Rheumatology and Immunology

The Department of Rheumatology and Immunology of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine is a nationally leading tertiary Grade A base for the clinical care, research, and teaching of rheumatic diseases in traditional Chinese medicine. It is a key specialty and key discipline designated by the National Administration of Traditional Chinese Medicine during the 11th, 12th, and 13th Five-Year Plans, a development unit for a Tianjin “top priority” key specialty, and the lead organization of the collaborative group for the National Administration of Traditional Chinese Medicine’s key disease “Zao Bi” (dryness-related Bi syndrome). It is also a sub-center for the diagnosis and treatment of key diseases including rheumatoid arthritis and systemic lupus erythematosus. This key specialty has distinctive traditional Chinese medicine characteristics and significant therapeutic effects from integrated Chinese and Western medicine. Its advantageous diseases include common rheumatic and immune diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, gout, and ankylosing spondylitis. Disease-specific outpatient clinics have now been opened successively.

The Department of Rheumatology and Immunology is the unit serving as the chairperson’s office of the Rheumatology Professional Committee of the Chinese Association of Integrative Medicine, the unit serving as the chairperson’s office of the Professional Committee for Drug Research on Rheumatic and Immune Diseases of the China Association of Chinese Materia Medica, the unit serving as the chairperson’s office of the Rheumatology Professional Committee of the Tianjin Society of Traditional Chinese Medicine, and the unit serving as the chairperson’s office of the Rheumatology Professional Committee of the Tianjin Society of Integrative Medicine; it is also the unit serving as vice chairperson of the Rheumatology Professional Committee of the Tianjin Medical Association. Relying on the above multi-faceted, high-level specialty platforms, the department collaborates with dozens of tertiary Grade A hospitals of traditional Chinese medicine throughout China, focuses on key areas of rheumatic disease, studies core issues, improves specialty standards, and has established a research system with distinctive characteristics of a rheumatology and immunology specialty.

The “Toxic Bi Theory” established by Professor Liu Wei is the core theory of this specialty. Professor Liu Wei was the first to propose the “Toxic Bi Theory,” advocating treating Bi diseases on the basis of toxins, and summarized corresponding therapeutic methods such as detoxifying and unblocking the collaterals. He developed hospital preparations and established a complete treatment system for Toxic Bi that includes theory, therapeutic principles, formulas, and medicines. He established detoxification and collateral unblocking as the treatment principle for Bi diseases and created the hospital preparation “Qingbi Tablets” (developed in 1998 and used for more than 20 years), which is safe and effective for treating rheumatoid arthritis. In addition, by expanding and extending the “Toxic Bi” theory, he proposed the “deficiency, stasis, and toxin theory” for the etiology and pathogenesis of Sjögren syndrome and treats the disease by supplementing qi and nourishing yin, clearing heat and detoxifying, and activating blood and removing stasis. He also proposed strengthening healthy qi and detoxifying to treat systemic lupus erythematosus, achieving significant therapeutic effects; related research projects have received multiple national and provincial- or ministerial-level awards. Under the specialty diagnosis and treatment system guided by the “Toxic Bi Theory,” the department is at the domestic leading level in clinical and basic research on rheumatic and immune diseases including rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, gout, and ankylosing spondylitis. It has undertaken more than 20 projects, including projects under the National Key Research and Development Program, the National Natural Science Foundation of China, the National Science and Technology Support Program during the 11th and 12th Five-Year Plans, the Tianjin Municipal Commission of Science and Technology, and the Wu Jieping Medical Foundation. It has received more than 10 national and provincial- or ministerial-level awards, including the second prize of the National Science and Technology Progress Award for research on enhancing efficacy and reducing toxicity in the treatment of systemic lupus erythematosus according to the theory of toxin, deficiency, and stasis. Over the past 10 years, the department has published more than 10 academic books, trained more than 100 master’s and doctoral students, and published more than 200 papers in core journals. The department currently has 96 beds, admits more than 2,000 patients annually, and records more than 60,000 outpatient visits each year.

Under the leadership of Professor Liu Wei, a “Qihuang Scholar,” the rheumatology and immunology team led and joined forces with more than 10 domestic tertiary Grade A clinical institutions to conduct joint research and formulate guidelines for the integrated Chinese and Western medicine diagnosis and treatment of gout, as well as traditional Chinese medicine diagnosis and treatment guidelines and expert consensuses for rheumatic and immune diseases including reactive arthritis, adult-onset Still’s disease, undifferentiated arthritis, rheumatoid arthritis, systemic lupus erythematosus, and Behçet disease. These efforts have promoted the international standardization of traditional Chinese medicine. The traditional Chinese medicine clinical pathway for Zao Bi (Sjögren syndrome) was one of the first batch of clinical pathways for key traditional Chinese medicine specialties and disease-specific conditions to be issued nationwide. It has been applied in more than 10 tertiary Grade A hospitals of traditional Chinese medicine and has gradually been promoted nationwide, receiving widespread recognition. Analysis of the application of the clinical pathway in more than 300 patients with Sjögren syndrome showed that the relief rates for dry mouth and dry eyes reached more than 70%, disease activity decreased significantly, and all laboratory indicators improved significantly compared with those before treatment. At the same time, through a series of improvements, standardization, and evaluation of this clinical pathway, the department established a rheumatic disease diagnosis and treatment evaluation system based on the Toxic Bi Theory. The system can effectively guide clinical practice, meets clinical needs, and has led to continuous improvement in the quality of clinical medical services, producing significant social benefits.

During the 12th Five-Year Plan period, the specialty actively participated in the National Administration of Traditional Chinese Medicine’s strategic research on the development of TCM standardization and led or participated in the formulation and revision of 13 TCM standardization projects of the administration. It led the formulation of TCM clinical diagnosis and treatment guidelines for four diseases—Behçet disease, reactive arthritis, adult-onset Still’s disease, and undifferentiated arthritis—and participated in the formulation and revision of standardized TCM diagnosis and treatment guidelines for rheumatoid arthritis, systemic lupus erythematosus, gout, dermatomyositis, scleroderma, osteoarthritis, and acupoint application during the spring and autumn equinoxes, among other diseases and treatments. It became the largest standardized rheumatic disease diagnosis and treatment center in China. During the development period, the specialty’s clinical service capacity and clinical efficacy improved significantly. Operational indicators, including outpatient visits, discharges, number of beds, and the rate of TCM treatment, increased year by year. The proportion of patients admitted with critical, severe, or difficult-to-treat conditions exceeded 40%, and the proportion of patients from outside the region exceeded 30%. Patients came from all districts of Tianjin as well as Beijing, Shandong, Hebei, Henan, Inner Mongolia, Jiangxi, Anhui, Shaanxi, Gansu, Heilongjiang, Jilin, Liaoning, Zhejiang, Hainan, and more than 10 other provinces, cities, and autonomous regions.

Based on the National Administration of Traditional Chinese Medicine’s work on developing key disciplines and key specialties, the specialty has established close cooperative relationships with more than 10 domestic and overseas specialty institutions for TCM rheumatic diseases, including more than 10 tertiary Grade A TCM rheumatology departments in Beijing, Shanghai, Guangzhou, Yunnan, Gansu, Shandong, Zhejiang, Jiangsu, Anhui, and Liaoning. Through various forms of cooperation, including assistance, accepting visiting trainees, academic conferences, public health lectures, and teleconsultations, the specialty has helped establish or expand more than 10 county-level TCM and integrated Chinese and Western medicine rheumatology departments in Tianjin’s suburban counties and throughout China. In active response to the call of the Party and the state to assist impoverished areas through the Belt and Road Initiative, the specialty has helped many TCM hospitals in impoverished areas establish rheumatology departments and has carried out assistance work in remote, impoverished areas of Yunnan, Gansu, and Guizhou. It has provided guidance and assistance with ward rounds, consultations, and lectures, as well as technical support, receiving unanimous praise from doctors and patients. At the same time, as an outreach expert of the Tianjin TCM Culture and Public Education Delegation, a Tianjin health education expert, and a public education expert of the China Association of Chinese Medicine, the department’s experts, represented by Professor Liu Wei, regularly give lectures on medical and health knowledge each year through Tianjin Television, Qingdao Television, China.com, and many other media outlets, popularizing knowledge of relevant internal diseases for patients, their families, and the general public. Each year, the department organizes at least 10 free medical consultation events, benefiting tens of thousands of patients and receiving widespread praise from the public.

The Department of Rheumatology and Immunology, a key specialty of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, will use the work platform of the key specialty to raise the level of diagnosis and treatment of diseases in the specialty from individual initiatives to broad implementation through the development of specialty alliances, medical clusters, renowned physician clinics, and public welfare activities. It will further improve its technical level, expand its professional influence, and strive to build a first-class domestic center for the diagnosis and treatment of rheumatic diseases using traditional Chinese medicine and integrated Chinese and Western medicine.