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Table of Contents
REVIEW ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 4  |  Page : 187-192

The present scenario, challenges, and future anticipation of traditional mongolian medicine in China


1 Department of Mongolian Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
2 Department of Pakistan Traditional Medicine, COMSATS University Islamabad, Lahore, Pakistan
3 Department of Medicine and Pharmacy, College of Pharmacy, South-Central University for Nationalities, Wuhan, China
4 Department of Mongolian Medicine, School of Mongolian Medical, Inner Mongolia Medical University, Hohhot, China
5 Health Management Center, Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao, Chinao, China
6 Department of Brain Disease, Inner Mongolia International Mongolian Hospital, Hohhot, China
7 Psychosomatic Medical Center, Inner Mongolia International Mongolian Hospital, Hohhot, China

Date of Submission29-Apr-2019
Date of Decision01-Aug-2019
Date of Acceptance23-Aug-2019
Date of Web Publication03-Dec-2019

Correspondence Address:
Prof. Hui-Hui Zhao
Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Chaoyang District, Beijing 100029
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/wjtcm.wjtcm_34_19

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  Abstract 


The objective was to study the present scenario, challenges, and future anticipation of traditional Mongolian medicine (TMM) in China. The literature was retrieved using various sources of information such as meetings with TMM experts, research and review articles, national health databases, and government websites and authoritative papers. Health care using TMM, TMM education and research, and the pharmaceutical industry of TMM has been improved by implementing TMM growth policies. TMM has been extensively used for health care in Mongolia and in various regions of China including Beijing. The national education system of China contains a stream of TMM education. There is a yearly increase in research productivity in the field of TMM due to extensive research funding by the government. The rapidly growing pharmaceutical industry of TMM has provided more availability of TMM to more patients. The literature search revealed good preservation and development of TMM in China, urging the need to take steps for the promotion of its spread and development in China and worldwide.

Keywords: Health care, pharmaceutical industry, research productivity, traditional Mongolian medicine


How to cite this article:
Tong HY, Zhang SQ, Murtaza G, Zhao HH, Huang XJ, HR, WL, Bao WY, WJ, WY, Chen LY. The present scenario, challenges, and future anticipation of traditional mongolian medicine in China. World J Tradit Chin Med 2019;5:187-92

How to cite this URL:
Tong HY, Zhang SQ, Murtaza G, Zhao HH, Huang XJ, HR, WL, Bao WY, WJ, WY, Chen LY. The present scenario, challenges, and future anticipation of traditional mongolian medicine in China. World J Tradit Chin Med [serial online] 2019 [cited 2019 Dec 8];5:187-92. Available from: http://www.wjtcm.net/text.asp?2019/5/4/187/271968




  Introduction Top


According to the data of China's sixth national census in 2010, there are about 6 million Mongolian population in China and about 4.23 million in the Inner Mongolian Autonomous Region (http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm, http://www.stats.gov.cn/tjsj/tjgb/rkpcgb/dfrkpcgb/201202/t20120228_30397.html). Mongolian population is 3.3 million, out of which half belongs to rural areas.[1] In 2015, the values of the human Development Index assigned to Mongolia was 0.73.[2] Health-care facilities are rendered by both public and private sectors.[3]

On the basis of philosophies and practices of Mongolian culture, traditional Mongolian medicine (TMM) system is also being practiced like other ethnic or traditional minority medicines in China. The origin of TMM belongs to the early 13th century. Later on, it evolved into a typical medicine system in the Inner Mongolia and its neighboring areas.[4] Based on its unique theoretical systems, TMM has accumulated a wealth of clinical experiences in the development process.

The health-care system of various provinces of Inner Mongolia including ÖmnÖ govi and KhÖ vsgÖl comprises of TMM to an appreciable extent.[5] A remarkable focus has been concentrated in the current years on the promotion and development of TMM in China through the incorporation of health care, pharmaceutical education, and scientific research of TMM.[6] With the passage of each year, the statistics reveal an increase in research productivity in the field of TMM.[7] An appreciable efficacy and furtive nature of treatment procedures are attracting the attention of more public.[8],[9]

Nonetheless, the development of TMM in China has resulted in the emergence of several concerns as well. Therefore, this study was carried out to investigate the present scenario, challenges, and future anticipation of TMM in China and present these data to the international readers and researchers who are involved in the research of the complementary and alternative medicines.


  Methodology Top


The retrieval of literature was made by collecting various information regarding research and review articles, national health databases, and government websites and authoritative papers on TMM from the China National Knowledge Infrastructure (CNKI) database using various key terms such as TMM and traditional Mongolian medicines. However, the CNKI does not reflect articles written in the Mongolian language. Moreover, TMM experts in various agencies, institutes, and associations were approached through E-mail or telephone.

In an attempt to retrieve and extract data, various determinants of TMM-based health-care system such as hospitals, health professionals, and patients were studied quantitatively. The academic institutes including universities and colleges which are majorly offering education in the field of TMM were also studied. Furthermore, the data regarding research institutes, research projects, journals, and publications on TMM were collected. In addition, the literature was also searched to excavate the pharmaceutical industry for TMM and the national strategy and the apprehensions on the development of TMM in China.


  Results and Discussion Top


Past of traditional Mongolian medicine

Based on the origin, TMM in Inner Mongolia is younger than traditional Chinese medicine (TCM) in China. There are several pieces of evidence which reveal the inheritance of TMM during the 13th and 16th centuries.[10],[11],[12],[13],[14] The first hospital of TMM in Inner Mongolia was established in the 1940s.[10],[12],[13] TMM training was formally initiated after the Chinese revolution in 1949.[10] Furthermore, the strengthening of the Chinese economy exerted a positive effect on the regulation of TMM, resulting in its rapid development. The first undergraduate program of TMM was established in 1958.[10],[15],[16],[17] The rules and regulations of TMM were introduced in 2001 and renewed in 2010.[12],[18],[19]

Health care through traditional Mongolian medicine

According to a study conducted in 2015, 66 TMM hospitals (16% of the total hospitals) in Inner Mongolia were providing TMM medical service.[20] Among these TMM hospitals, six were assessed as tertiary hospitals and 35 were assessed as secondary hospitals. There were 55 TMM hospitals located in Inner Mongolia. These hospitals contained a total of 15,649 beds;[20] however, there was partial coverage of patients through TMM.[20] The number of outpatients and inpatients was 7.6 million and 0.3 million, respectively.[20]

There are several hospitals in Inner Mongolia including International Mongolian Hospital, which is the largest tertiary hospital in Inner Mongolia, and has taken an integration of Inner Mongolia's health and talent resources. This university was established in 2012 and has evolved into one of the largest institutes of clinical research in TMM in Inner Mongolia in 6 years.[14]

In Mongolian Regions of Liaoning, Jilin, Heilongjiang, Xinjiang, and Qinghai provinces, there are many TMM hospitals and institutes that are providing TMM-based health facilities. Mongolian Hospital of Liaoning was also assessed as one of the top hospitals in Inner Mongolia that are playing an important role in TMM clinical and research. Boertala Mongolian Hospital and Bayingolin Mongolian Hospitals of Xinjiang are also famous TMM hospitals. In the same time, TMM hospitals or departments were also found in various provinces of China.

Some of the TMM hospitals contain distinctive clinical departments, for instance, the TMM therapy department.[20] The language used in the clinical service provision is Chinese or Mongolian.[21] For diagnosis and treatment process in TMM service delivery, the care provider needs a deep discussion with patients.[22],[23] As far as the acceptance of TMM service is concerned, it is normally accepted by most minority populations and most of the populations have never heard about it.[24],[25],[26]

Traditional Mongolian medicine professionals

In spite of TMM development policy during the last 10 years, the total health workforce of TMM is still much lesser than that of Western and Chinese medicine. There were overall 17,000 TMM health professionals, but there was only 0.7 professional/1000 population in 2015.[27],[28]

The educational model adopted for TMM involves 5-year Bachelors and 3-year Masters at university level only. For the compensation of health workforce, the alternative training programs are still in practice.[22] In spite of some universities offering TMM, there are two schools of TMM also,[29] where >500 undergraduate students are pursuing their education.[15],[16],[17],[29],[30],[31],[32] For TMM practice, it is compulsory for the trainees to appear in the license examination (National Practicing Physician Qualification Test) and pass it; nonetheless, the rate of the qualifying personnel is low.

Health information system

The government of Inner Mongolia has established a Unitized Medicine Information System for the operation of its hospitals. This system is regularly updated for the basic information of hospitals including facilities, health-care professionals, and health facilities.[33],[34] This information is produced, analyzed, disseminated, reported, and utilized by the TMM administration in Inner Mongolia. Inner Mongolia Medical University has a TMM literature information system which is involved in the retrieval, organization, and publication of TMM-related material. A TMM information system with a facility of integrated translation of various languages is currently being constructed by the government.[34]

Pharmaceutical industry of traditional Mongolian medicine

Various pharmaceutical companies are working on new approaches to producing more patent TMM. Up to the end of 2015, there were five TMM pharmaceutical companies in Inner Mongolia Autonomous Region which have passed the Good Manufacturing Practice (GMP) certification.

The number of traditional Mongolian medicaments used in China is more than 2000, out of which 1300 are used on a regular basis.[20],[35] Clinically, the TMM is promisingly effective in different diseases, especially orthopedic issues which are largely prevalent in horse riders.[11],[20],[24],[36] In the process of scientific research and clinical investigations, many patent TMM have earned great repute because of their promising efficiency and safety. These products include Zhenbao pill and Zhachong-13 pill in treating cardio-cerebro-vascular diseases and rheumatism; Baolier Capsule in treating hyperlipidemia; and Guanxinshutong capsule in treating angina pectoris. Zhenbao pill, Zhachong-13 pill, and Baolier capsule were also covered under the National Basic Medical Care Insurance Medicine Catalogue.[37],[38],[39],[40],[41]

The TMM pharmaceutical industry produces limited products, likely due to strict government rules and standardization failure because of limited research.[42] The number of TMM products standardized and allowed for marketing in 1986 was 322, whereas it was only 57 in 1998.[10],[43],[44],[45],[46]

Funding and supporting traditional Mongolian medicine

The government has not only allocated a higher budget for TMM hospital than TCM[20] but also reduce drug expenses by 20% - 50%, and increase reimbursement rate by 15% - 20%.[47] Nonetheless, the refundable products are very smaller (i.e. only 88 products) in number than that of Western and Chinese medicines.

Governance and policymaking regarding traditional Mongolian medicine

TMM administrators make policies and development planning in accordance with the guidelines of national charter and the health status of people in Inner Mongolia.[20] The managers design and amalgamate the system structure, standards, guidelines, drug catalogs, and oversights to expedite an improved management.[20] These accomplishments assist the government in the better promotion of TMM development, protection of the culture of Inner Mongolia, and provision of uniform privileges to all ethnic groups. Nonetheless, the government provides funds for research in basic sciences only and does not support clinical trials and public health studies.[20]

Strategies on developing traditional Mongolian medicine

The Western world considers TMM and Chinese medicines as the complementary and alternative medicines; however, these are the classically used medicines, like Western medicines, in Chinese national health system.[19] During the previous decades, the central and local governments established and implemented policies on the preservation and development of TMM. According to the constitution of the People's Republic of China approved by the Central Government in 1982, the development of both Western and traditional medicines is the liability of the state. Later on, the minority medicines utilized in China were declared as the traditional medicines of China by the State Council and the Central Committee of the Communist Party of China in 1997. The health protection of all ethnic populations requires the development of minority medicines as well. The struggle to accelerate the development of traditional medicines was further enhanced in 2009 by the State Council.[22]

The national medical work was further strengthened in the 12th 5-year national plan. In the 13th 5-year plan, it was declared that supporting the development of national medicine is a mission of promoting the health development of China.[29] In the context of the description of TCM in the 13th 5-year plan, one of the important tasks of the development of TCM s is to promote the development of national medicine.[46]

The Inner Mongolia Autonomous Region has also paid appreciable attention to the development of TMM. In 2010, the region's government formally promulgated and implemented the “Mongolian Medicine and Traditional Chinese Medicine Regulations of Inner Mongolia Autonomous Region,” followed by the enaction of the “Decision of the People's Government of Inner Mongolia Autonomous Region on Supporting and Promoting the Development of Mongolian Medicine and TCM Industry” in 2013 and the “Suggestions on Accelerating the Development of Mongolian Medicine in Health Work” in 2015. In 2016, the State Council promulgated the Law of the People's Republic of China on TCM, aiming at guaranteeing and promoting the development of all traditional medical systems of China, including Mongolian medicine. From a policy perspective, TMM is in a stage of rapid development.[32]

Educational status

TMM education had been incorporated into the national education system in China, covering secondary vocational education and higher education (including the undergraduate, master, and medical doctor's programs). Until 2016, TMM had been majorly set up in two universities, namely, Inner Mongolia University for Nationalities and Inner Mongolia Medical University.[19]

In 1958, the Mongolia Medical College Department of TCM launched a Mongolian medical education at higher education level in China. In 1979, the Inner Mongolia Medical College was established. This was the first national medical institution of higher education in China that became the center of the country for the training of senior personnel in Mongolian medicine.[31] In 2000, Inner Mongolia National Normal University, Inner Mongolia College of Mongolian Medicine, and Jeremy Livestock College merged to form the College of Traditional Mongolian Medicine and Pharmacy. In 1992, the Mongolian medical history literature professional got access to a postgraduate qualification. And, in 2005, Inner Mongolia Medical University launched TMM doctoral training.[12] In recent years, China's Mongolian medicine professional training of >20,000 Mongolian medicine college students, more than 700 graduate students, and more than 50 doctoral students has been accomplished.[28]

The system of the Mongolian college education is an important form of modern Mongolian higher education. TMM majors have been set up in Fuxin Higher Training College and Wulanchabu Medical College. In addition, many other institutions are offering TMM classes and lectures.

Mongolian secondary education has developed rapidly. In Inner Mongolia Autonomous Region, there have been nearly ten secondary professional schools, and a large number of primary medical personnel have been trained in rural and pastoral areas.[17]

In the national and provincial medical and educational sectors to promote and help the national medical master program, the prominent traditional Mongolian doctors set up a special inheritance studio.[27]

Besides, there are several laboratories for TMM research, for example, Inner Mongolian Key Laboratory of Mongolian Medicine Chemistry, Key Laboratory of R and D Engineering of TMM, the State Ethnic Affairs Commission and Ministry of Education, and Institute of Mongolian Medicine Chemistry of Inner Mongolian University. In recent years, these research institutes and laboratories achieved more than 100 TMM achievements in medicine research, of which 20 have been industrialized.[34]

In the past few decades, a number of Mongolian medicine academic associations such as the Inner Mongolia Autonomous Region Mongolian Medicine Association in 1978 and the Chinese Medicine Institute of Mongolian Medicine Branch have been established. Some well-known institutes for TMM research such as the Institute of Inner Mongolia Institute of Mongolian Medicine, Tongliao Mongolian Medical Research Institute, Erdos Mongolian Medical Research Institute, Wulanhaote City Public Development and Application of TCM Research Institute, and Liaoning Fuxin Mongolian Medicine Research Institute have also been launched.[17]

TMM journals were also founded in the 1980s. Traditional Mongolian Medicine of China (ISSN: 1006-3854) was established by the China Medical Association of Minorities and Inner Mongolia Institute of Chinese and Mongolian Medicine in 1987. Over the past two decades, an increasing trend has been noticed in the number of published articles related to TMM of China [Figure 1]. TMM researchers can also publish academic works in other medical journals in China. These publications are mainly focused on literature search, clinical studies, and pharmaceutical investigations. In recent years, more than 260 Mongolian medical literature and monographs have been collated, translated, and published.
Figure 1: A summary of the published articles related to traditional Mongolian medicine of China from 1999 to 2018

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In addition to working on advanced research projects on TMM launched by the Health and Education Authority, TMM professionals are not only focusing on the inheritance and propagation of their clinical experiences, but also evaluating these experiences via clinical studies in the recent years for the promotion of TMM worth in the general public. In addition, Mongolian pharmaceutical companies are vigorously developing the new forms of TMM to make more convenient and effective medical services for patients.

Apprehensions on traditional Mongolian medicine development

In spite of all these developments, attention should also be paid to apprehensions on TMM development.[45] First, the expansion of TMM health service coverage to other regions of inland China is suggested. Second, comprehensive planning should be accomplished to enhance TMM awareness in the whole Chinese public. Third, a low number of TMM patents also hinder the promotion of TMM which should also be considered. Fourth, the number of TMM-based health professionals, and particularly those who are having command in the English language, is very low. Due to this deficiency, the scientific productivity on TMM is also very low, suggesting that TMM research needs more efforts for its promotion. The fifth concern belongs to small-scale production of TMM by pharmaceutical companies. These aspects and their interaction hinder the sustainable growth of TMM.


  Conclusion Top


This article preliminarily describes a review of various aspects of the current scenario of TMM in Inner Mongolia and China. It reveals substantial preservation and development of TMM during the last two decades. Nonetheless, the subsequent part of this article describes the current challenges and limitations which are hindering the widespread use of TMM in Inner Mongolia and China. In spite of the best efforts of the authors to acquire the desired data, the limited data on some aspects could be obtained, which may make the information biased. TMM can be developed further by adopting modern methods of research, promoting the modernization of TMM, implementing government policies for the development and promotion of TMM at all levels, cultivating talented TMM experts, taking administrative actions for the protection of TMM, regulating market trends, and supporting the pharmaceutical industry on TMM.

Acknowledgments

This work was supported financially by the National Key R&D Program of China (No. 2018YFC1708206).

Financial support and sponsorship

This study was supported financially by the National Key R&D Program of China (No. 2018YFC1708200&2018YFC1708206).

Conflicts of interest

There are no conflicts of interest.



 
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