| 三、中医药的传承与发展 |
III. Carrying Forward the Tradition and Ensuring the Development of TCM |
| 基本建立起覆盖城乡的中医医疗服务体系。在城市，形成以中医（民族医、中西医结合）医院、中医类门诊部和诊所以及综合医院中医类临床科室、社区卫生服务机构为主的城市中医医疗服务网络。在农村，形成由县级中医医院、综合医院（专科医院、妇幼保健院）中医临床科室、乡镇卫生院中医科和村卫生室为主的农村中医医疗服务网络，提供基本中医医疗预防保健服务。截至2015年年底，全国有中医类医院3966所，其中民族医医院253所，中西医结合医院446所。中医类别执业（助理）医师45.2万人（含民族医医师、中西医结合医师）。中医类门诊部、诊所42528个，其中民族医门诊部、诊所550个，中西医结合门诊部、诊所7706个。2015年，全国中医类医疗卫生机构总诊疗人次达9.1亿，全国中医类医疗卫生机构出院人数2691.5万人。中医药除在常见病、多发病、疑难杂症的防治中贡献力量外，在重大疫情防治和突发公共事件医疗救治中也发挥了重要作用。中医、中西医结合治疗传染性非典型肺炎，疗效得到世界卫生组织肯定。中医治疗甲型H1N1流感，取得良好效果，成果引起国际社会关注。同时，中医药在防治艾滋病、手足口病、人感染H7N9禽流感等传染病，以及四川汶川特大地震、甘肃舟曲特大泥石流等突发公共事件医疗救治中，都发挥了独特作用。 |
Establishment of a TCM medical care system covering both urban and rural areas. An urban TCM medical care network, mainly comprising hospitals for TCM (including ethnic minority medicine and integrated Chinese and Western medicine), TCM clinics and general hospitals' TCM clinical departments, and community health centers, has been formed. A rural TCM medical care network has been established, mainly composed of county-level TCM hospitals, TCM clinical departments of general hospitals (specialized hospitals and maternal & child health centers), TCM departments of township-level health centers, and village health clinics, which provides basic TCM healthcare services.
Statistics collected at the end of 2015 show that there were 3,966 TCM hospitals across the country, including 253 hospitals of ethnic minority medicine and 446 hospitals of integrated Chinese and Western medicine; there were 452,000 practitioners and assistant practitioners of TCM (including practitioners of ethnic minority medicine and integrated Chinese and Western medicine); there were 42,528 TCM clinics, including 550 for ethnic minority medicine and 7,706 for integrated medicine; there were 910 million visits that year to TCM medical and health service units across the country and 26,915,000 inpatients treated.
In addition to making contribution to the prevention and treatment of common, endemic and difficult diseases, TCM has played an important role in the prevention and treatment of major epidemics and medical relief in public emergencies and natural disasters. The contribution of TCM and integrated Chinese and Western medicine in treating SARS (severe acute respiratory syndrome) has been affirmed by the World Health Organization (WHO). TCM treatment of influenza A virus subtype H1N1 has yielded satisfactory results, arousing widespread attention in the international community. In addition, TCM has made distinctive contributions to the prevention and control of epidemics such as HIV/AIDS (Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome), HFMD (Hand, Foot and Mouth Disease), and Influenza A virus subtype H7N9 in humans, as well as to medical relief following the Wenchuan earthquake, the Zhouqu mudslide and other public emergencies and natural disasters.
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| 中医预防保健服务加快发展。推进中医预防保健服务体系建设，在二级以上中医医院设立“治未病”科室，在基层医疗卫生机构、妇幼保健机构、疗养院等开展“治未病”服务，社会中医养生保健机构发展迅速。推进中医药健康服务发展，开展中医药健康旅游、医养结合。中医药健康管理项目作为单独一类列入国家基本公共卫生服务项目，中医药在公共卫生服务中的潜力和优势正逐步释放，推动卫生发展模式从重疾病治疗向全面健康管理转变。 |
Expedited development of TCM disease prevention and healthcare services. The system of TCM disease prevention and healthcare services has been expedited by establishing preventative healthcare departments at TCM hospitals at/above the second class and providing TCM preventative medical care services at community-level medical and health service institutions, maternal & child health centers and rehabilitation centers. Also seen is rapid growth in the number of privately run TCM healthcare institutions. Endeavor has been made to promote the development of TCM health services and carry out TCM health tourism and TCM integrated treatment and convalesce. TCM health management program has been incorporated as a separate category into the national basic public health service program, gradually releasing the potential and strengths of TCM in public health services, thus fostering a shift from treatment of serious diseases to comprehensive health management in the mode of health development. |
| 中医药在医药卫生体制改革中发挥重要作用。在深化医药卫生体制改革中，充分发挥中医药临床疗效确切、预防保健作用独特、治疗方式灵活、费用相对低廉的特色优势，放大了医改的惠民效果，丰富了中国特色基本医疗卫生制度的内涵。中医药以较低的投入，提供了与资源份额相比较高的服务份额，2009年至2015年，中医类医疗机构诊疗服务量占医疗服务总量由14.3%上升到15.7%。2015年，公立中医类医院比公立医院门诊次均费用低11.5%，住院人均费用低24%。 |
Important role played by TCM in the reform of the medical care system. In the course of advancing the reform, TCM's distinct strengths, such as its clinical effectiveness, its unique role, flexible ways of treatment and relatively low cost in disease prevention and healthcare, have been fully exploited to augment benefits of reform for the people and enriched the connotation of China's basic medical care system with distinct characteristics. With relatively low cost, TCM has contributed rather a higher share of services in relation to the resources it is entitled to. The medical care services provided by TCM institutions in the national total increased from 14.3 percent to 15.7 percent in the few years from 2009 to 2015. In 2015, out-patient expenses per visit and in-patient expenses per capita at public TCM hospitals were, respectively, 11.5 percent and 24 percent lower than those at general public hospitals. |
| 建立起独具特色的中医药人才培养体系。把人才培养作为中医药事业发展的根本，大力发展中医药教育，基本形成院校教育、毕业后教育、继续教育有机衔接，师承教育贯穿始终的中医药人才培养体系，初步建立社区、农村基层中医药实用型人才培养机制，实现从中高职、本科、硕士到博士的中医学、中药学、中西医结合、民族医药等多层次、多学科、多元化教育全覆盖。截至2015年年底，全国有高等中医药院校42所（其中独立设置的本科中医药院校25所），200余所高等西医药院校或非医药院校设置中医药专业，在校学生总数达75.2万人。实施中医药传承与创新人才工程，开展第五批全国名老中医药专家学术经验继承工作，建设了1016个全国名老中医药专家传承工作室、200个全国基层名老中医药专家传承工作室，为64个中医学术流派建立传承工作室。开展全国优秀中医临床人才研修、中药特色技术传承骨干人才培训、乡村医生中医药知识技能培训等高层次和基层中医药人才培养项目。124名中医药传承博士后正在出站考核。探索建立引导优秀人才脱颖而出的褒奖机制，开展了两届国医大师评选，60位从事中医药、民族医药工作的老专家获得“国医大师”荣誉称号。 |
Building a distinctive system of training for TCM professionals. Training of professionals is essential for the development of TCM. Thus, great efforts have been made to promote development of education in TCM, basically putting in place a system of training for TCM professionals that features an organic link-up between college, graduate and continuing education, and run through master-apprenticeship training. This, together with a mechanism for training of practical TCM professionals geared toward the needs of the urban and rural communities that has also been initially established, forms a multi-dimensional education network covering multiple disciplines at different levels, including TCM, traditional Chinese pharmacology, integrated Chinese and Western medicine, and ethnic minority medicine at secondary and higher vocational schools, colleges, postgraduate and doctoral studies. By the end of 2015, there were throughout the country 42 institutions of higher learning in TCM (including 25 TCM colleges), and more than 200 Western medicine institutions of higher learning or non-medical higher learning institutions offering programs in TCM, enrolling in total as many as 752,000 students.
In the course of implementing the program of training professionals for inheritance and innovation in TCM, efforts have been made to conserve and disseminate the academic ideas and practical experience of the fifth batch of prominent TCM experts. By 2015, 1,016 studios had been set up for carrying forward their expertise; 200 studios had been set up for passing on the expertise of prominent TCM experts at the grassroots level; 64 studios had been established for promoting various schools of TCM.
TCM training programs targeted at professionals at both grassroots and higher levels have been held, such as training in TCM knowledge and skills for village doctors, training for conserving special traditional pharmacological skills, and advanced training for outstanding TCM clinical practitioners. Together, 124 researchers are finishing postdoctoral studies in TCM inheritance at the Chinese Academy of Chinese Medical Sciences and their work is being evaluated. Exploration has been made in establishing an incentive mechanism for outstanding TCM workers to come to the fore. By 2015, the title of TCM Master had been awarded to a total of 60 experts practicing TCM and ethnic minority medicine.
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| 中医药科学研究取得积极进展。组织开展16个国家级中医临床研究基地建设及中医药防治传染病和慢性非传染性疾病临床科研体系建设，建立了涵盖中医药各学科领域的重点研究室和科研实验室，建设了一批国家工程（技术）研究中心、工程实验室，形成了以独立中医药科研机构、中医药大学、省级以上中医医院为研究主体，综合性大学、综合医院、中药企业等参与的中医药科技创新体系。近年来，有45项中医药科研成果获得国家科技奖励，其中科技进步一等奖5项。屠呦呦因发现“青蒿素——一种用于治疗疟疾的药物”，荣获2011年美国拉斯克临床医学奖和2015年诺贝尔生理学或医学奖。因将传统中药的砷剂与西药结合治疗急性早幼粒细胞白血病的疗效明显提高，王振义、陈竺获得第七届圣捷尔吉癌症研究创新成就奖。开展中药资源普查试点工作，并初步建成由1个中心平台、28个省级中心、65个监测站组成的中药资源动态监测信息和技术服务体系，以及16个中药材种子种苗繁育基地和2个种质资源库。组织开展民族医药文献整理与适宜技术筛选推广工作，涉及150部重要民族医药文献、140项适宜技术。这些科研成果的转化应用，为提高临床疗效、保障中药质量、促进中药产业健康发展提供了支撑。 |
Positive progress made in TCM scientific research. Sixteen national TCM clinical research bases have been built as part of the clinical research system for preventing and treating infectious diseases and chronic non-infectious diseases with TCM. This, together with a number of key research centers and labs covering all disciplines of TCM and national engineering (technology) research centers and labs in this respect, have brought into being a TCM sci-tech innovation system that is based on independent TCM research institutes, TCM universities, and TCM hospitals at and above the provincial level, and participated by comprehensive universities, general hospitals and TCM enterprises.
In recent years, 45 TCM research achievements have been awarded national sci-tech prizes, of which five were first-prize winners of the National Science and Technology Progress Award. Tu Youyou won the 2011 Lasker Award in clinical medicine and the 2015 Nobel Prize in Physiology or Medicine for discovering qinghaosu (artemisinin). Wang Zhenyi and Chen Zhu were awarded the Seventh Annual Szent-Gyorgyi Prize for Progress in Cancer Research for combining the Western medicine ATRA and the TCM compound arsenic trioxide to treat acute promyelocytic leukemia (APL).
A pilot program for Chinese medicinal resources survey has been implemented, forming a dynamic information and technology system with one central platform, 28 provincial-level centers, and 65 monitoring stations. Sixteen seed and seedling bases for Chinese medicinal plants and two germplasm banks have been established. Organizational work has been done for collation of literature and screening of appropriate skills of ethnic minority medicine, involving 150 works on ethnic minority medicine and 140 appropriate skills. The transformation and application of these research results has provided support for enhancing clinical effectiveness, ensuring the quality of Chinese medicine, and fostering the sound development of the TCM pharmaceutical industry.
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| 中药产业快速发展。颁布实施一系列加强野生中药资源保护的法律法规，建立一批国家级或地方性的自然保护区，开展珍稀濒危中药资源保护研究，部分紧缺或濒危资源已实现人工生产或野生抚育。基本建立了以中医药理论为指导、突出中医药特色、强调临床实践基础、鼓励创新的中药注册管理制度。目前，国产中药民族药约有6万个药品批准文号。全国有2088家通过药品生产质量管理规范（GMP）认证的制药企业生产中成药，中药已从丸、散、膏、丹等传统剂型，发展到现在的滴丸、片剂、膜剂、胶囊等40多种剂型，中药产品生产工艺水平有了很大提高，基本建立了以药材生产为基础、工业为主体、商业为纽带的现代中药产业体系。2015年中药工业总产值7866亿元，占医药产业规模的28.55%，成为新的经济增长点；中药材种植成为农村产业结构调整、生态环境改善、农民增收的重要举措；中药产品贸易额保持较快增长，2015年中药出口额达37.2亿美元，显示出巨大的海外市场发展潜力。中药产业逐渐成为国民经济与社会发展中具有独特优势和广阔市场前景的战略性产业。 |
Rapid development of the TCM pharmaceutical industry. A number of laws and regulations have been enacted and implemented on strengthening the protection of TCM wild medicinal resources; a number of national and local nature reserves have been established; research has been conducted on the protection of rare and endangered Chinese medicinal resources; and artificial production or wild tending have been carried out for certain scarce and endangered resources.
A registration management system has been basically established for TCM pharmaceuticals under the guidance of theories of traditional Chinese medicine and pharmacology, highlighting the strengths of TCM, setting great store by clinical practice and encouraging innovation. To date, 60,000 TCM and ethnic minority medical drugs have been approved, and 2,088 pharmaceutical enterprises that have been approved by the Good Manufacturing Practice (GMP) of Medical Products are manufacturing Chinese patent medicines. The dosage forms of TCM medicines have increased from a traditionally limited number of forms such as pills, powders, ointments and pellets into more than 40, including dropping pills, tablets, pods and capsules, indicating marked improvement in the technological level of Chinese medicinal drug production, and initial establishment of a modern Chinese medicine industry based on the production of medicinal materials and industrial production and tied together by commerce.
In 2015, the total output value of the TCM pharmaceutical industry was RMB786.6 billion, accounting for 28.55 percent of the total generated by the country's pharmaceutical industry, and becoming a new source of growth in China's economy. Planting Chinese medicinal herbs has become a key means of adjusting the rural industrial structure, improving the eco-environment, and increasing farmers' incomes. Trade in Chinese medicinal products has maintained rapid growth, and the export value of Chinese medicines amounted to US$3.72 billion in 2015, signifying the great potential of Chinese medicines in overseas markets. The TCM pharmaceutical industry has gradually developed into an industry with distinctive strengths and broad market prospects, which is of strategic importance to national economic and social development.
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| 中医药文化建设迈出新步伐。中国政府重视和保护中医药的文化价值，积极推进中医药传统文化传承体系建设，已有130个中医药类项目列入国家级非物质文化遗产代表性项目名录，“中医针灸”列入联合国教科文组织人类非物质文化遗产代表作名录，《黄帝内经》和《本草纲目》入选世界记忆名录。加强中医药健康知识的宣传普及，持续开展“中医中药中国行”大型科普活动，利用各种媒介和中医药文化宣传教育基地，向公众讲授中医药养生保健、防病治病的基本知识和技能，全社会利用中医药进行自我保健的意识和能力不断增强，促进了公众健康素养提高。 |
New progress in TCM culture. The Chinese government treasures and protects the cultural value of TCM, and endeavors to build a system for passing on the traditional culture of TCM. In total, 130 TCM elements have been incorporated into the Representative List of National Intangible Cultural Heritage, with TCM acupuncture and moxibustion being included in the Representative List of the Intangible Cultural Heritage of Humanity by UNESCO, and the Huang Di Nei Jing (Yellow Emperor's Inner Canon) and Ben Cao Gang Mu (Compendium of Materia Medica) are listed in the Memory of the World Register. Efforts have been reinforced to promote public awareness in TCM healthcare, including events under the campaign of Traditional Chinese Medicine Across China. Public talks have been organized through media and TCM education bases popularizing basic knowledge and skills of TCM healthcare and prevention and treatment of illnesses. In this way, public awareness of and ability to practice TCM healthcare has been enhanced, and general public health has improved. |
| 中医药标准化工作取得积极进展。制定实施《中医药标准化中长期发展规划纲要（2011－2020年）》，中医药标准体系初步形成，标准数量达649项，年平均增长率29%。中医、针灸、中药、中西医结合、中药材种子种苗5个全国标准化技术委员会及广东、上海、甘肃等地方中医药标准化技术委员会相继成立。42家中医药标准研究推广基地建设稳步推进，常见病中医诊疗指南和针灸治疗指南临床应用良好。民族医药标准化工作不断推进，常见病诊疗指南的研制有序开展，14项维医诊疗指南和疗效评价标准率先发布，首个地方藏医药标准化技术委员会在西藏自治区成立，民族医药机构和人员的标准化工作能力不断提高。 |
Positive progress in TCM standardization. The Outline of the Medium- and Long-term Development Plan for the Standardization of Traditional Chinese Medicine (2011-2020) has been issued and implemented, putting in place initially a system of TCM standards which amount to 649, showing an average annual growth of 29 percent. Five national technical committees of standardization have been established for, respectively, Chinese medicine, acupuncture and moxibustion, TCM drugs, integrated Chinese and Western medicine, and seeds and seedlings of Chinese medicinal plants, with local standardization technical committees of traditional Chinese medicine and pharmaceuticals being set up in Guangdong, Shanghai, Gansu and some other localities. The building of 42 research and application bases for TCM standardization is proceeding smoothly, and the clinical application of guidelines for TCM diagnosis and treatment of commonly seen diseases and guidelines for acupuncture and moxibustion is proving effective.
Steady progress has also been witnessed in standardization of ethnic minority medicine, so has been orderly advancement in the formulation of guidelines for diagnosis and treatment of commonly seen diseases. In this regard, Uyghur medicine has taken the lead, with the publishing of 14 guidelines for disease diagnosis and treatment, and curative effect evaluation. The first local technical committee for standardization of Tibetan medicine has been established in the Tibet Autonomous Region. Constant improvement has been observed in the competence and efficiency of institutions and workers in relation to the standardization of ethnic minority medicine and pharmacology.
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