面對人畜共患病毒跨物種傳播的持續威脅，未來爆發呼吸道“X疾病”的風險依然處于高位。在此背景下，開發安全有效的抗病毒策略是一項由迫切臨床需求驅動的長期而關鍵的使命。近期，鐘南山院士在Chinese Herbal Medicines雜志發表社評：New draft: Elucidating complex efficacy of traditional Chinese medicine in combating respiratory viral diseases。該文直擊核心：如何解構中醫藥抗病毒的復雜療效？

中國在使用傳統中醫藥（TCM）防治急性呼吸道感染方面有著悠久的歷史。在應對過去歷次疫情的過程中，中醫藥始終被證實是攻堅新興傳染病的重要武器。在中醫“整體觀念”和“辨證論治”核心原則的指導下，中醫藥干預側重于患者的整體病理狀態。這種整體調理的方法不僅能提供有效的治療，而且在阻止疾病由輕癥向重癥進展方面發揮著至關重要作用，使其成為新藥研發的重要源泉。

越來越多的臨床證據證實了多種中草藥及其復方制劑的顯著療效。然而，一個根本性的挑戰阻礙了其在全球范圍內的理解與接受：臨床實踐與機制驗證之間的脫節。與主要依賴針對特定病原體的單分子藥物的西醫不同，中藥方劑是草藥化合物的復雜混合物。正是這種“多成分、多靶點”的特性，既構成了核心挑戰，也帶來了獨特的機遇：解構這一復雜系統是鑒定特定活性成分并闡明其協同作用機制的關鍵。

因此，旨在針對單一靶點治療的傳統抗病毒藥物篩選模型，無法真實地復制臨床疾病的復雜性，也無法捕捉到中醫藥的整體治療特點。由于缺乏切合中醫藥獨特屬性的藥效篩選與評價平臺，導致難以破解其臨床療效背后的藥效物質基礎和分子機制。這一局限性阻礙了中醫藥在國際抗病毒治療中的廣泛應用。

完善中國抗病毒中藥的前沿研究體系具有重要的戰略意義。通過加強整合病毒學、藥理學、系統生物學和數據科學的跨學科合作，我們可以用現代科學的嚴謹性為傳統智慧賦能。開發先進的、契合中醫藥特點的評價模型，將加速抗病毒研究成果的臨床轉化。通過這些努力，中醫藥能夠得到系統性的驗證，并在全球抗擊呼吸道病毒威脅的武器庫中發揮更重要、更受認可的作用。

參考資料：

https://www.sciencedirect.com/science/article/pii/S1674638426000080

Throughout human history, the relentless battle against global pandemics has persisted. Since the 20th century, the world has witnessed a series of emerging and acute respiratory infectious diseases, including four major influenza pandemics: Spanish Flu (H1N1)-1918-1919, Asian Flu (H2N2)-1957-1958, Hong Kong Flu (H3N2)-1968-1969, and Swine Flu (H1N1) pdm09-2009, and the three coronavirus epidemics/pandemics: Severe acute respiratory syndrome (SARS)-2002-2003, middle east respiratory syndrome (MERS)-2012-present, and coronavirus disease-2019 (COVID-19)-2019-present. These catastrophic diseases have caused a disastrous impact on both the global economy and human health.

With the ongoing threat of zoonotic virus cross-species transmission, the risk of a future respiratory “Disease X” remains high. In this context, developing safe and effective antiviral strategies is a critical and long-term mission driven by urgent clinical needs.

China has a long history of using traditional Chinese medicine (TCM) to treat and prevent acute respiratory infections. Responses to past epidemics have consistently demonstrated that TCM serves as a vital tool in confronting emerging infectious diseases. Guided by its core principles of a holistic approach and syndrome differentiation, TCM interventions focus on the individual’s entire pathological state. This holistic approach not only provides effective treatment but also plays a crucial role in preventing the progression of disease from mild to severe stages, making it a significant source for novel drug research and development.

A growing body of clinical evidence confirms the significant therapeutic effects of various Chinese herbal medicines and their compound preparations. However, a fundamental challenge impedes their global understanding and acceptance: Gap between clinical practice and mechanistic validation. Unlike Western medicine, which predominantly relies on single-molecule drugs targeting specific pathogens, TCM formulations are complex mixtures of herbal compounds. Precisely this multi-component, multi-target nature presents both the core challenge and the unique opportunity: Deconvoluting this complex system is key to identifying specific active ingredients and elucidating their synergistic mechanisms of action.

Consequently, conventional antiviral drug screening models, designed for single-target therapies, fail to authentically replicate the complexity of clinical disease or capture the holistic therapeutic characteristics of TCM. The lack of pharmacodynamic screening and evaluation platforms tailored to TCM’s unique attributes makes it difficult to decipher the pharmacodynamic material basis and molecular mechanisms underlying its clinical efficacy. This limitation hinders the widespread international adoption of TCM in antiviral therapy.

Therefore, it is strategically crucial to improve China’s cutting-edge TCM research system for antiviral medications. By strengthening interdisciplinary collaboration that integrates virology, pharmacology, systems biology, and data science, we can empower traditional wisdom with modern scientific rigor. Developing advanced, TCM-appropriate evaluation models will accelerate the clinical translation of antiviral achievements. Through these efforts, TCM can be systematically validated and positioned to play a more substantial and recognized role in the global arsenal against respiratory viral threats.