TCM Master ZHANG Bo-li, Hero of Combating Coronavirus Disease 2019 with Integrated Traditional Chinese and Western Medicine

ZOU Jian-hua (鄒建華), Shelley OCHS (歐陽(yáng)珊婷), LIU Zi-ning (劉子寧)

1. Translation Centre of World Federation of Chinese Medicine Societies, Beijing 100101, China 2. Beijing United Family Health Clinic, Beijing 100083, China

INTRODUCTION OF ZHANG BO-LI

Dr. ZHANG Bo-li has long been engaged in research on the prevention and treatment of cardiovascular and cerebrovascular diseases and the modernization of traditional Chinese medicine. He carried out research on objectivization of tongue diagnosis in traditional Chinese medicine, and developed a new research filed in tongue colorimetry and tongue diagnosis. This work won the third prize in the National Science and Technology Progress Awards. He also carried out research on the vascular dementia(VD) system, and formulated VD syndrome classification standards and a three-phase syndrome management plan based on steady levels, fluctuation and decline; he clari fied the dynamic evolution of stroke syndromes and their auras, and established a comprehensive treatment plan. He established the cerebrospinal fluid pharmacological method to reveal the protective mechanism of Chinese medicine on nerve cells, and won the second prize in the National Science and Technology Progress Awards for this work.

Supported by the "973" plan three times in a row, he created a method and key technology for the development of compatibility components of modern Chinese medicines, and won the second prize of National Science and Technology Progress. He completed the first large-scale, evidence-based study of secondary prevention of coronary heart disease with traditional Chinese medicine treatment, and established a series of methods for evidence-based evaluation of traditional Chinese medicine, and also won the second prize in the National Science and Technology Progress Awards for this work .This has opened up research fields for the secondary development of proprietary Chinese medicines, promoted technological innovations and quality improvement in traditional Chinese medicine industry. This has promoted the technological upgrade of the traditional Chinese medicine industry, cultivated large groups of traditional Chinese medicines. He won the first prize.in the National Science and Technology Progress Awards.

PRELUDE

At the beginning of the Chinese new year of the Gengzi Rat, we should all be reuniting with our families. With the lantern flowers in full bloom, how could an epidemic invade the land of China? We saw the river city was sinking; haze began to rise on all sides, and the Coronavirus Disease-2019(COVID-19) began to ravage Wuhan. Since the outbreak of the epidemic, General Secretary Xi Jinping has attached great importance to personally directing and deploying resources. He has presided over several meetings of the Standing Committee of the Central Political Bureau to study prevention and control of the epidemic. He made important instructions, and pointed the way forward for winning the fight against the epidemic and providing the fundamental guidelines.

Facing the drizzle, ZHANG Bo-li flew from the shore of the Bohai Sea to Jiangcheng, Wuhan,. On January 27, when he was directing the "anti-epidemic war" in Tianjin, he was summoned by the Central Epidemic Prevention and Control Steering Group.

Three days earlier, the Central Steering Group for COVID-19 Epidemic Prevention and Control had been established. ZHANG Bo-li, a member of the Chinese Academy of Engineering and president of Tianjin University of Traditional Chinese Medicine,was among those designated as team leaders.

AN UNUSUAL YEAR BESET WITH DANGERS

He set off. This was an expedition with a mission. 17 years ago, when called upon to work on the frontlines of SARS, he stepped forward without hesitation. On the Spring Festival of Gengzi,China, he "went in the opposite direction" again and overwhelmed. "Meeting people's needs is our mission",he said. For more than a month, he has been working non-stop. Putting himself in danger, he has worked in hospitals and communities, consulted on patient cases, investigated the epidemic, prepared Makeshift Hospital s, and prepared herbal prescriptions.

Dr. ZHANG described his attitude when he was called upon to join the effort: "When the state is in danger, the doctor is the soldier. It is better to bear it myself than to let the people suffer!" His vow remains unchanged. Someone asked him," you are old, can you avoid going to the front"? He replied firmly, with tears in his eyes. "No! If the epidemic is not serious, the country would not call me. I must come and fight well!"

HE IS A NATIONALLY RECOGNIZED SCHOLAR

At the age of 72, he agreed to come to th e forefront of a big war. The first few nights after he arrived in Wuhan, he could not sleep well at night because the situation was far worse than he had anticipated.

The epidemic broke out on a large scale, with large numbers of cases, overwhelming hospitals.Visiting a number of hospitals on the field, ZHANG Bo-li and comrades from the Central Epidemic Prevention and Guidance Group found that hundreds of patients were gathered in the fever clinics of major hospitals. They saw long queues of people waiting to see doctors, crowded areas with people waiting to be tested, and stuffed to capacity CT examination rooms.In the hallways, patients with intravenous drips were mixed with people still waiting in line to register. What was even more disturbing is that hospital beds were already in short supply, and many confirmed cases could not be hospitalized at all.

The chaos made him anxious and distressed.

"If this situation does not change, it will present tremendous challenges for subsequent prevention,control, and treatment, and will further accelerate the spread of the virus. We must take decisive measures."ZHANG Bo-li looked digni fied. That night, at a meeting convened by the Central Epidemic Prevention and Control Steering Group, ZHANG Bo-li proposed that patients must be classified and managed in layers,with centralized isolation. Four categories of patients should be quarantined together: fever, observational stage, close contacts, and suspected cases. In the future, patients with diagnosed diseases should also be treated separately, providing different facilities for mild and severe cases.

The epidemic is spreading. Faced with this new virus, determining how to reduce mortality and improve cure rates requires great wisdom. ZHANG Bo-li was prepared for this mission. He has studied traditional Chinese medicine for a lifetime. He said that Chinese medicine is a great doctor who has saved thousands of people from diseases. It is a unique part of the wealth of the Chinese nation and a priceless treasure. It must be allowed to play the role that it can in the prevention and control of this epidemic.

ZHANG Bo-li suggested that schools and hotels should be requisitioned as quarantine observation points, and patients should be universally treated with traditional Chinese medicine.

On January 28, the first batch of thousands of patients began taking Chinese medicines; on the 29th, 30,000 people took Chinese medicines.After a day or two, some mild patients experienced reductions in their fevers.

In fact, his team has already used the method of fighting the virus with the integration of traditional Chinese and Western medicine in Haihe Hospital.Moreover, when he led the TCM effort to fight SARS in 2003, he veri fied the effectiveness of this method.The Central Epidemic Prevention and Control Steering Group called him to Wuhan this time, hoping that his team could again play a special role in preventing and controlling the epidemic of COVID-19.

ZHANG Bo-li (left) has entered the "Red Zone" several times to give consultation on patients.

"We recommend that Chinese medicine be fully utilized in the makeshift hospitals. I can do this job!"Dr. ZHANG Bo-li and Dr.LIU Qing-quan, who is also an expert in the Leading Group of the CPC Committee for COVID-19 Containment, sent a written petition with their recommendations to the authorities. Traditional Chinese medicine and Western medicine each have their own advantages and their complementary advantages. Saving lives is the most important thing,ZHANG Bo-li proposed that the large, temporary hospitals be run by Chinese medicine doctors.

The proposal was supported by the Leading Group of the CPC Central Committee for COVID-19 Containment, and Jiangxia Makeshift Hospital was established, mainly using the comprehensive Chinese medicine treatment. Jiangxia Makeshift Hospital admitted more than 500 patients, primarily mild cases. The most gratifying thing was that none of the patients in Jiangxia Makeshift Hospital developed severe disease, and none of the medical staff was infected. After the initial experience of the first one, almost all the Makeshift hospitals started using traditional Chinese medicine.

At the same, due to the strong recommendations from experts such as ZHANG Bo-li, critically ill patients in Wuhan Xiehe, Tongji, Jinyintan and other hospitals were also treated with integrated Chinese and Western medicine. Some of these severely ill patients recovered to the point where they only had mild symptoms, and many were discharged. At present,rates of traditional Chinese medicine intervention in Wuhan hospitals is close to 100%, although it began from a low of 30% utilization. The participation of Chinese medicine and Chinese medicine physicians has grown due to the positive clinical results.

HE IS A SOLDIER

Doctors are like soldiers in white. On February 12, ZHANG Bo-li led a 209-person TCM medical team into the Dahuashan Makeshift Hospital in Jiangxia District, Wuhan. This medical team led by the academician is known as the "National Team of Traditional Chinese Medicine" to the outside world.There were 209 experts in the fields of Chinese medicine, respiratory critical medicine, imaging, clinical laboratory, nursing and other specialties from the grade III, class A hospitals in Tianjin, Jiangsu, Henan, Hunan,and Shaanxi provinces, respectively. They carried out clinical treatment, prevention and clinical research on traditional Chinese medicine and COVID-19.

After TCM entered the large-Makeshift Hospital hospitals, ZHANG Bo-li was even busier. He supervised consultations during the day, met with others in the evening, studied treatment options, and even consulted on specific cases and personally prescribed formulas to patients. The students tried to persuade him to rest:"You are too busy every day, let us do something!" He replied, "I am leading soldiers to battle, how can I not be on the front line? Otherwise I am just talking on paper."Whenever he put on protective clothing, he would stay in the isolation wards for hours.

"You stick your tongue out, let me see it."Through the goggles, ZHANG Bo-li looked at the patient's tongue, then stretched out his hand to take the pulse of the patient.

Whenever he is in protective clothing, he is a soldier. Traditional Chinese medicine pays attention to observation, listening, questioning and palpating the pulse. "How can I understand the law of onset and how to fight the virus if I am not in the wards or touching the patients?" he said. This is why ZHANG Bo-li insisted on going to the front line.

Some patients had low or fluctuating oxygenation levels. Once, ZHANG Bo-li had a clinical consultation and asked the doctor to inject Shengmai Injection (生脈), Shenmai Injection(參麥注射液), and give the patient Dushen Decoction(獨(dú)參湯). After a day or two, the patient's blood oxygen saturation level stabilized, and after another day or two, the oxygenation levels went up.

For critically ill patients, ZHANG Bo-li emphasized that the treatment method should be integrated traditional Chinese and Western medicine, with Western medicine as the primary treatment, and traditional Chinese medicine as the assistant. But sometimes the assistant also plays a key role. During clinical diagnosis and treatment, ZHANG Bo-li found that decisive and early use of traditional Chinese medicine injections for critically ill patients, early and without hesitation, often played a role in turning the tide.

More and more patients recovered and were discharged. ZHANG Bo-li found that some of these patients in the recovery stage still had symptoms such as cough, dif ficulty breathing, palpitations, and fatigue, so he proposed to establish a COVID-19 patient rehabilitation clinic at the Hubei Provincial Hospital of Integrated Traditional Chinese and at the Wuhan Chinese and Western Medicine Hospital to manage and treat these patients.

With the support of the Chinese Academy of Engineering and relevant units, ZHANG Bo-li organized and led a joint team from Wuhan Xiehe Hospital and Wuhan Traditional Chinese Medicine Hospital to establish a health management platform for infected medical staff in Hubei. This platform tracks their health status, and uses integrated Chinese and Western medicine intervention methods to help them recover better.

HE IS A WARRIOR

On February 16, Dr. ZHANG became ill due to gallbladder inflammation. The leader of the Central Epidemic Prevention and Steering Group forced him to accept being hospitalized. The "Wuhan Defense War"was a time when there were so many patients waiting to be treated, so he hoped that conservative treatment could be provided and he could avoid surgery for the time being. "You can't drag this out anymore, you must have a surgery !" The expert responsible for treating him was determined and told him so.

On February 18, ZHANG Bo-li was pushed to the operating table. Before the operation, as is the usual custom, they wanted to seek the opinions of family members, but he said, "Don't tell my family,I will sign for myself!" He was afraid that his wife would be very worried about him having surgery in Wuhan with the epidemic still spreading.

Afraid of affecting the resolute team spirit,ZHANG Bo-li speci fically asked that the news of his surgery not be disclosed to the outside world. After the anesthesia, the first thing he asked for when he woke up was to have his assistant read the epidemic report. Then he called and asked about the situation at Jiangxia Makeshift Hospital, and answered phone calls from the medical staff there.

A day or two after the operation, ZHANG Boli started working again in the wards. A small table was added next to his bed, and he worked with a needle stuck in his left arm, and a pen in his right hand. This was a critical time for integrating traditional Chinese and Western medicine to treat COVID-19. He couldn't rest and relax!

"The battle is still going on, I can't lie down!" .As a national leader in the field of traditional Chinese medicine treatment, he deeply felt that his work in Wuhan was a great responsibility. "Will the country live or die? Do you avoid it because of fortune or misfortune? (茍利國(guó)家生死以，豈因禍福避趨之)? He was well prepared for his trip to Wuhan. "The liver and the gallbladder look like each other, this time I leave the gallbladder here!" ZHANG Bo-li said humorously.

For several consecutive days, the number of confirmed cases in Wuhan has dropped sharply,and ZHANG Bo-li's worries have eased a great deal.In the worst stage of the epidemic in Wuhan, facing the lights on the Lantern Festival on the 15thday of the first month, ZHANG Bo-li wrote a poem:

戰(zhàn)地?zé)艄?jié) In the Front on Lantern Day

(Translated by ZHAO Yan-chun)

"燈火滿(mǎn)街妍，

Lantern light does all the streets fill,

月清人跡罕。

But no souls in the moonlit chill.

別樣元宵夜，

Lo! What a different Lantern Day!

抗魔戰(zhàn)正酣。

The defense war is under way.

你好我無(wú)恙，

When you are safe and I am sound,

春花迎凱旋。

We'll triumph with all flowers around."

Spring is coming, and the day of triumph is getting closer.

PRACTICE AND EXPERIENCE OF COMBINING CHINESE AND WESTERN MEDICINE IN FIGHTING THE EPIDEMIC

TCM Arrests the Progression from Mild to Severe Disease

On 3rdMarch, ZHANG Bo-li and LIU Qing-quan etc. were interviewed by reporters. Academician ZHANG Bo-li first mentioned that, at that time, more than 4,000 TCM medical personnel across the country were sent to fight the "epidemic" at the front line, and more than 90% of confirmed cases had TCM interventions.

ZHAO Yan-chun:Professor of English at Shanghai University,Director of Shanghai University Center for Translation and Publishing, Editor of Translating China, President of International Sinology and Education, President of Chinese Culture Translation and International Promotion, Executive President of Chinese Classics Bilinguals' Association

Traditional Chinese medicine was clearly effective for relieving fever, cough, fatigue and other symptoms, as well as improving the absorption of lung inflammation, and accelerating conversion to negative. It was especially useful in preventing mild cases from becoming severe cases. He said:"Professor LIU Qing-quan and I undertook the study of the integrated treatment of traditional Chinese and western medicine in the Ministry of Science and Technology. We used a retrospective study of 108 cases to obtain data on clinical effectiveness,including imaging changes on CT.

The rates of patient intervention with integrated Chinese and Western medicine (CW group) was 93.2%,The Western medicine only group was (W group)was 74.3%. For the clinical cure rate, the CW group was 91.8%, and W group was 71.4%; the conversion rate is 4.1% in the CW group and 11.4% in the W group.

It can be seen from this data that combined traditional Chinese and Western medicine treatment is more effective than Western medicine only.Academician ZHANG's team reached a consensus after discussion with the experts on Clinical Evaluation of the University of Liverpool, UK. In mild patients, we really see the ef ficacy. The main indicator is 'turnover rate', which is the development of serious and severe disease. This indicator is the key; we measured the patients that did not become severe. The second indicator is the time to full recovery."

ZHANG Bo-li believes that the key point of promoting integrated Chinese and Western medicine is the "combination", not "fighting alone".For example, in the treatment of critically ill patients,if there is no ventilator or other respiratory support,and circulatory support, etc., the patient may have died earlier, and therefore the treatment of traditional Chinese medicine would not have had a chance to take effect. This is a common sense.

Do not Encourage Everyone to Take Medicines if They do not Have Symptoms

ZHANG Bo-li introduced their data on 564 patients (71% mild and 29% general) at Jiangxia Makeshift Hospital and the 5 Chinese medical teams (national team of Chinese medicine) that were responsible for managing it. Patients mainly had Chinese medicine. In addition to taking Chinese medicine, they also practiced Tai Chi and Ba Duan Jin,and used massage, herbal patches and acupressure tacks, and acupuncture treatment. A full set of traditional Chinese medicine methods were available in these hospitals. At the moment, the "three zeros"have been achieved: zero-turnover patients, zero-retesting positive, and zero-infection in medical staff.

This shows that the application of traditional Chinese medicine can completely achieve the purpose of treating mild and common COVID-19,and its ef ficacy is mainly re flected in shortening the healing time and reducing the proportion of cases that change into severe illness. The medicines used by patients are mainly Xuanfei Baidu (宣肺敗毒), Qingfei Paidu Decoction (淸肺排毒湯), and a few formula granules (Chinese patent medicines).Four categories of patients, close-contacts, fever,medical observation, and suspected cases, primarily used proprietary Chinese medicines, such as Jinhua Qinggan Granules (金花清感顆粒)and Lianhua Qingwen Capsules (蓮花清瘟膠囊). For patients in the hospital wards, injections such as Xue Bi Jing (血必凈) could be used .

ZHANG Bo-li believes that in the treatment of severe COVID-19, suppressing the "inflammatory factor storm" is key, and the earlier the use of Xue Bi Jing Injection (血必凈注射液), the better. Note that it must be used in suf ficient amounts, and one does not need to be restricted to the of ficial instructions; if it is used boldly, it can often cut off the development of critical illness. He emphasized: "We do not encourage everyone to take medicines, but for those who have symptoms, of course, they should take medicines for prevention and treatment."

"If you preserve your healthy qi, how can pathogenic qi invade?" ZHANG Bo-li said, quoting the Yellow Emperor's Inner Classic. The focus of Chinese medicines prevention and control is to regulate the functional state of the body, not just the virus itself. People get sick as a result of the struggle between the virus and the human immune system. If the virus wins, you will get sick. Therefore,it is not easy to get sick if you increase your own resistance. Isolated high-risk groups or those who are in close contact with con firmed cases can take some TCM decoctions appropriately. This can be in accordance with the diagnosis and treatment plans and recommended prescriptions recommended by the competent authorities such as the National Health Committee, the National Administration of Traditional Chinese Medicine, and so on."

If the Combination of Traditional Chinese and Western Medicine has Not Been Acehieved, it Means We Have not Worked Hard Enough

ZHANG Bo-li explained that he and Professor LIU Qing-quan had taken into account the tracking of the rehabilitation period of the recovered patientsfrom the beginning of the Makeshift Hospital construction.In the design and development of the project, there are rehabilitation interventions at a later stage, and two rehabilitation clinics were opened quite quickly,one at Wuhan Traditional Chinese Medicine Hospital,and the other at Hubei Province Integrated Chinese and Western Medicine Hospital. At the same time, a platform has been set up at Wuhan Union Medical College Hospital, and all infected medical personnel in Hubei Province have been included in this platform for rehabilitation intervention management. This work will now be initiated. On March 12, the original Makeshift Hospital medical team was sent to the "Isolation Station" for the rehabilitation and diagnosis treatment to the recovered patients.. A rehabilitation clinic was set up at Jiangxia Makeshift Hospital of Traditional Chinese Medicine to establish hospital patient filing for the recovered patients in the district and implement rehabilitation management. What is the changing pattern of novel coronavirus from infection to final recovery? I only know that in severe cases, multiple organs are damaged during the recovery period, and the immune system is damaged more than in SARS.How long will it take for it to be completely repaired?This requires a long period of observation and research, and the experience gained in rehabilitation management will be valuable clinical data.

ZHANG Bo-li said: "I have been emphasizing the advantages of the combination of Chinese and Western medicine. They have worked very well together. In Jiangxia Makeshift Hospital, although only Chinese medicine was used, we also had respiratory support equipment, with oxygen inhalation and oxygen infusion.We also had IV medicines and CT imaging and nucleic acid testing, which all are all methods of Western medicine. For basic diseases, we had commonly used drugs on hand in case they were needed. Thanks to the support of Western medicine, we can have more comprehensive Chinese medicine to treat COVID-19.China has two sets of medical methods, and they have complementary advantages. This is the best treatment for patients, so why not use it! Some people say that Chinese and Western medicine cannot be combined,I disagree with this view. If you really take these two medicines, many clinical problems can be solved by combining Chinese and Western medicine. Our predecessors have already veri fied this. If we can't do it well, it means that we have not worked hard enough."

"Two Achievements" in Using Combined Chinese and Western Medicine to Treat COVID-19

ZHANG Bo-li said that this time in the fight against the COVID-19 epidemic, there were "two peaks" in the combination of Chinese and Western medicine. One is that high-level experts in traditional Chinese medicine and Western medicine jointly conducted consultations and rounds. There was no barrier to mutual research,and we simply used whatever measures were needed to save people. The other was high-level research to treat the critical disease. COVID-19 is dangerous and highly changeable, and multidisciplinary joint treatment reduced mortality. These "two highs" had actually promoted the progress of intensive medicine."I hope that more and more diseases will carry out such collaborative research in the future. If this can be done, then the development of Chinese medicine can be expected in the future."

Looking Forward to the Development of Effective Medicines for COVID-19

Speaking of the problem of "specific medicines",ZHANG Bo-li said that there are indeed no specific medicines for the treatment of COVID-19. However, the integration of traditional Chinese and Western medicine provides an effective program. At present, the ef ficacy of this program is just as effective as spec ifi c drugs.

ZHANG Bo-li said, "I have called for the development of one or two" broad-spectrum "new drugs against COVID-19. When SARS came, we started research and development on this project.Who knew that it would stop and disappear without a trace; this time, on the COVID-19 we have started research, But, will it persist for a long time? Or will it leave without saying goodbye? Will it recur this winter? What should I do if it mutates? So I advocate'resolving to change without change' and developing one or two broad-spectrum antiviral drugs ."

ZHANG Bo-li introduced that the traditional Chinese medicines used this time were two patent Chinese medicines. One is Jinhua Qinggan Granule(金花清感顆粒). During the bird flu epidemic more than ten years ago, Beijing organized the city's forces to excavate and develop a formula from more than one hundred ancient recipes. It was the academician WANG Chen that organized a multi-center clinical trial. Compared with the Western medicine "Duffy",the ef ficacy was quite comparable, and the price was much cheaper. Lianhua Qingwen Capsule (蓮花清瘟膠囊) is also a traditional Chinese medicine for the treatment of in fluenza developed on the basis of two ancient prescriptions. For another example, "Xue Bi Jing" (血必凈) is a traditional Chinese medicine injection, which plays a role in inhibiting the cytokine storm in severe patients and preventing the further development of the disease when treating COVID-19.Western medicine steroids are also used for this purpose, but Xue Bi Jing (血必凈) is safer and more effective with fewer side effects. Professor QIU Haibo and his team have done extensive research on it.

Sharing China's Experience for Global Epidemic Prevention

When talking about how Chinese medicine has contributed to the global fight against the pandemic,ZHANG Bo-li shared: "I have been communicating with my overseas counterparts on the internet almost every night. I connected with Mr. HE Jia-lang,the president of the Italian Association of Chinese Medicine, and he actively used our national protocols.The control measures and clinical experience were introduced to the Italian Ministry of Health and the National Institutes of Health. They were particularly interested in plasma exchange therapy and the suppression of cytokine storms. They were also very interested in the prevention and treatment of COVID-19 by traditional Chinese medicine.

LI Yi-ming, president of the Swiss Association of Traditional Chinese Physicians, proposed a joint project with Switzerland, Germany, France,Italy, Spain, the Netherlands and other countries to implement methods from China. They are very interested in the successful use of Chinese medicine and think that China's experience is worth learning from. The China Foreign Aid Medical Team has taken Jinhua Qinggan Granule (金花清感顆粒) to Iraq and Lianhua Qingwen Capsule (蓮花清瘟膠囊) to Italy.Some hospitals and clinics in the United States, Japan,and South Korea have also asked about whether we can donate some proprietary Chinese medicines. We are willing to share our experience with the world, but their government's acceptance of traditional Chinese medicines may still require a some legal and technical procedures before that can happen. Our school (Tianjin University of Traditional Chinese Medicine) and the international 'TCM Confucius Institute', introduced Chinese medicine for dealing with the epidemic, and this has also expanded its in fluence."

ZHANG Bo-li said that for Chinese medicine to expand internationally, first, it must be based on demand, second, it must comply with standards. If standards must be established first, then science and technology are the foundation. We must practice our internal skills and do our job well. In this way, Chinese medicine will fly higher and fly further.

Makeshift Hospital Realized "Three Transformations." ZHANG Bo-li described how the idea of the Makeshift Hospitals was the product of the advice of Academician WANG Chen. The decision was made by the Leading Group of the CPC Central Committee for COVID-19 Containment, with the support of government at all levels in Wuhan, and the assistance of medical staff from across the country. It was an initiative in this war of resistance against the epidemic and played an important role. I hope to further summarize our experience, standardize construction standards,facilitate configuration, and establish procedures.,We will incorporate them into the national emergency treatment and control system. The contracted Jiangxia Makeshift Hospital by also summed up good experience. What I feel most deeply is the realization of the "three transformations".

The first is the changing role of medical staff. In the past, we mainly saw doctors in the hospital. When we arrived at the Makeshift Hospital, medical staff mainly served the patients. Because when patients come into the hospital that they have fears, anxieties and often feel helplessness. Let the patients feel safe first, and ensuring there is a warm atmosphere in the hospital is the top priority. The medical staff of the Makeshift Hospital put service first, making the care and comfort of patients their priority, trying to make the hospital feel like a home. Jiang Xia Makeshift Hospital used cloth curtains to provide patients with some private space.The patients would celebrate birthdays with parties.In the wards we organized Tai Chi exercises, Eight Pieces of Brocade, and elected "patients with three excellencies"(imitating a designation in Chinese public schools) and more. In short, the makeshift hospitals are like a big family, making patients feel cared for, and actively cooperate with treatment. Later, some patients were even reluctant to leave the hospitals and said, "I'll live in isolation here, this is great."

The second is changing the role of patients.They are no longer simply accepting passive treatment, but actively participating in their treatment and the management of the hospital. For example,the medicines taken by patients were originally issued by nurses, but later some patients took the initiative to take medicines to everyone. They also helped clean the ward, clean up garbage,and actively organize activities. The doctor-patient relationship was very harmonious.

The third is the change in management methods. We set up groups of Party members among the patients and mobilized them. The success of the Chinese Revolution was due to the fact that the branch was built on the company, and so we built the party organization in the makeshift hospital, which was a very meaningful management innovation.

ZHANG Bo-li said that at any time, the Party is the core, and Party members must play an exemplary role. This is not empty preaching, but real actions.

ZHANG Bo-li explained that part of the Chinese medicine team is now in the outpatient isolation clinic,while the others are resting. We follow all orders and are always ready to enter the new battle field. At the end of the press conference, Academician ZHANG Bo-li said meaningfully: "I have seen a rare year and may not be able to keep up with the work in the next epidemic. Of course, it is best if we do not have an epidemic. I hope that when there is an epidemic in the future, we can let Chinese medicine teams into designated hospitals, so that we can combine traditional Chinese medicine and Western medicine.The results of our experiences this time may soon be summarized and the ef ficacy will be clear. If you give Chinese medicine a position, I will show you how well it can perform for you!"

FULLY UTILIZING INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN THE EPIDEMIC PREVENTION AND CONTROL

In this fight for epidemic prevention and control, the integration of Chinese and Western medicine played an important role. From the perspective of the composition of medical teams in various places, both Western medicine and traditional Chinese medicine physicians were included. From the perspective of diagnosis and treatment, Western medicine treatment and traditional Chinese medicine treatment were effectively combined.On February 6, 23 patients who were discharged from the Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine and Wuhan Municipal Hospital of Traditional Chinese Medicine were treated with integrated traditional Chinese and Western medicine during their stay in hospital. This shows that the method of integrated traditional Chinese and Western medicine is effective in preventing and treating COVID-19. In fact,when fighting SARS in 2003, Chinese medicine played an active role in reducing average fever time, improving symptoms of sepsis, promoting lung inflammation absorption, improving immune function, reducing steroid consumption, and reducing side effects. In the prevention and treatment of COVID-19, we still need to adhere to the combination of traditional Chinese and Western medicine and pay equal attention to traditional Chinese and Western medicine, in order to give full play to the advantages of traditional Chinese medicine, and protect the lives of patients.

Modern pharmacological research shows that many Chinese medicines have antipyretic and antiinflammatory effects, and therefore can improve fever symptoms, control the spread of pulmonary in flammation, and promote in flammation absorption.Unlike many pharmaceutical drugs, they have multifaceted, multi-path, multi-target effects. In addition,although they are also antiviral, the advantages of Chinese medicine intervention are that it can regulate the human immune function and stimulate the body's own defense capabilities. For the treatment of mild patients, integrated Chinese and Western medicine treatment can focus on improving symptoms,shortening the course of treatment, and promoting healing. Fever, dry cough, and fatigue are the common symptoms in many patients. Some patients have symptoms such as asthma, and the lungs oozing, and other symptoms. In traditional Chinese medicine, you can take use the methods of purifying the lungs and removing the pathogens,, clearing heat and detoxifying, relieving asthma, phlegm,and purging. For severe and critically ill patients,traditional Chinese medicine has a role in reducing lung exudation, inhibiting the release of in flammatory factors, stabilizing blood oxygen saturation, and reducing the quantity of antibiotic use.

Severe and critically ill patients have dyspnea and a marked decrease in blood oxygen saturation,which requires respiratory support or even invasive mechanical ventilation. At this time, on the basis of Western medicine treatment, combined with traditional Chinese medicine intervention, it can play a certain role in stabilizing blood oxygen saturation, improving patient breathing, and inhibiting the release of inflammatory factors. For recuperating patients, focus on accelerating the recovery process. In some recovering patients,although the virus's nucleic acid test has turned negative, symptoms such as fatigue, cough, and poor mental status still exist, especially the changes in the patient's lung CT scans. clinical symptoms are not symmetrical and asynchronous. Discharged patients may still have unabsorbed inflammation in the lungs,and the body may not have fully recovered. Continued treatment with traditional Chinese medicine will help improve the symptoms of patients and promote the repair of damaged organs and tissues. There are still patients with low immune function at the time of discharge that need more active treatment.

Since the founding of New China, remarkable achievements have been made in the integration of traditional Chinese and Western medicine.To win the battle for epidemic prevention and control, we must make use of the advantages and characteristics of integrated Chinese and Western medicine to continuously improve the efficacy and the cure rate, and reduce the mortality rate. Let Traditional Chinese Medicine serve humanity!

FIGHTING THE EPIDEMIC,STRENTHENING THE BACKBONE OF CHINESE MEDICINE

Intervention should be as Early as Possible,but Chinese Medicine also Needs Institutional Guarantees

During Wuhan's in-depth exploration of the front line and the application of traditional Chinese medicine to diagnose and treat patients, ZHANG Bo-li was deeply touched and reflected deeply on how to strengthen the prevention and control of epidemics with traditional Chinese medicine.

He faced the problems, "First, although TCM has designated hospitals, the number and the number of beds in them is still quite small, and a systematic and comprehensive TCM diagnosis and treatment system is lacking. Second, the top-level design of TCM diagnosis and treatment methods needs to be improved. Synergy needs to be optimized to form a comprehensive force. Third, prejudice or lack of confidence in Chinese medicine still exists,including amongst patients, doctors and management staff. The use of Chinese medicine in non-Chinese medicine hospitals needs to be promoted."

He summed up his experience and lessons,"First, we must not only summarize the clinical ef ficacy of traditional Chinese medicine for COVID-19, but also think at the theoretical level. For example, in TCM,COVID-19 is dominated by dampness pathogen,with a longer incubation period and relatively???disease development. It is relatively mild in the early stages of development, but there can be a sudden exacerbation of the disease. These are in line with the characteristics of dampness, which is sticky, and heavy turbidity, which tend to linger. At the same time,the dampness pathogen easily transforms into heat and toxin, so we should add out own innovatations to the theory of traditional Chinese medicine.

Second, in terms of disease mechanisms,the country and various regions have issued many different TCM diagnosis and treatment plans, which are in line with the principle of adapting to local conditions. However, it is also necessary for TCM to intervene in the prevention and treatment work at the initial stage, to master clinical data, to study the rules of disease syndromes, and to optimize TCM based on the characteristics of pattern changes. If we do this, the diagnosis and treatment plans will be more clinically instructive. Third, TCM medical teams should be fully established in the epidemic places, and more TCM designated hospitals should be established.Once there is a new epidemic of an infectious disease,Chinese medicine treatment and the necessary organizations should be established as soon as possible. In this outbreak, although Chinese medicine was involved earlier than SARS, it was still a bit late. In the future, there will be similar situations for Chinese medicine. Early and systemic intervention is needed to ensure the satisfactory effects of TCM in epidemics."

Rational Utilization of Chinese Medicine for Prevention

With the development and change of the epidemic situation, the National Health Commission and the State Administration of Traditional Chinese Medicine have continuously updated relevant diagnosis and treatment protocols, and local protocols have also been introduced to fit local conditions. However, in these protocols, the focus is on the treatment with traditional Chinese herbal medicine. The kind of overall comprehensive treatment that is emphasized in traditional Chinese medicine is not mentioned. For patients with different medical conditions, external treatments such as acupuncture,scraping, cupping, etc. are not added or recommended to improve the quality of life of the patients. This is a sign ifi cant oversight.

ZHANG Bo-li admits that, indeed, most patients used traditional Chinese herbal medicine alone, and other methods of treatment were much more limited due to lack of conditions. However, some areas, such as Guangxi, have used comprehensive therapies.

This time, traditional Chinese medicine injections played an important role in the treatment of severe pneumonia and were recommended in the national diagnosis and treatment program. Special mention should be made of the rehabilitation stage. Some traditional Chinese medicine rehabilitation methods can be used to promote physical recovery, such as Taijiquan, Eight Pieces of Brocade, dietary therapy,acupoint-related therapies, and psychological counseling. This truly reflects the advantages of comprehensive intervention with Chinese medicine.

Fighting COVID-19: Chinese Medicine Has Played a Role Throughout

Throughout the development of the Chinese nation over thousands of years, the threat of epidemics,large and small, has never been far away from human beings. In the course of the past years, the traditional Chinese medicine has formed a comprehensive and unique theory and practice system. Since the founding of the People's Republic of China, traditional Chinese medicine has played its due role in the prevention and treatment of epidemic infectious diseases such as Japanese encephalitis, meningococcus, hemorrhagic fever, SARS, and flu, including avian and swine flu.

In clinical examinations and researches, ZHANG Bo-li found that Chinese medicine has curative effects in reducing fever symptoms, controlling disease progression, reducing steroid use, and reducing complications. He suggested: Individualized treatment of traditional Chinese medicine decoction for patients with mild to moderate illness, and integrated treatment of traditional Chinese and Western medicine for severe patients. Everything must be based on the principle of bene fits the patient the most!

With the continuous advancement of the participation and breadth of TCM diagnosis and treatment, at present, more than 7,0000 patients have been treated by TCM or combined Chinese and Western medicine, and most patients have been cured and discharged.

ZHANG Bo-li said, "From a deep perspective,traditional Chinese medicine has designated teams and hospitals in the epidemic prevention process.There are more than 400 beds in the two designated hospitals of the Hubei Province Traditional Chinese and Western Medicine Hospital and Wuhan Traditional Chinese Medicine Hospital. In Wuhan Jinyin Tan Hospital, more than 40 beds were designated for TCM treatment. The treatment by TCM staff enabled patients to receive systematic and standardized TCM treatment and this achieved good results. In addition, many Chinese medicine hospitals across the country have participated in the admission of patients or established a TCM consultation system; various provinces and cities issued documents requiring all patients to receive TCM treatment. In this fight against COVID-19, the entire process of TCM has played a role in improving symptoms, shortening the course of treatment, and promoting healing for mild and moderate patients. For severe and critically ill patients,CM can reduce lung exudation, control excessive in flammation and prevent the disease from worsening;for patients recovering, it can promote the rehabilitation process. In addition to clinical treatment, clinical and pharmaceutical scientific research has also been carried out simultaneously with our clinical work. We have undertaken national scienti fic and technological emergency research projects-Clinical research on the prevention and treatment of pneumonia caused by the novel coronavirus with combined traditional Chinese and Western medicine to reveal more evidence".

It is understood that in the treatment of COVID-19 in Hubei Province, the cumulative utilization rate of Chinese medicine reached 91.91%.On March 18, 2020, the CGTN's "Global Epidemic Consultation Room" program, the Academician of the Chinese Academy of Engineering Dr. ZHANG Bo-li and other Chinese medical experts spoke with their American counterparts sharing and exchanging experience of TCM anti-epidemic.

TCM has proven effective in the treatment of an increasing number of COVID-19 cases in China,showing that the ancient system of healing can play a complementary role to Western medicine in fighting epidemic outbreaks.