my country ’s first grassroots diabetes Chinese medicine prevention and control management guidelines are released: joining the characteristics of Chinese medicine evaluation, advocating non -drug therapy

Content source: China Traditional Chinese Medicine Reporter: Li Na

On September 7, the State Administration of Traditional Chinese Medicine, the Chinese Academy of Traditional Chinese Medicine, the Fujian Provincial Traditional Chinese Medicine Administration, the Xiamen Health Commission, and the First Affiliated Hospital of Xiamen University "National Guidelines for Prevention Management Management of Traditional Chinese Medicine" Hold. The "Guide" is my country's first guidelines for the prevention and treatment of Chinese medicine for diabetes in China, give full play to the advantages of traditional Chinese medicine treatment, join the characteristics of traditional Chinese medicine assessment, promote non -drug therapy, attach importance to solving common symptoms, and improve the quality of life.

The "Guide" contains the requirements for the prevention and control of traditional Chinese medicine in diabetes, diabetes screening and diagnosis, lifestyle prevention and treatment, common risk of diabetes, and common symptoms of traditional symptoms.

The "Guide" focuses on early screening and early evaluation, and adds the characteristics of Chinese medicine evaluation. Proposal, phlegm, qi deficiency, yin deficiency, etc. are common constitutions of diabetes. The fourth diagnosis should be combined with clinical symptoms and tongue veins. The common testimony of diabetes is hot trauma syndrome, liver stagnation and spleen deficiency syndrome, phlegm -turbid interpretation syndrome, damp heat syndrome, qi and yin deficiency syndrome.

The "Guide" focuses on not being sick first, and attaches importance to prevention and preliminary intervention. Promote conditional medical and health institutions, and carry out early intervention of Chinese medicine health education and traditional Chinese medicine. For interventional risk factors (such as obesity, hypertension, disorders of blood lipid metabolism, etc.), a variety of comprehensive intervention methods such as Chinese medicine syndrome differentiation, medicated diet, acupuncture, and acupuncture are given, which is conducive to preventing and delaying the occurrence of diabetes and complications.

The "Guide" focuses on the treatment of common symptoms of diabetes, and it is clear that the advantages of traditional Chinese medicine dialectics are obvious. For 13 common symptoms such as thirst, sweat, fatigue, fatigue, insomnia, constipation, and abdominal distension for patients with diabetes, giving Chinese medicine syndrome differentiation and tea replacement prescriptions, as well as ear acupoint stickers, traditional Chinese medicine foot bath, acupoint application, traditional Chinese medicine smoking and washing, etc. Treatment. At the same time, it is equipped with "Concise Handbook of Chinese Medicine for Common Symptoms of Diabetes" for reference for more symptoms.

The "Guide" highlights the operationability of the grassroots level. It is recommended that medicines and foods, tea, and various non -drug therapy of Chinese medicine, and compile the "heart and body piles" of traditional Chinese exercise such as integrated stakes, eight sections, and Tai Chi. Simple, the masses are highly acceptable and easy to persist.

In addition, the "Guide" recommends the Chinese medicine practitioner of the "three divisions" to participate in the team service model, that is, Chinese medicine practitioners, endocrine diabetes specialists, health managers (caregivers), etc. to form a multi -disciplinary care team. The combined service method combines traditional Chinese medicine into the prevention and control of diabetes, and uses the role of traditional Chinese medicine cure, physical conditioning, alleviating symptoms, improving the quality of life, and synergistic sugar control.

The "Guide" was written by Yang Shuyu, a chairman of the Grass -roots Diabetes Prevention and Treatment Committee of the Chinese Academy of Traditional Chinese Medicine, and the professor of the First Affiliated Hospital of Xiamen University. You can also refer to it.

Depth of the news

How to walk into the main battlefield of diabetes prevention and control

As the country with the most diabetic patients in the world, diabetes has pose a great threat to the health of Chinese residents. Diabetes can be controlled and controlled. The grassroots are the key links of diabetes prevention and control, and they are also weak links.

How difficult is the prevention and control of grass -roots diabetes? Data show that the comprehensive control rate of blood glucose, blood pressure, and blood lipids in grassroots diabetes in my country is only 5.6%. Traditional Chinese medicine prevention and treatment of diabetes does have curative effect, but if there is no guide or clinical path as the basis, it is difficult to use Chinese medicine to prevent diabetes at the grassroots level. Essence

my country's first grassroots diabetes and traditional Chinese medicine prevention guidelines were released. A set of models were established. The training of physicians in various places ... Under multi -party co -effort, Chinese medicine has steadily entered the main battlefield of diabetes grassroots prevention and control.

Step 1: Revised Guide

——Thisy of Chinese medicine enters the two major authoritative guidelines for the prevention and control of diabetes

Data show that 12.8%of adults in my country have diabetes, of which more than 50%of them have chronic complications such as cardiovascular, kidney and neuropathy. main reason.

Facing the health threat caused by diabetes, Chinese and Western medicine have issued relevant guide response.

As early as 2003, the first edition of the first edition of the "China Type 2 Diabetes Prevention Guide" formulated by the Chinese Medical Association Diabetes Branch ended the history of my country's relying on foreign guidelines to guide diabetes. Authoritative guide.

In 2014, he was commissioned by the State Administration of Traditional Chinese Medicine, and the Chinese Academy of Traditional Chinese Medicine was amended and released the "Guidelines for the Clinical Diagnosis and Treatment of Chinese Medicine Diabetes" to provide technical methods for the prevention and treatment of diabetes for traditional Chinese medicine to make it more scientific and standardized.

However, this difficult "hard bone" at the grassroots level is the shortcomings of the two guidelines of Chinese and Western medicine.

In 2018, for the guidance of primary medical staff to provide comprehensive and continuous diabetes health management services to residents, the National Department of Health and Health of the National Health and Health Commission commissioned the Chinese Medical Association to set up a national grass -roots diabetes Prevention Management Office (hereinafter referred to as the "Sugar Defense Office") Jia Weiping, an academician of the Chinese Academy of Engineering and the director of the Shanghai Institute of Diabetes, co -chaired the "Guidelines for the Prevention and Control Management of Grassroots Diabetes (2018)", which has become an authoritative guide for grass -roots diabetes prevention.

However, this version of the guidelines did not involve the content of Chinese medicine, which aroused the thinking of Yang Shuyu, the seventh chairman of the Diabetes Branch of the Chinese Medicine Society of Chinese Medicine and Yang Shuyu, a professor at the first affiliated hospital of Xiamen University. As an old expert engaged in the first -line diabetic clinical clinical first -line work, as early as the early 1990s, Yang Shuyu found in the consultation that diabetic patients were supplemented with Chinese medicine while treating blood sugar at the same time as western medicine. Essence

"Clinical practice has proved that grass -roots groups have a strong demand for diabetic non -drug therapy and appropriate Chinese medicine technical therapy." Yang Shuyu proposed that if there is no content of traditional Chinese medicine in the two major authoritative guidelines There is no "standard" in the prevention and treatment of diabetes in Chinese medicine. Western medicine diagnosis and treatment can be "inserted to the end" at the first, second and third -level hospitals, but it is difficult to land after the treatment of Chinese medicine for the third -level hospital.

In order to solve this "card neck" problem, in June 2019, the leaders of the State Administration of Traditional Chinese Medicine investigated in Fujian. In a report to the leaders of the Bureau, Yang Shuyu proposed that grass -roots diabetes therapy should be promoted "equal emphasis on traditional Chinese and western medicine". The suggestions of adding traditional Chinese medicine services to the guide have been highly recognized.

After efficient collaboration with relevant departments, Yang Shuyu was supplemented as the deputy director of the Sugar Defense Office, responsible for organizing, revising and discussing the revision of the content of Chinese medicine.

Although the current chairman of the Diabetes Branch of the Chinese Medical Association, Zhu Dalong and the director of the Sugar Defense Office, Jia Weiping, as a western medicine expert, has always been tolerant of Chinese medicine to be tolerant and open. They attach great importance to Yang Shuyu and organize traditional Chinese and western medicine experts. Under the guidelines, the expert opinion consensus meeting was held online and offline. Although the debate was fierce, unification was continuously reached in the meeting.

With the joint efforts of traditional Chinese and Western medicine experts, they further revised the "Chinese Medicine Treatment of Diabetes" in the "Chinese Medicine Treatment of Diabetes" in the "Chinese Medicine Treatment of Diabetes (2020)", and in May this year, the "National Grassroots Diabetes Prevention Management Guide ( 2022) The first "Chinese Medicine Prevention and Control of Diabetes" chapter.

So far, Chinese medicine is written into the two major authoritative guidelines for the prevention and control of the country's diabetes, and has written a new epoch -making article.

Step 2: Formulate guidelines

——The first national diabetes grass -roots Chinese medicine guide was released

Since the 18th National Congress of the Communist Party of China, improving grassroots traditional Chinese medicine service capabilities has always been the focus of the State Administration of Traditional Chinese Medicine.

"The" Opinions on Promoting the Innovation and Development of TCM inheritance and Innovation and Development "of the Central Committee of the Communist Party of China mentioned diabetes. Chinese medicine's own guide. "Uncle Yang recalled.

On December 12, 2020, with the support of the State Health and Health Commission and the State Administration of Traditional Chinese Medicine, the Chinese Society of Chinese Medicine established the "Grassroots Diabetes Prevention Expert Guidance Committee", which was served as the chairman of Yang Shuyu.

Without being held up, under the leadership of Yang Shuyu, in just two years, this member covered the guidance committee of more than 1,000 people and members of the hospital at all levels of diabetes at all levels. Single, write and publish my country's first grassroots diabetes Chinese medicine guide- "National Guidelines for Prevention and Treatment of Traditional Chinese Medicine in the National Diabetes Grassroots".

From the independent setting of traditional Chinese medicine chapters to the formulation of independent traditional Chinese medicine prevention management guidelines, the little bit behind this condenses the effort and sweat from Yang Shuyu and the team.

In order to ensure the authority of the guide, they follow the theory and evidence of traditional Chinese medicine, take the clinical practicality and operability of the grassroots as the starting point, and conduct in -depth on -site investigations. Incident and exclusion standards, data extraction, comprehensive analysis of evidence, physical quality evaluation and recommendation standards, expert consensus, and recommendation of recommendations are formulated.

They also distributed the questionnaires of the "Doctors at all levels and the Guide to Prevention and Treatment of Diabetes and Investigation and Requirements", and conducted investigations and interviews with more than 1,000 grass -roots physicians. Over the past two years, a total of 1150 questionnaires were distributed, the samples were distributed in 30 provinces and 192 counties and cities; 461 doctors (40.09%) of the third -level hospitals, 307 physicians (26.70%) of secondary hospitals, 382 primary doctors (33.2222 (33.2222 %). By understanding the status and needs of the "knowledge, faith, and behavior" of primary doctors in the guidelines of diabetes and Chinese medicine, further clarify the direction and content focus of the guidelines.

As my country's first grassroots diabetes traditional Chinese medicine prevention guide, the guide continuously absorbs the research results of Chinese medicine in recent years on the basis of two major authoritative guidelines, further enriching and improved Chinese medicine intervention measures. Coordinate sugar control, improve symptoms, prevent complications; edit "mind and body piles", easy to learn, can be practiced everywhere; promoting simple and honest Chinese medicine methods such as tea drinking and appropriate technology of Chinese medicine; advocating "the mind and body governance", making human feelings humane The medical person, exploring "music therapy" and "aromatherapy therapy" and so on.

This is unanimously recognized by fellow experts. "The concept of traditional Chinese medicine, the theoretical foundation of the system, the complete theoretical system of the law and the prevention system, and the rich treatment methods, all reflect the unique advantages of traditional Chinese medicine in the prevention and treatment of chronic diseases. This is especially true for diabetes. "

Step 3: Implement guide

——The "Three Divisions Common Management" model allows the guide to play an advantage

Only the guide is not enough, and it is the key to promoting how to land. As early as the amendment of the guide, Yang Shuyu realized that "in order to make the guide's efficient guidance of the prevention and treatment of grass -roots diabetes, the most important thing is that there is a set of diagnosis and treatment systems that allow the guide to implement it."

For more than ten years, he has been committed to exploring the diabetic diagnosis and treatment model of "grounding gas", from the initial "diabetic integrated management" to "sugar friend network" (diabetes throughout the process), to exploring the "three divisions", The "Xiamen Model" was highly evaluated by the State Council, and it was promoted nationwide.

"'Three Divisions' Co -Management' is a vertical mode." Yang Shuyu explained that patients with specialist physicians, grassroots generals (family physicians) and health managers were jointly managed by large hospitals. In this clear hierarchical diagnosis and treatment model, the guide can provide operating specifications for doctors at all levels, especially the guide with Chinese medicine content, which allows grass -roots general physicians to find jobs from it. Advantage.

However, in the vertical mode, it is difficult for a specialist and a physician to be in the same "space -time", and it is difficult for Chinese and western medicine to achieve effective communication. In order to realize the role of Chinese and Western medicine coordinated sugar and further play the role of guidelines, in recent years, Yang Shuyu has also transformed and upgraded the "three divisions" model to become a "three divisions of co -management care" outpatient clinics.

"This is a horizontal mode that is caused by the patient's consultation around the patient, and the health career of the endocrinology specialist," said Zhao Nengjiang, deputy director of the guidance committee of grass -roots diabetes Prevention and Treatment. Symptoms, such as poor gastrointestinal digestion, numbness, itchy skin. If in the past, a patient prescribed prescriptions with different doctors of different specialists and took more than a dozen drugs every day. There were blood sugar, lowering blood pressure, blood regulation, and treatment of gastrointestinal diseases, treating insomnia quality.

"The three divisions are commonly controlled by the guard clinic, which is equivalent to inviting traditional Chinese medicine and western medicine to complement each other." Zhao Nengjiang mentioned that in this horizontal mode, the endocrine specialist is responsible for establishing a disease diagnosis and formulating a hypoglycemic plan; a Chinese medicine doctor Responsible for improving symptoms and regulating constitution; caregivers take care of the whole process, use Internet technology to establish contact with patients through mobile phones.

Based on this model, the landing process of the guide is more clear: Chinese and Western medicine can operate according to the guide, especially the physician can give play to the advantages of the general science according to the guidelines, and solve the common symptoms of various specialties through syndrome differentiation. The purpose of solving the one -stop of the whole department "" indicator control and the improvement of the quality of life ". With the help of the "three divisions of the three divisions" model, the guide has also further homogenized and standardized the management of grassroots prevention and control of diabetes.

Step 4: Promotion Guide

—— Training a large number of grassroots and western studies in western studies

Through a large number of visits and investigations, Yang Shuyu found that even if there is a landing model, the lack of grass -roots professional physicians and talents, and the knowledge and skills of chronic diseases such as diabetes need to be improved. If you want to further improve the efficiency of the guideline, the key is to cultivate the meeting. People who use guidelines.

In recent years, Yang Shuyu and the team have adhered to the training of grassroots talents to promote guidelines. In Linxia, ​​Gansu, Anxi, Nan'an, Fujian, Nan'an, Shenzhen, and other places for tissue grass -roots diabetes guidelines for tissue 8 games, and more than 80,000 online and offline audiences.

He and the team also chose 5 hospitals including Taining County General Hospital of Sanming City, Fujian Province, Quanzhou Anxi Traditional Chinese Medicine Hospital, and South Bank Traditional Chinese Medicine Hospital. Help, further strengthen the study and practice of grass -roots medical staff on diabetes related knowledge.

In December 2016, Yang Shuyu, then director of the Xiamen Health and Family Planning Commission, took the lead in promoting the first class of "Western School Middle School" in Xiamen. After three years of training, in September 2020, 166 students passed the "Western School Middle" completion examination. Out of succession.

As the first batch of "Western Studies" students in Xiamen, there are some clinical first -line western medicine experts. Because they see the effect of Chinese medicine treating diabetes, they have stimulated the interest of Chinese medicine, so they want to follow the road of traditional Chinese and Western medicine.

There are also some young students who graduated from traditional Chinese medicine colleges. They return to the grassroots level after graduation, but engage in business that is not related to traditional Chinese medicine. By participating in the "Western School Middle School" class, they return to the grassroots Chinese medicine team to become a solid force to consolidate grassroots diabetes. Essence

These cultivated grass -roots talents can not only provide patients with the appropriate technologies of traditional Chinese medicine in the guidelines, but also the characteristics of chronic diseases of diabetes, so as to achieve early discover, early diagnosis, and early control, which greatly improves the ability of grassroots diabetes to prevent control.

In July 2022, the State Administration of Traditional Chinese Medicine held a press conference on the improvement of the grass -roots service capabilities of traditional Chinese medicine that the grass -roots traditional Chinese medicine service network became improved, the construction of grassroots Chinese medicine teams was strengthened, and grass -roots Chinese medicine service capabilities were significantly improved. The prevention and control of grass -roots Chinese medicine at the grassroots level of diabetes is an important practice of "strong muscles and bones" in grassroots Chinese medicine services. In the future, with the goal of a healthy China strategy, under the guidance of the guide, the prevention and control of traditional Chinese medicine at the grassroots level of diabetes will also stride forward.

Edit: Dong Juntong

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