful support for basic research. In December 2005, Ministry of Science & Technology accepted through inspection the project of Drug Innovation & TCM Modernization, a major technological special project of National 863 Program (China Development Plan of High-Tech Research).
In 2005, 4 TCM research projects obtained National 2nd Award of Technological Progress; on November 4, 2005, 7 research achievements obtained the 1st Award of Science & Technology (2005) by China Association of Traditional Chinese Medicine; and on January 17, 2006, 6 research achievements obtained the 1st Award of Science & Technology in the first session of China Association of Integrated Chinese & Western Medicine.
As shown by the statistical data of Chinese TCM technological achievements, in 2005, there were 3000 published TCM articles, 154 published technological books, 43 accepted applying patents, 31 awarded patents, 93 invention patents, and 1584 TCM projects (including 143 basic researches, 371 application researches, 593 development tests, 349 applied R&D achievements, 126 popularized demonstrative technological services, and 2 production activities). At present, China has established 3 Safety Assessment Center of TCM and 4 Clinical Trial Center of TCM Normalization, and initiated the construction of 3 National Laboratory of TCM Pharmacological Normalization and 4 National Research Center of TCM Engineering Technology; SATCM has guided the establishment of 135 Tertiary Demonstrative Laboratory of TCM around China; China has successfully completed the R&D of a series of new TCM varieties for various major diseases (such as AIDS, cardiovascular diseases, cerebrovascular diseases, and tumor) and the secondary development of various traditional famous high-quality Chinese patented medicine (such as Liuwei Dihuang Wan and Huoxiang Zhengqi Wan); and 7 TCM varieties have been approved by FDA for clinical trial, and have applied for international patent.
Overall development strategies of TCM discipline in future five years (based on the development current conditions and trend of China TCM discipline): greatly strengthen the inheritance, arrangement, and exploration of TCM traditional knowledge and technical system; launch the systematic arrangement and modern illustration of TCM traditional knowledge, deeply explore the TCM scientific literatures and classical medical books, and construct the TCM knowledge database system; establish the personalized TCM diagnosis & therapy system, systematically research and explore the academic concepts, clinical experience, and treatment method of famous & old TCM doctors, and construct modern inheritance technical system of TCM; construct the modern TCM diagnosis & therapy system; establish the assessment method & criteria of TCM effectiveness and safety; launch the research on TCM prevention & treatment of major diseases; improve the quality standard and technical level of TCM products; establish the internationalized standard specifications and R&D technical platform up to TCM characteristic, research and establish TCM international standard, and strengthen the R&D and registration of medical and health products up to international market need; inherit and research the traditional pharmaceutical technology and experience, and transform them into TCM engineering technology and process specifications; actively promote the cooperation and academic technical exchange of TCM therapy, education, research, and production; promote TCM legislation; apply TCM as therapeutic drugs in hospital, drugstore, and medical insurance system; and effectively popularize the TCM knowledge and culture through the joint establishment of hospitals, schools, and research institutes; promote TCM talent strategy, construct TCM lifetime education system, strengthen TCM talent training, launch TCM pedagogical research, and explore and establish the education mode up to self rules of TCM education.
Development goal of China TCM discipline in future five years: launch the systematic deep arrangement and normalized research of TCM theoretic concept and internal meaning, and gradually form the normalized TCM theory with uniform terminology, clear concept and internal meaning, definite theoretic level, and strict illustration; deeply research the TCM physiological and pathological theory and reveal TCM scientific internal meaning with the core content of viscera state, channel & collateral, and Qi & blood; launch the normalized research on syndrome & symptom complex, explore the cell molecular biological mechanism with representative syndrome & symptom complex, and gradually form the scientific assessment system of TCM syndrome & symptom complex; standardize and improve the diagnosis and examination method mainly with 4 diagnostic methods) and the personalized TCM diagnosis & therapy system under the guidance of holistic concept; preliminarily ascertain the effective substances basis of some definitely-effective TCM drugs and representative famous TCM formula, and explore their action mechanism; preliminarily establish the more systematic methods and technologies suitable for research on effective substances and action mechanism; establish and improve the quality assessment and assurance system of TCM; and preliminarily reveal the scientific internal meaning of property and formula compounding theory of some TCM drugs, and mainly launch various TCM researches (such as property and preparing principle); deeply research the modern biological mechanism for regulating effect of acupuncture therapy, and lay theoretical foundation for the establishment of modern acupuncture therapy; improve the clinical effectiveness of TCM prevention & treatment on common diseases, recurrent diseases, and complex difficult dangerous severe diseases, and strengthen the TCM research on various major diseases (such as cardiovascular diseases, cerebrovascular diseases, diabetes, tumor, dementia, and Parkinson’s Syndrome); strengthen the research on TCM prevention & treatment of key infectious diseases (such as AIDS, viral hepatitis, SARS, and highly-pathogenic human avian influenza); and strive to make a certain breakthrough in preventing and treating major diseases and complex difficult diseases.
Many problems during TCM discipline development (despite greater progress): necessary further improvement of TCM technological innovation ability, and no breakthrough progress of some major theories and key technologies despite a certain achievements; urgently necessary improvement of talents competence; no effective implementation and execution of some policies & measures to protect and support TCM development; no full display of unique TCM advantages; urgently necessary improvement of research on TCM standardization and normalization; necessary improvement of New TCM drug R&D level; and no essential improvement of TCM current conditions (including long-term insufficient input, poor basis, and small foundation). Thus, China must adopt the following essential measures to solve the current existing problems during TCM discipline development: further implement the development strategy of TCM academic body, improve the ability of TCM technological innovation, strengthen the training of TCM talents, strengthen the implementation and execution of TCM policies & regulations, and highlight the unique advantages of TCM clinical diagnosis & therapy.
|