Yang Zhong-Qi, Tang Hui-Min, Tang Ya-Qin, DU Yan-Ping, Yuan Wei-An, Li Bo, Zou Chong, Tang Jian-Yuan, Gao Rui, Hu Si-Yuan, Zhang Lei
the First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510407, China.
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai 201203, China.
Zhongguo Zhong Yao Za Zhi. 2021 Apr;46(7):1686-1690. doi: 10.19540/j.cnki.cjcmm.20210213.501.
This article proposes that the research and development of new Chinese medicines should be based on the clinical values of traditional Chinese medicine(TCM), and expounds the multiple clinical values of new Chinese medicines such as therapeutic effects, adjuvant treatment effects, improvement of disease symptoms, improvement of quality of life, prevention of diseases, etc., so as to broaden the clinical indications of new Chinese medicines. It is pointed out that the clinical value of TCM determines the clinical efficacy evaluation method of new Chinese medicines, so as to construct a clinical evaluation system of new Chinese medicines with the characteristics of TCM. It is proposed that the clinical value of new Chinese medicines should be found under the guidance of TCM theo-ry and clinical practice, and the theoretical innovation of TCM should be emphasized. There is no difference in the clinical value of drugs, and the key is to meet the clinical needs of patients. The research and development of new Chinese medicines ignores the theoretical guidance of Chinese medicine, and relying solely on animal experiment data may lead to failure of clinical trials. Different from the individualized treatment of TCM clinical syndrome differentiation, summarizing the core pathogenesis of TCM is the basis for the development of new Chinese medicines. It is necessary to summarize the pathogenesis of the disease under the guidance of TCM theory and encourage the application of modern medical methods to clarify the diagnosis of the disease. In view of the characteristics of new Chinese medicine research and development, it is proposed that the supporting role of human experience should be emphasized, and the technical points of clinical trials of new syndrome-type Chinese medicines should be explained.The use of objective indicators for syndrome evaluation, the selection of appropriate scales, and the formulation of reasonable treatment courses are advocated. During the research and development of new Chinese medicines, it is not only necessary to pay attention to modern medical safety indicators, but also to observe the evolution of TCM syndromes and specific TCM symptoms.
本文提出,中药新药研发应基于中医药的临床价值,并阐述了中药新药在治疗作用、辅助治疗作用、改善疾病症状、提高生活质量、预防疾病等方面的多重临床价值,以拓宽中药新药的临床适应证。指出中医药的临床价值决定了中药新药的临床疗效评价方法,从而构建具有中医药特色的中药新药临床评价体系。提出应在中医药理论和临床实践指导下挖掘中药新药的临床价值,强调中医药理论创新。药物的临床价值并无差异,关键是要满足患者的临床需求。中药新药研发忽视中医药理论指导,单纯依靠动物实验数据可能导致临床试验失败。与中医临床辨证个体化治疗不同,总结中医核心病机是中药新药研发的基础。有必要在中医药理论指导下总结疾病的病机,并鼓励运用现代医学方法明确疾病诊断。针对中药新药研发特点,提出应重视人的经验的支撑作用,并阐述新证型中药临床试验的技术要点。提倡采用客观指标进行证候评价,选择合适的量表,制定合理的疗程。在中药新药研发过程中,既要关注现代医学的安全性指标,也要观察中医证候及具体中医症状的演变。