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| REVIEW ARTICLE |
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| Year : 2021 | Volume
: 4
| Issue : 1 | Page : 46-49 |
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Application of traditional Chinese medicine in treating COVID-19
Meng- Cheng Liu, Hong- Yun Gao
Department of Foreign Language, School of Foreign Languages, Anhui University of Technology, Maanshan 243002, Anhui, China
| Date of Submission | 22-Aug-2020 |
| Date of Acceptance | 05-Feb-2021 |
| Date of Web Publication | 31-Mar-2021 |
Correspondence Address:
Prof. Hong- Yun Gao
School of Foreign Languages, Anhui University of Technology, Maanshan 243002, Anhui
China
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/CMAC.CMAC_5_21
Traditional Chinese medicine (TCM) has been applied to the treatment of the novel coronavirus (COVID-19). In the epidemic, COVID-19 patients were treated through integrated TCM and Western medicine. The effect was remarkable, especially in the treatment of mild COVID-19 cases. This paper introduces several TCM treatments to COVID-19, put forward by both domestic and foreign scholars.
Keywords: COVID-19, effect, principle, traditional Chinese medicine, treatment
How to cite this article:
Liu MC, Gao HY. Application of traditional Chinese medicine in treating COVID-19. Chin Med Cult 2021;4:46-9 |
| Introduction | |  |
A novel coronavirus (COVID-19) pandemic outbroke in Wuhan in December 2019 and earlier there had already been such cases in the other parts of the world. After several months of home quarantining, temperature monitoring, and other precautionary measures [Figure 1], the epidemic situation soon became effectively controlled. Meanwhile, COVID-19 cases were on the rise in the rest of the world. COVID-19 belongs to the beta genus of coronavirus, with a capsule and round or oval in shape, often polymorphic. The genetic characteristics are significantly similar to SARS coronavirus and MERS coronavirus. At present, the homology of SARS coronavirus found in human beings and that found in bats is more than 85%.[1] Novel coronavirus pneumonia is the main source of infection. However, asymptomatic infection may also become a source of infection. The pathological changes of patients with new-type coronavirus pneumonia are mainly in the lung, presenting consolidation in varying degrees, involving the spleen, lung, joint, bone marrow, cardiovascular system, liver and gallbladder, kidney, brain tissue, and the other body organs. According to the Centre for Disease Control and Prevention guidelines and public perception, the incubation period is thought to be 14 days with a median time of 4–5 days from exposure to symptoms onset.[1] There are also many asymptomatic patients. Fever, fatigue, and dry cough are the main manifestations. A large number of patients exhibited nasal obstruction, running nose, diarrhea, and other symptoms such as chest distress, conjunctivitis, and muscular soreness. Many patients have lost their sense of smell and appetite. Severe cases are often accompanied by dyspnea after 1 week. Severe cases developed rapidly into acute respiratory distress syndrome, septic shock, metabolic acidosis, and coagulation dysfunction. Nonsevere patients do not need to be hospitalized. Most patients can improve or even heal by themselves within 1–2 weeks through a combination treatment of traditional Chinese medicine (TCM) and Western medicine. Severe patients need to be hospitalized for further treatment. The following sections will analyze the principle of TCM in the treatment of COVID-19 and preventive prescriptions [Figure 1].
| Traditional Chinese Medicine Treatment Principle for COVID-19 | | |
TCM can effectively alleviate or prevent epidemic and reduce the relevant death rate. The reason of such effect is that TCM treats diseases and epidemics from the perspective of life. TCM is people-oriented and emphasizes the relationship between nature and humans, and from this perspective, human diseases are dealt with.[2] COVID-19, in particular, is not only explored and treated in this way, but also thought about from the perspective of life as a whole. TCM pays great attention to the harmony between Yin and Yang, qi and blood, as well as the improvement and enhancement of the body's own immunity and disease resistance (during disease or epidemic outbreak). The primary principle of prevention and treatment of COVID-19 is the “holistic view,” which holds that the pestilence from nature will infect the human body through corresponding channels, and the human body will resist the pathogen through corresponding abilities. TCM prevention is the main way to prevent change of the contracted disease by altering the environment, regulating the body, and resisting severe pressure. This idea of overall prevention and control guides the application of various measures of TCM in preventing diseases. Wang Qi, an academician of the Chinese Academy of Engineering and President of the Institute of TCM Body Constitution and Disease Prevention under the National Institute of TCM Constitution and Preventive Treatment of Beijing University of Chinese Medicine, said on April 17 that TCM has shown unique advantages in reducing mortality and improving the cure rate during the COVID-19 epidemic.
Specifically speaking, there are two steps in TCM for treating diseases. The first is to “prevent the transmission of change （遏阻传变）” to make patients stay for treatment. More than 2000 years ago, the Huang Di Nei Jing (《黄帝内经》 Huangdi's Internal Classic) proposed that “preventing disease from occurring, preventing change of the contracted disease (未病先防, 既病防变).” The novel coronavirus pneumonia is a major infectious disease, especially in the modern era. It has a rapid transmission property, which requires the application of “perspiration, vomiting, diarrhea, warming, clearing, eliminating, and supplementing” from the perspective of TCM to effectively block the rapid deterioration of the disease and avoid sudden organ failure, so as to save the life of the patient. Prevention and treatment of the pandemic are of priority.
Second, “strengthening the healthy and eliminating pathogenic factors (扶正祛邪)” is to achieve a healthy state of balance between Yin and Yang. The Huangdi's Internal Classic stated that “no matter what your disease is, as long as the Yin and Yang are in harmony, no symptoms are considered bad.”[2] TCM attaches great importance to the harm of “Evil Qi (邪气)” to the human body, but more emphasis is placed on the ability of “Healthy Qi (正气)” to resist evil, poison, and disease. In the case of novel coronavirus pneumonia, during the early prevention, treatment or recovery, TCM helps the body to maintain the “Healthy Qi” throughout the disease, so as to remove the “Evil Qi”. TCM provides patients with vital energy throughout the course to dispels Evil Qi. To a large extent, TCM is preferred to people who get sick rather than patients who suffer from diseases. TCM pays more attention to the physiological state of the human body and adopts the treatment methods by adjusting to the circumstances, restoring physiology, and improving resistance against diseases, rather than simply eliminating the symptoms and toxicity of disease. This means that when TCM does not know what the virus is, it can still carry out syndrome differentiation under the guidance of the holistic concept, choose the appropriate treatment, and achieve the purpose of “healthy qi expelling pathogen (正胜邪退)” and recovery.
Zhang Boli, in his article TCM Can Completely Cure General Patients with Mild COVID-19, said that a total of 564 patients have been admitted to Dahuashan Field Hospital, Jiangxia District, Wuhan, and none of them have become seriously ill or returned to the hospital second time during the operation of the hospital. This has demonstrated that TCM can completely cure patients with mild COVID-19. In the absence of specific drugs or vaccines, the unique advantages of TCM in the diagnosis and treatment of the disease is capable of bringing itself into full play to explore and form a systematic multi-target intervention scheme featuring combination of TCM and Western medicine in the treatment of COVID-19 patients.[3] This has become a convincing demonstration of the inheritance and innovation of TCM. Severe epidemic outbreaks in the past have produced new medicinal prescriptions and in-depth explorations of ancient classical prescriptions for use in clinical practice. A selected number of effective prescriptions represented by “three herbs and three prescriptions (三药三方)” has also become an important feature and advantage of Chinese COVID-19 treatment program.[3]
| TCM Preventive Plan for COVID-19 | | |
The prescription is suggested which uses Huang Qi (黄芪 Radix Astragali seu Hedysari) 30 g, Jin Yin Hua (金银花 Flos Lonicerae) 15 g, Chen Pi (陈皮 Pericarpium Citri Reticulatae) 9 g, Da Zao (大枣 Fructus Jujubae) 5 g, Gan Cao (甘草 Radix Glycyrrhizae) 7 g.[4]
| Recommended Traditional Chinese Medicine Treatment for COVID-19 | | |
The followings are several novel coronavirus therapeutic prescriptions which can be applied to the treatment of patients depending upon the different stages of infection [Figure 2].
| Initial Stage | | |
If novel coronavirus pneumonia is confirmed, the initial clinical manifestations are observed in the form of fever or lack of fever, dry cough, chills, fatigue, or pale tongue with a white coating. These clinical manifestations belong to the lung syndrome caused by cold damp. The recommended prescriptions use the following herbal plants: Cang Zhu (苍术 Rhizoma Atractylodis) 15 g, Chen Pi (陈皮 Pericarpium Citri Reticulatae) 10 g, Hou Po (厚朴 Cortex Magnoliae Officinalis) 10 g, Huo Xiang (藿香 Herba PogoStemonis) 10 g, Sheng Jiang (生姜 Rhizoma Zingiberis Recens) 10 g, Bing Lang (槟榔 Semen Arecae) 10 g, Qiang Huo (羌活 Rhizoma et Radix Notopterygii) 10 g, Cao Guo (草果 Fructus Tsaoko) 6 g, raw Ma Huang (麻黄 Herba Ephedrae) 6 g.[4]
| Intermediate Stage | | |
If the patient's condition progresses to the intermediate stage, it may manifest with the following symptoms: continued fever, chills, sweats, cough and panting, scanty yellow phlegm, panting abdominal distention, constipation, red tongue, yellow greasy coating, or dry yellow coating. This is caised nu epidemic toxicity leading to lung closure. The recommended prescription is to use such herbal things as: Ku Xing Ren (苦杏仁 Semen Armeniacae Amarum) 10 g, Shi Gao (石膏 Gypsum Fibrosum) 30 g, Gua Lou (瓜蒌 Fructus Trichosanthis) 30 g, Da Huang (大黄 Radix et Rhizoma Rhei) 6 g (decoct later), stir-fried Ma Huang (麻黄 Herba Ephedrae) 6 g, Ting Li Zi (葶苈子 Semen Descurainiae) 10 g, Tao Ren (桃仁 Semen Persicae 10 g, Cao Guo (草果 Fructus Tsaoko) 6 g, Bing Lang (槟榔 Semen Arecae) 10 g, Bai Zhu (白术 Rhizoma Atractylodis Macrocephalae) 10 g.[4]
| Severe Stage | | |
The clinical manifestations of the severe stage are dyspnea and the patient may require auxiliary ventilation, accompanied by restlessness, dizziness, and other symptoms. The patient's tongue is dark purple in color, with thick and greasy coating, or dry coating. The patient is likely to have the syndrome of internal closure and external detachment (内闭外脱证). The main symptoms include difficulty in breathing, frequent panting or need mechanical ventilation, accompanied by dizziness, irritability, sweating, cold limbs, dark purple tongue, and thick greasy tongue coating. The recommended prescription is to use the following herbal things: Ren Shen (人参 Radix Ginseng) 15 g, Fu Zi (附子 Radix Aconiti Lateralis Preparata) 10 g (decoct first), Shan Zhu Yu (山茱萸 Fructus Corni) 15 g, Su He Xiang Pill (苏合香丸) or An Gong Niu Huang Pill (安宫牛黄丸).[4]
| Recovery Stage | | |
The main clinical symptoms for patients in the recovery period are found in shortness of breath, poor appetite, fatigue, enlarged tongue with white and greasy coating. This is the syndrome of deficiency of lung and spleen qi. The recommended prescription is: Ban Xia (半夏 Rhizoma Pinelliae) 9 g, Chen Pi (陈皮 Pericarpium Citri Reticulatae) 10 g, Dang Shen (党参 Radix Codonopsis) 15 g, stir-fried Huang Qi (黄芪 Radix Astragali seu Hedysari) 30 g, Fu Ling (茯苓 Poria) 15 g, Huo Xiang (藿香 Herba PogoStemonis) 10 g, Sha Ren (砂仁 Fructus Amomi Villosi) 6 g (decoct later)[4] [Figure 2].
| Treatment Effect | | |
TCM plays an important role in the treatment of COVID-19, which belongs to the category of “pestilence” disease in TCM. Pestilence disease is a fierce and infective disease which is caused by the pestilential pathogen. However, aside from the disease condition, local climate characteristics and physical condition of the patients could also affect the progression of the disease. The novel coronavirus pneumonia is treated by different treatment methods in different stages. It has been shown that the treatment of the novel coronavirus pneumonia by TCM resulted in fewer side effects, which can relieve symptoms and accelerate patients' recovery.
Taking TCM internally improves pulmonary function and pulmonary fibrosis in COVID-19 patients. Deficiency of qi, yin, yang, blood stasis, and phlegm are the main pathogenesis of COVID-19. Treatment regimens focus on promoting qi, nourishing yin, invigorating yang, reducing phlegm, and activating blood circulation which are of great clinical significance for improving the pulmonary function and pulmonary fibrosis condition of COVID-19 patients during rehabilitation.[5]
In response to the new pandemic, TCM has shown its ability in treating acute and severe COVID-19 disease, and its treatment is not inferior to Western medicine. However, TCM still faces many challenges in the treatment of COVID-19. Due to the implementation of different TCM diagnosis and treatment programs in various regions, standardization of clinical prescription is difficult to achieve, which is not conducive to large statistical data analysis of TCM efficacy. As the pandemic changes from time to time, TCM prescription needs to be changed according to the diagnosed syndromes, making it difficult to develop a fixed strategy. This makes the evaluation of long-term clinical efficacy and safety of TCM problematic.
| Conclusion | | |
TCM has played an important role in the fight against the COVID-19 pandemic. The treatment of TCM is not the so-called “specific medicine” for killing the virus, but it is a “recipe” designed after syndrome differentiation. What these TCM prescriptions do is to help the “Healthy Qi” eliminate the cause of the symptoms, and eventually cure the disease. In fact, both TCM and Western medicine are similar in this way.[6] A TCM practitioner once said, “I add another layer of definition to the “Zhong” of Chinese medicine - TCM itself cannot cure any disease. Its mind, language, manipulation, acupuncture and stone needling are nothing more than establishing a “Zhong” channel between the patient and his inherent “Tao” and physical capacity.” To put it simply, TCM is a matchmaker, or an intermediary. The TCM gives consideration to both physical form and spirit, which is the bridge between nature and human, and the boundary between spirit and material substance. It is so that the integrated Chinese medicine and Western medicine treatment will fight shoulder to shoulder and give full advantages to win the battle against COVID-19. Nowadays, there are many published studies showing the effectiveness of TCM. This article is an additional summary of the treatment of COVID-19 with TCM.
Funding
The study was financed by a grant from the Humanities and Social Sciences Research Project of Anhui Province (SK2018ZD004).
Conflicts of interest
None.
| References | | |
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| 2. | She ZQ, Lu J, Xu YQ. Discussion on TCM syndrome management of common COVID-19. Hubei J Tradit Chin Med 2020; 1:47-8.  |
| 3. | Zhang BL. Traditional Chinese medicine can completely cure common patients with mild COVID-19. Health World 2020; 6:15. |
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| 5. | Chen Y, Chen ZL, Xie XM, Wang J, Luo L, Ren Y. Thinking and exploration of the application of traditional Chinese medicine in the rehabilitation treatment of COVID-19. Chin Tradit Chin Med Emerg 2020;29:1693-5, 1701. |
| 6. | Feng XG. Cooperative anti-epidemic, how does TCM work. Health News 2020; 5:1-2. |
[Figure 1], [Figure 2]
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