儿童中成药的精准治疗

Precise treatment of children with precision treatment of Chinese patent medicine

针对目前儿童中成药在临床使用中存在的“六少”“三多”等现象,提出儿童中成药的使用要力求精准。精准治疗包含3方面的内容:即精准定位、精准评价和精准研发。精准定位是指药物治疗的西医病种应明确,中医证型要清楚;标明是治疗药物还是辅助治疗药物;特别是目前中成药大多是西医生在使用,所以,既要阐明中医的证候,更要明确可改善的症状。精准评价是利用循证医学的方法,全面、系统、准确地评价药物干预的节点,解决的具体问题;在患儿法定监护人知情同意的基础上,客观评价成人药治疗儿童疾病的疗效及不良反应。精准研发要“有为、有所不为”,对于儿童发病率比较高、中医治疗效果比较好、目前已上市的中成药品种比较少的疾病,要重点研发;对于有些虽然是常见病,但目前已上市的中成药品种较多的情况下,要少研发;特别是对于没有创新和突破的品种,尽量不研发。

In view of the current phenomenon of "six less, three more" in the clinical use of precision treatment of Chinese patent medicine for children, the use of precision treatment of Chinese patent medicine for children should strive for precision. Precision therapy includes three aspects: precision positioning, precision evaluation and precision research and development. Precise positioning means that the types of western medicine diseases treated by drugs should be clear, and the types of traditional Chinese medicine(TCM) types should be clear. Indicate whether it is therapeutic or adjunctive;especially at present, precision treatment of Chinese patent medicine is mostly used by western medical doctors, so it is necessary to clarify the TCM symptoms, but also to clarify the symptoms that can be improved. Precise evaluation is a comprehensive, systematic and precise evaluation of drug intervention nodes and specific problems to be solved by using evidence-based medicine methods. On the basis of informed consent of children’s legal guardians, the efficacy and adverse reactions of adult drugs in the treatment of children’s diseases were objectively evaluated. Precise research and development should determine what to be done and what not to. For diseases with high morbidity in children and good therapeutic effects in Chinese medicine, but with fewer varieties of precision treatment of Chinese patent medicines currently on the market, we should focus on research and development;for some although it is a common disease, but currently has been listed in the case of more varieties of precision treatment of Chinese patent medicine, spend less on research and development;especially for which have no innovation and breakthrough varieties, try not to focus on them.