Endocrinology

I. Specialty Overview

The Department of Endocrinology of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine was reorganized in 1998 and is currently a designated unit for the development of a key specialty under the National Administration of Traditional Chinese Medicine’s “12th Five-Year Plan,” an institution authorized to confer doctoral degrees in the Endocrine and Metabolic Diseases track of TCM Internal Medicine at Tianjin University of Traditional Chinese Medicine, the host institution of the Diabetes Professional Committee of the Tianjin Association of Chinese Medicine, the National Clinical Evaluation Center for New TCM Drugs in Endocrinology, the Tianjin Clinical Skills Training Base for Chief Primary-Care Diabetes Physicians, a Chinese Medical Association-certified institution for diabetes health education and management, and a Tianjin Workers’ Pioneer Unit. It also serves as a deputy-chair institution of the Diabetes Professional Committee of the Chinese Association of Chinese Medicine, the Endocrinology Professional Committee of the Chinese Association of Chinese Medicine, the Expert Committee on Integrated Traditional Chinese and Western Medicine Endocrinology of the Chinese Medical Doctor Association, and the Endocrinology Professional Committee of the Tianjin Association of Integrated Traditional Chinese and Western Medicine; a vice-president institution of the Diabetes Professional Committee of the World Federation of Chinese Medicine Societies, the Endocrinology Branch of the World Federation of Chinese Medicine Societies, and the China Association for the Promotion of Diabetes Prevention, Treatment and Rehabilitation; a member of the Beijing-Tianjin-Hebei Specialty Alliance for the Collaborative Development of Traditional Chinese Medicine; and a “Nationally Renowned TCM Endocrinology/Diabetes Specialty.” In 2022, it was recognized by the National Administration of Traditional Chinese Medicine as a participating institution in the construction project for the “National Studio for the Inheritance of Renowned Veteran TCM Experts.”

The Department of Endocrinology currently has 10 outpatient rooms, including 1 TCM treatment room and 1 patient education room; 48 inpatient beds; for nearly 3 years, outpatient visits have consistently exceeded 100,000, with 1500 patients discharged annually and an inpatient TCM treatment rate of over 80%; and 5 specialty clinics. It currently has 33 medical and nursing staff members, including 19 physicians, 12 staff members with senior professional titles (6 with full senior titles), 6 with doctoral degrees, 2 doctoral supervisors, and 9 master’s supervisors; and 14 nursing staff members.

II. Research Projects

III. Research Awards

IV. Conditions of Specialty Expertise

Diabetes Mellitus (Xiaoke Disease)

Diabetes mellitus falls within the TCM category of “Xiaoke.” Xiaoke is a disease whose principal clinical manifestations are polydipsia, polyphagia, polyuria, fatigue, weight loss, or sweet-tasting urine. The traditional TCM pathogenesis of Xiaoke disease is based on yin deficiency and dryness-heat. Through long-term clinical practice, combined with research on the roles of DM-related insulin resistance, glucotoxicity, lipotoxicity, and other factors in the pathogenesis of diabetes, as well as TCM pathogenesis theory and relevant modern research data, we proposed that “turbid toxin is an initiating factor in the pathogenesis of diabetes”; internal accumulation of turbid toxin is one of the important pathogenetic mechanisms of Xiaoke disease.

In clinical practice, according to the different stages of pathological change in Xiaoke disease, we apply syndrome differentiation and treatment and select corresponding formulas and medicines. On the basis of supplementing qi and nourishing yin, we add substances that transform turbidity and resolve toxin; the method of transforming turbidity and resolving toxin runs throughout the treatment. In addition to conventional methods such as oral administration and injection, we flexibly select external treatments such as fumigation, washing, moxibustion, acupuncture, and massage according to the patient’s condition, treating internally and externally at the same time to improve efficacy and shorten the treatment course.

Diabetic Kidney Disease (Xiaoke Kidney Disease)

Diabetic kidney disease develops from diabetes, and its basic TCM pathogenesis is root deficiency with branch excess; however, it also has the pathological characteristics that, after Xiaoke has persisted for a long time, the original qi becomes deficient first and excess arises from deficiency. Root deficiency refers to deficiency of yin and yang, qi and blood, and the five zang organs, with deficiency of the spleen and kidneys in particular as the core; branch excess refers to pathogenic factors such as qi stagnation, blood stasis, phlegm-turbidity, turbid toxin, and damp-heat. Its occurrence and development are mainly a pathological process in which long-standing Xiaoke damages yin and consumes qi, damage to yin extends to yang, all five zang organs become deficient—especially the spleen and kidneys—and failure to secure the essence instead produces and allows leakage of turbid dampness, which then obstructs the blood vessels with stasis, resulting in internal accumulation of turbid toxin and damage to the renal collaterals. The emphasis of the pathogenesis differs at different stages of development. Overall, however, the basic pathogenesis of this disease is “root deficiency with branch excess,” especially deficiency of both qi and yin and endogenous generation of turbid toxin.

Therefore, reinforcing the healthy qi and dispelling pathogenic factors, with securing and promoting drainage applied in tandem, is an important treatment principle. The drug we developed for early proteinuria in diabetic kidney disease—Shenxiao Granules—has shown outstanding clinical efficacy and achieved good social and economic benefits.

Diabetic Peripheral Neuropathy (Xiaoke Bi Syndrome)

The TCM disease name for diabetic peripheral neuropathy is “Xiaoke disease Bi syndrome.” We believe that, although the disease location is mainly obstruction of the meridians and the disease often enters the collaterals after a prolonged course, resulting in stasis and obstruction of the collaterals, its disease nature, because it develops after Xiaoke and the healthy qi is already deficient, is characterized by stagnation arising from deficiency, followed by deficiency caused by excess. Recent studies have found that, when yang fails to move qi, qi and blood become further depleted, gradually leading to kidney deficiency and insufficiency of the Du meridian, which is the root of the disease’s protracted persistence, namely, “pain due to loss of warmth and nourishment”; while phlegm-turbidity, blood stasis, cold, and dampness generated by deficiency further obstruct the meridians and collaterals, which is the crux of worsening disease. Therefore, we have concluded that the treatment of diabetic neuropathy should be based on the major principle of “warming, moistening, and unblocking.”

In terms of syndrome differentiation and medication, supporting healthy qi and dispelling pathogens should be fundamental, and the relationship between tonifying deficiency and unblocking the collaterals (dispelling pathogens) should be properly managed. Even if the urgent priority is to dispel cold, transform turbidity, invigorate blood, resolve toxin, and use other methods of dispelling pathogens and unblocking the collaterals, the specific condition should still be taken into account and the dryness-moistening method of guiding yang, supplementing qi, nourishing blood, tonifying the kidney, and strengthening the Du meridian should be applied as appropriate; moreover, the method of warming yang, moistening, and unblocking the collaterals should run throughout the treatment of this disease. Clinical treatment emphasizes that, on the premise of syndrome differentiation and treatment and the selection of formulas and medicines, agents that transform stasis and unblock the collaterals should be added as appropriate, drawing on the rationale of “using unblocking as supplementation” and “using unblocking as assistance,” with good clinical efficacy achieved.

Gouty Arthritis (Turbid-Stasis Bi Syndrome)

Gout is a disease designation shared by traditional Chinese and Western medicine. In the Standards for Diagnosis and Therapeutic Efficacy of TCM Diseases and Syndromes, gout is explicitly defined as “redness, swelling, and pain in the joints of the extremities caused by elevated serum uric acid.” In 1989, Professor Zhu Liangchun, a National TCM Master, proposed the disease name “Turbid-Stasis Bi” based on the characteristics of this disease.

Based on long-term clinical practice, we conclude that gout occurs because of insufficient congenital endowment or constitutional deficiency and spleen-kidney deficiency, compounded by dietary indiscretion. Dampness (phlegm) -turbidity therefore arises internally, remains in and obstructs the blood vessels, and is difficult to discharge and transform; the blood becomes sluggish and congealed, transforming into stasis-turbidity; constraint and blockage transform into heat and accumulate into toxin. Turbidity gives rise to toxin; turbid toxin, attracted by their common qi, mutually intensifies its harmful effects, resulting in internal accumulation of turbid toxin. Turbid toxin remains in the blood and is triggered when it combines with external pathogens, or by excessive alcohol consumption and unrestrained eating of rich, fatty, and sweet foods. Damp-turbidity and blood stasis, together with internal accumulation of turbid toxin, are the key pathogenic mechanisms of this disease.

With regard to syndrome differentiation and treatment, we differentiate and treat according to the acute attack stage, intercritical stage, and chronic tophaceous lesion stage, respectively, using comprehensive therapies such as Chinese herbal decoctions, acupuncture and moxibustion, and medicated fumigation.

Subacute Thyroiditis (Goiter Pain)

Subacute thyroiditis is the most common painful thyroid disease. It is self-limiting, usually caused by a viral infection of the thyroid, and characterized by transient pain, destructive injury to thyroid tissue, and a systemic inflammatory response. Based on its principal clinical manifestations and TCM pathogenesis, we named it “Goiter Pain.”

We believe that the “endogenous toxin” involved in its onset is mostly caused by emotional dysregulation or dietary indiscretion, which damage the zang-fu organs and impair the circulation of qi, blood, and body fluids; its main pathogenesis is “conglomeration of toxic pathogens.” We perform staged syndrome differentiation and treatment in conjunction with changes in thyroid function (namely, the thyrotoxic phase, the hypothyroid phase, and the thyroid function recovery phase).

Department of Endocrinology, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

Director Wu Shentao, Department of Endocrinology, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

Director Wang Bin, Department of Endocrinology, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.