Chapter 313: Treating Tuberculosis with Traditional Chinese and Western Medicine
Pan Ye distributed the paper information of the two medicines to the first person present.
The doctors who studied abroad from the two hospitals took the information with doubts and quickly browsed through it, wanting to see what the Chinese medicine hospital could do.
Lin Sanqi continued to deceive:
“To be honest, I have a medical team with very strong scientific research capabilities behind me, but you don’t need to ask where they are.
According to our team's research, if only the isoniazid + streptomycin model is used, the tuberculosis treatment rate is only 33%, less than half, and the side effects are very huge.
For example, operations on the liver and kidneys can cause strong ototoxicity and easily lead to deafness in patients, especially children.
In order to continue selling drugs, the manufacturer of streptomycin has been covering up this serious side effect. You can find out this shocking inside story by simply asking around in the pediatric department.
It's not just the side effects. The course of this dual therapy takes about 24 months.
If refractory pulmonary tuberculosis is encountered, the course of the disease will be extended, which not only increases the financial burden on patients, but also makes it difficult for some patients to bear the harm of related complications. After all, the longer the medication is used, the stronger the toxicity of the drug.
The doctors who studied abroad nodded one after another, obviously having no objection to the views put forward by Lin Sanqi.
Lin Sanqi explained while moving slowly among the crowd, making sure everyone could hear what he said.
"So our team made comprehensive reforms based on isoniazid + streptomycin and discovered the quadruple therapy of isoniazid, rifampicin, pyrazinamide and ethambutol.
We found that the combination of these four drugs is more effective and requires a shorter treatment period. Of course, this isn't just empty talk; we have relevant data, all documented in the literature."
(The data is absolutely true, Lin Sanqi copied the existing information)
However, as people who have studied abroad and have a rigorous attitude towards modern medicine, the 20 doctors present at the Union Hospital and the Digital Hospital were skeptical and did not believe everything Lin Sanqi said.
Lin Sanqi didn't take it seriously. After all, every word he said and every piece of information he provided had been tested over decades. They were absolutely authoritative and credible, and could withstand the test of time and clinical trials. So he was full of confidence:
Regarding the two new drugs, rifampicin and ethambutol, let me briefly explain:
Rifocol is a broad-spectrum antibiotic that has a strong antibacterial effect against Mycobacterium tuberculosis and is also effective against Gram-positive or Gram-negative bacteria, viruses, etc. It is mainly used to treat tuberculosis, meningitis and Staphylococcus aureus infection.
Ethambutol is an antibacterial and anti-tuberculosis drug. Its mechanism of action is that it can penetrate into the body of mycobacteria and interfere with the synthesis of RNA, thereby inhibiting the reproduction of bacteria. It has a very clear inhibitory effect on mycobacteria in the growth and reproduction period.
Let me give you another example. Isoniazid, rifampicin, pyrazinamide, and ethambutol, these four drugs, each have their own responsibilities and roles in the treatment of tuberculosis. I will use the analogy of a battle to describe them:
For example, "isoniazid" is a pioneer in the fight against tuberculosis.
As a powerful anti-tuberculosis drug currently on the market, we first use isoniazid as the vanguard to attack the tuberculosis bacteria, bombarding them and suppressing the enemy's arrogance.
Rifampicin can be regarded as the main force in treating tuberculosis.
Because rifampicin has a more comprehensive bactericidal effect, it even has a certain killing effect on some broad-spectrum drug-resistant bacteria. This drug is the only one that can kill large groups of Mycobacterium tuberculosis.
"Ethambutol" is the blocking force in the anti-tuberculosis program.
This is mainly because it does not produce poor drug resistance with other anti-tuberculosis drugs, that is, the regimen with it can enhance the efficacy of the entire treatment regimen and delay the development of drug resistance in bacteria.
If during the treatment process, stubborn tuberculosis bacteria try to escape, ethambutol can eliminate them at the targeted point and prevent them from breaking out.
Finally, "pyrazinamide" is a scavenger among anti-tuberculosis drugs. Its biggest feature is that it can kill tuberculosis bacteria in cells.
Because tuberculosis bacteria are very tenacious, even if they are engulfed by the macrophages, the king of the immune system, they may still survive and proliferate tenaciously, and even burst and kill the macrophages.
This is a rather terrifying ability, which means that tuberculosis bacteria can travel in the blood with the help of macrophages and spread throughout the body. Spreading to the brain and causing meningitis can be fatal.
Pyrazinamide is a drug that can kill tuberculosis bacteria in every corner of the body, preventing deserters or any lurking troublemakers. It is a real scavenger.
Our research shows that if these four drugs are used in combination, the average patient can be completely cured in just 6 months, with a cure rate of almost 95%.
Of course you will say, didn’t you say it can be cured 100%?
You are all Western medicine doctors, and you know that excessive use of antibiotics for a long time will lead to drug resistance. Among the four drugs I just mentioned, three are bactericidal drugs and one is an antibacterial drug. Drug resistance can easily occur over time.
This is when we need to use second-line medications. We'll talk about second-line medications later. As long as we master this quadruple therapy, we can cure most cases of tuberculosis. This is where my confidence comes from."
After hearing this, the doctors who studied abroad were silent for a long time.
Everyone was evaluating the logic of these four medicines and the loopholes in medical theory and pharmacology, but after thinking for a long time, they all felt that what Lin Sanqi said seemed very reliable.
At this time, Yang Guang couldn't help but raise his hand and ask:
"Director Lin, we understand your explanation. Now there's only one question left. You've listed countless clinical cure data, but you can't provide the source of the data. So even if you publish the paper, it won't be recognized.
So we need your data in China, such as how many patients you have treated, what your cure rate is, etc. Of course, you can't just give us a number; we need the patient's medical records, including chest X-rays, sputum culture reports, etc.
As soon as Yang Guang said this, the other doctors nodded.
Lin Sanqi thought to himself, these 20 doctors are indeed not as easy to fool as the newly graduated college students and apprentices. No wonder they all ended up in a miserable situation, because they would question every word others said, did not believe in authority, and bravely raised objections.
Perhaps in this era, people who are too sober are not popular.
But Lin Sanqi had received modern education and understood what tolerance meant, so he did not feel offended at all by Yang Guang's frankness.
Lin Sanqi knew that it was the first day he met them and he would not be able to convince them at all, nor would he be able to establish his own authority in one day.
What's more, he doesn't need this kind of authority worship. We are all doctors and independent individuals. There is no need for personality cult. As long as everyone does their best, it will be fine.
"Doctor Yang, that's a good question. Let me first tell you about the current situation in China. I have already treated 11 people with quadruple therapy, one of whom is my future father-in-law and the father of Comrade Pan Ye who works for me.
The result of this first case can be determined as recovery. Both the X-ray and the subsequent sputum examination confirmed the absence of tuberculosis. I have the specific case and examination sheet here, and you can check them at any time.
Of course, I know that one case does not mean anything, and there is a rare phenomenon of tuberculosis healing on its own.
So in our tuberculosis department, oh yes, everyone in the hospital is better off calling themselves tuberculosis patients, and never talk about tuberculosis all the time. There's no other way. After all, we are a traditional Chinese medicine hospital, and we have to listen to whoever feeds us, and we still have to reflect the characteristics of traditional Chinese medicine."
Hehehe~~~
Everyone in the yard chuckled.
A Western medicine department was established in a traditional Chinese medicine hospital. This was the first time in China, and everyone was quite curious.
"Currently, our tuberculosis department has admitted eight patients, two of whom are Ma Lianliang and Zhao Yanxia, both famous actors. The other eight are employees of our Traditional Chinese Medicine Hospital. After a month of treatment, they have shown very good results.
Ma Lianliang's condition is more serious, reaching type II hematogenous disseminated pulmonary tuberculosis, so the treatment course is longer; Zhao Yanxia has almost no clinical symptoms, which means she is an asymptomatic virus carrier.
At this time, Bi Xinglong suddenly interrupted:
"Wait, Director Lin, you just mentioned type II hematogenous disseminated pulmonary tuberculosis. What kind of tuberculosis is that? We've never heard of it before."
Lin Sanqi blinked and looked at the other doctors: "Have you never heard of type II hematogenous disseminated pulmonary tuberculosis?"
"No!"
"There are Type II, and Type III and IV?"
Lin Sanqi nodded: “It’s true!”
Both sides stared at each other, and then Lin Sanqi understood. This was probably caused by the information gap between the two eras. In this era, tuberculosis typing should not have existed, or has not yet been formed?
Thinking of this, Lin Sanqi quietly took out a 2022 edition of "Infectious Diseases" from his backpack and turned to the fifteenth section "Tuberculosis". Sure enough, he found the following passage in the textbook:
"Based on the pathogenesis and clinical characteristics of tuberculosis, the Tuberculosis Branch of the Chinese Medical Association revised and formulated a new classification system for tuberculosis in my country in 1998."
There are five types in total.
Primary pulmonary tuberculosis (type I), hematogenously disseminated pulmonary tuberculosis (type II), secondary pulmonary tuberculosis (type III), tuberculous pleurisy (type IV), and extrapulmonary tuberculosis (type V).
Lin Sanqi could recite the five-type classification, but it was the first time he knew that the classification was not formulated until decades later.
Seeing Lin Sanqi in a daze, Pan Ye, who was sitting next to him, gently pushed him:
"Everyone is looking at you, why are you daydreaming?"
Lin Sanqi suddenly slapped his thigh:
"Okay, okay, okay, it's great to work with professionals. Look, our conversation today has already spurred the publication of several papers. For example, our research group on tuberculosis typing could publish over ten papers."
Then Lin Sanqi became a little worried. How could he publish his paper? These days, there is no communication with developed countries, and he doesn’t even have a way to submit his paper.
When the doctors from the two hospitals present heard the paper, their eyes widened.
Ordinary doctors only think about how to cure diseases, while higher-level doctors think about how to summarize the experience gained from treating diseases, or summarize the abnormal phenomena found in clinical practice through scientific research.
Then publish the paper.
The significance of a paper is not only that you can be recorded in history, but more importantly, it can be seen by all doctors in the world, so that everyone can learn new knowledge and skills, and then apply them in clinical practice to jointly promote the development of medicine.
Of course, the number of papers published and the level of medical journals can also reflect a doctor's status in the medical community.
Each of the 20 doctors present hopes to have his or her own research group and publish his or her own paper.
Bi Xinglong asked excitedly, "Director Lin, can we set up our own research group at the Chinese Medicine Hospital? Will the hospital allow it and provide funding?"
Lin Sanqi waved his hands and shook his head:
"Don't worry, don't worry. We will definitely set up a research group, but not right away. And we don't need the hospital's approval. We can just organize it ourselves. What's important now is curing the disease. In your words, that means we need a large patient base."
As soon as these words were spoken, everyone calmed down.
Yes, it is not that easy to do research projects. It requires equipment, funds and leadership support. It is better to be down-to-earth and be a "worker".
Yang Guang stood up at this time, and then Cong Sheng, Fu Jinsheng, Jin Yuchun and nine other doctors also stood up:
"Director Lin, please give us the instructions. We will ensure that the task is completed."
The doctor from Union Hospital was quite embarrassed and quickly stood up hesitantly: "Director Lin, we will do whatever you say."
Lin Sanqi knew that the people in the Digital Hospital might not necessarily believe in him, but they were better disciplined and more obedient, so they were willing to follow his orders.
The doctors at Union Hospital are under someone else's roof and have to bow their heads. Who knows what they are complaining about in their hearts.
Building trust requires a process and an opportunity.
"Well, since we are all colleagues and senior doctors, I won't be polite.
In this way, our 20 doctors will be divided into 4 wards, with 5 doctors in each ward. You will form your own teams and elect a department director. I have a thick skin and will temporarily serve as the director of the major ward.
In addition, I have seven newly assigned college students here. They are both interns and department staff. Among them, Comrade Pan Ye is my fiancée, and I will personally lead her. The remaining six college students will be divided into four departments.
There are also 24 soldiers from our Chinese medicine hospital, 6 of whom are divided into each department.
These soldiers are like trainees. They have no medical knowledge and no foundation. I hope you can take on the responsibility of teaching them and help them become excellent medical workers."
The 20 overseas doctors all nodded in agreement.
Both Union Hospital and Digital Hospital have their own "medical schools", and these doctors usually supervise students, so this is not a difficult task for them.
Yang Guang asked: "Then how should we proceed with our next work?"
Lin Sanqi gestured to Pan Ye again, and Pan Ye began distributing materials again:
"You should all be able to operate machines like the X-ray machine, hematology analyzer, coagulation analyzer, and biochemistry analyzer, right? I don't need to hire anyone else to do it, right?"
The crowd chuckled again: "Don't worry, Director Lin, we all know how to operate it. As long as there are parts, we can repair it ourselves."
Hehehe~~~
"Okay, as long as everyone knows how to operate it, it's easy. The process for admitting patients is the same. After admission, a comprehensive examination is performed and the condition is assessed. However, the treatment plan is different from other hospitals.
First, everyone uses this four-in-one medicine. Don’t be fooled by the fact that it is a Chinese medicine pill. In fact, the real secret inside is a Western medicine. It is called ethamidine, pyrazine, and rifampicin tablets. I have combined four ingredients of anti-tuberculosis drugs into one.
It is very simple to take Ethamopyrazine and Rifampicin Tablets. Just one tablet a day will be enough. You will write a doctor's prescription and the nurse will deliver it to the patient's bedside on time every day.
In addition, the rifampicin and ethambutol in the Ethambutol-Pyrazine-Rifampicin Tablets are my personal patented drugs, which are still in the application process, so it is best to keep it confidential. We should announce it as "Tuberculosis Pills" to the outside world to prevent it from being stolen by malicious patients for research.
So the nurses and interns will have to work hard and watch the patients swallow the medicine with their own eyes and not let them smuggle it out of the hospital. If it goes overseas, my loss will be heavy and your thesis will be ruined.
Even worse, if our tuberculosis department goes out of business, I can still pat my butt and continue to be the head of the purchasing department, but everyone here will be sent down to the countryside to farm and herd sheep."
Lin Sanqi said this with a smile, but his meaning was not polite at all.
People’s hearts are unpredictable, so some ugly things have to be said upfront.
"In addition, my Ethylamine, Pyrazine, and Rifampicin tablets also have very serious side effects, such as damage to liver and kidney function, gastrointestinal reactions, and effects on the nervous system.
What Pan Ye just sent is the instructions for Ethylamine, Pyrazine, and Rifampicin Tablets. You can take a closer look at it. You are all senior doctors and should know how to identify and treat it.
Oh, regarding treatment, we must give full play to the role of traditional Chinese medicine. For example, for the most common and most serious liver damage, such as a sharp increase in alanine aminotransferase, aspartate aminotransferase, and jaundice, we can seek help from traditional Chinese medicine.
I know some of you don't believe in Traditional Chinese Medicine (TCM), thinking it's witchcraft. I don't think that's necessary. Western medicine has its merits, and Traditional Chinese Medicine has its uses. We should leverage the strengths of both to better serve our patients.
In fact, even in 2013, Western medicine did not have any particularly good liver protection products. Commonly used products were polyene phosphatidylcholine, adenosine methionine, sulfapron enteric-coated tablets, etc.
There are also mainstream Western medicines such as ursodeoxycholic acid, liver protection tablets, silybin capsules, compound glycyrrhizin injection, etc., which are all closely related to traditional Chinese medicine.
Therefore, among liver protection drugs, Chinese patent medicines occupy a considerable portion, such as Tianma Qufeng Bupian, Qiju Dihuang Wan, Fuzheng Huayu Capsule, Ganluoxin Wan, etc.
However, the quality of Chinese patent medicines varies greatly. Many liver-protecting medicines may actually increase the burden on the liver, which has caused many people to lose trust in traditional Chinese medicine.
Now that Lin Sanqi has the best "Twelve Men's Traditional Chinese Medicine Team" in his hands, it would be a waste of talent if he doesn't use it.
At that time, Western medicine kills bacteria, while Chinese medicine maintains health; Western medicine treats the root cause, while Chinese medicine treats the symptoms;
This is definitely the best way to integrate Chinese and Western medicine.
Soon, 20 doctors formed four tuberculosis wards.
The director of Ward 1 is Bi Xinglong from Union Hospital, and the director of Ward 2 is Cai Chunhua; the director of Ward 3 is Yang Guang from Digital Hospital, and the director of Ward 4 is Fu Jinsheng.
These four directors were elected by the doctors themselves, including the head nurse and director of the nursing department. This free management style is very popular among doctors and nurses in the two hospitals.
However, every doctor has a question mark in his mind about how good the medical skills of Lin Sanqi, the director of the intensive care unit, are.
Then an accidental event made Lin Sanqi a legend in the health system and quickly established his own authority.
In the master bedroom on the second floor of the Nordic Snow Country Embassy, bursts of violent coughing were emanating...
(End of this chapter)
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