How to treat the so-called "folk imperial doctor"?

There are hot spots these two days. A man named Li Yuehua was suspected of practicing medicine illegally, which triggered a wide discussion from the people to the government. I think, if this matter is not clearly debated, I don't know how many ghosts will be produced in the future.

Event review (if you know, please look down)

The following news review is for people who don't know what happened. Readers who already know can skip it directly.

Li Yuehua, a doctor in a private clinic in Wu Hanyou, claimed to have invented a treatment for COVID-19 (it doesn't matter what the specific treatment is). He treated 15 patients in this way, and these patients basically recovered later. Therefore, he submitted a petition to the health department in Wuhan, hoping that the official could adopt his therapy to save lives.

What he never expected was that what was waiting for him was not coachable, the official line of fire, but three charges of illegal medical practice, illegal dispensing of medicines and disturbing normal medical care.

After the incident was exposed by the media, it quickly triggered a heated discussion among the people.

Hubei Provincial Health Department was suddenly submerged in the sea of Wang Yang during the People's War. Countless people cursed the official's arrogance, saying that the official only cared about whether there was a doctor's certificate, but did not care about whether the treatment was effective or not, and did not care about the people's lives.

On March 2nd, the People's Daily client published a review article entitled "Leave a Back Way for Folk Chinese Medicine".

The article thinks that the practice of Hubei Health and Health Commission is legal but unreasonable, and more practice space should be given to folk Chinese medicine practitioners. At the end of the article, the author wrote:

"The author and the general public hope that the Hubei Provincial Health and Health Commission can come up with a legal and reasonable solution."

With the help of the commentary articles of the People's Daily client (non-People's Daily commentators), the voice of civil crusade against Hubei Health and Health Commission is higher.

For example, the People's Daily WeChat official account article supports Li Yuehua: Please ask the Hubei Provincial Health and Health Commission to come up with a solution that conforms to laws and regulations! ",saw 65438+ million+,like 634+.

* Author's Note: As of press time, the article on the People's Daily client has been deleted, leaving only screenshots of the webpage.

Is it so important to have a black cat and a white cat?

As a professional science popularization person, I feel obligated to stand up and express my views clearly: for the sake of the lives and health of millions of people and the fact that countless tragedies in history will not be repeated, I firmly support the handling opinions of the Hubei Provincial Health and Health Commission. Keep the bottom line of evidence-based medicine and scientific spirit.

Please stay and listen to my reasons before you close the window angrily. Maybe this will save your next generation from an accident.

Among the many opinions that people support Mr. Li Yuehua, one of the most important ones is:

Whether it is a black cat or a white cat, catching a mouse is a good cat; Ordinary people only recognize the curative effect but not the "syndrome". As long as they can treat diseases, is it so important to have a doctor's certificate?

This view sounds reasonable at first glance. Maybe you are one of the people who hold this view.

However, this theory of black cats and white cats is a big mistake when applied to drugs. This is a blood and tears lesson that health departments all over the world have exchanged with the health and lives of countless people.

Stop the reaction

Please listen to me tell you a real case in history:

From 65438 to 0957, Grunter, a German company, invented a drug called thalidomide, which had a very good effect on treating pregnant women's pregnancy reaction, and it was soon listed in more than 20 countries around the world.

Meirui Company in the United States saw the business opportunity, won the agency right of thalidomide and prepared to sell it to the United States. At that time, the Food and Drug Administration (FDA) had been established in the United States, and the listing of new drugs required approval. The case was sent to the examiner, Dr. Chelsea.

After examination, Chelsea found that the safety test of this drug was very hasty, and it was only a formality. The safety test was completely unconvincing, so she resolutely refused to go on the market.

Of course, Murray is not happy. They argue that millions of people have taken thalidomide and the effect is good. You are not crazy to be so picky.

At that time, the public opinion also condemned Chelsea one-sidedly: Because of your so-called "dogmatism", many pregnant women don't need the specific medicine to avoid vomiting. But Chelsea resisted all the pressure and refused to approve. Chelsea's persistence has saved countless American families.

A few months later, human tragedies occurred one after another. Many deformed babies were born suddenly in Germany. Their limbs were severely atrophied and looked like seals, so they were called "seal limb" babies. The natural occurrence probability of this deformed baby is very small.

Horribly, baby seal limbs were born in large numbers in Germany from 1957, which was like being possessed. The incidence of infants with seal limbs in Germany has increased by 200 times.

In all countries where thalidomide is listed, the number of babies with seal limbs has soared. The culprit was quickly locked in, that is, the reaction stopped.

The news reached the United States, and the American people who were still angry and condemning Chelsea suddenly woke up from their dreams. Only then did they realize how many Americans had been saved by the rigid woman in their mouth, and Chelsea became a well-known heroine of the American people.

This incident has taught the food and drug regulatory authorities all over the world a lesson: drugs can't just look at their efficacy, and safety is more important than their efficacy. Drugs that have not undergone strict safety tests shall not be used on a large scale.

After listening to this story, I wonder if I can change some of your thoughts.

Let's assume that Mr. Li Yuehua's drugs and therapies can treat COVID-19, but they failed the strict safety test. Would you like to let your relatives and children use it?

Perhaps, people who know more about the Li Yuehua incident will immediately refute me and say: Li Yuehua has cured 15 people, and his therapy has been implemented for many years, indicating that there is no problem with safety.

Longdan Xiegan Pill

Don't worry, of course I know this thing. Please continue to listen to me tell you the second real case: In 2003, Xinhua News Agency issued a series of long reports, all about cases of kidney damage caused by taking Longdan Xiegan Pills.

Longdan Xiegan Pill is a classic Chinese medicine. Tongrentang, which produces it, is also one of the most famous Chinese medicine enterprises in China, with a production history of several decades.

Once these cases were reported, they also caused great controversy. Many people can't figure out how a classic Chinese patent medicine that has been eaten for decades has suddenly become a poison that causes renal failure.

The country naturally dare not ignore the problem of human life, and the Food and Drug Administration began to pay attention to it. A study found that as early as 1993, some herbal components in Longdan Xiegan Pills attracted the attention of the international medical community.

In 200 1 year, the US FDA issued an alarm, warning that many herbal ingredients including Longdan Xiegan Pill contained aristolochic acid, which would lead to renal failure. In 2003, the State Administration of Pharmaceutical Products also issued a notice banning drugs, and Tongrentang also urgently revised the formula of Longdan Xiegan Pill and cancelled Aristolochia manshuriensis containing aristolochic acid.

Later, the medical community made a lot of investigations, and it is estimated that there are hundreds of thousands of patients with severe kidney disease caused by Longdan Xiegan Pill in China. Why is such a serious side effect discovered decades after it went on the market?

There are two reasons:

Renal failure caused by Longdan Xiegan Pill is a chronic disease, and it is hard for ordinary people to think that it is caused by the slow accumulation of regular drugs.

Due to historical reasons, Longdan Xiegan Pills did not undergo strict safety tests when they were put on the market in 1960s.

There are many such cases, if you want to know, such as the famous Japanese "Xiaochaihu Decoction" incident, which is also a real case that has left a bloody lesson to the health department because of drug safety problems.

Knowing these real cases, will you feel at ease about Mr. Li Yuehua's "safety and effectiveness"? Don't say that he has treated 15 patients, even if he has treated 1500 patients, it can't be said to be safe and effective, because the US Food and Drug Administration in China has strict procedures for drug testing, and drug testing without strict procedures is a disrespect for science, which is all valuable experience gained with the health and lives of countless people.

I understand your kindness and your sense of justice, but in front of science, emotion is superfluous.

Is the patent useful?

Maybe someone noticed that Mr. Li Yuehua's acupoint injection therapy won the national invention patent 20 1 1;

Can't this prove that the country has recognized that his therapy is safe and effective?

Unfortunately, this only shows that you don't know the relevant legal knowledge of patent application. Obtaining a national invention patent has nothing to do with whether this therapy is safe and effective, but only proves that you are the first person to think of this method.

The patent office only conducts formal examination, not authenticity examination. In other words, the patent office only cares about whether the materials you submitted are complete, and the patent office has no ability to verify whether what you wrote on the materials is true or not.

If you don't believe me, you can search for "perpetual motion machine" on the website of the State Patent Office, and you will find more than 90 national invention patents of perpetual motion machine. As long as any one of them is really useful, then the Nobel Prize in Physics belongs to him.

Now do you understand that national patents cannot prove the safety and effectiveness of a treatment? The safety and effectiveness of drugs and therapies are controlled by China Drug Administration (CFDA).

Before writing this article, I also read a medical paper "A Kind of Acupoint Injection-Clinical Application of Trace Phenol" published by Mr. Li Yuehua (published in the first volume 1 1, 20 13 of Seeking Medicine).

This paper is about the treatment he claims can treat COVID-19. Although I am not a medical student, I often read medical papers at home and abroad, and I am familiar with the structure of medical papers.

His paper is not so much a paper as a minimalist doctor's note. We don't see any internationally accepted principles of large sample, randomized, double-blind, controlled experiment, and there are no case selection criteria, variable control, charts, data and statistical formulas.

In this paper (let's call it a paper), we can see that the diseases he claims to be effective in treatment include colds, mumps, oral ulcers, chronic rhinitis and so on. These diseases are all self-limiting diseases without exception, that is, diseases that have a high probability of recovery without any treatment. Thus, Mr. Li Yuehua's academic research level is unqualified.

Seeing this, I hope your anger towards the Hubei Provincial Health and Health Commission will be alleviated.

Perhaps, what you are thinking now is: In any case, in the current epidemic situation, even if there is a possibility of one in ten thousand, should the relevant departments try a new treatment? Li Yuehua's academic level is not good, you can find someone with a better level to study it. Didn't Tu Youyou screen artemisinin from many folk remedies?

Serious medical clinical trials

I can understand your feeling. This is the last topic I want to talk about in this article, and perhaps the heaviest topic: what is more sad than no drug trials is that there are too many trials.

In fact, like most of you, when I sleep at night, I also dream that a "sweeping monk" was born, which turned the tide and destroyed COVID-19. It's just that I don't have such dreams when I'm awake during the day.

At present, the only thing we can trust is science.

Only by adhering to the bottom line of evidence-based medicine and scientific spirit can we plant a big tree for our descendants!