|NEWS & VIEWS
|Year : 2021 | Volume
| Issue : 2 | Page : 124-126
Interview with Dr. Liu Qingquan: Traditional Chinese Medicine for COVID-19 Diagnosis and Treatment
Xin- Yue Chang1, Hai- Ying Li1, Er- Liang Wang1, Yu- Chao Liu2
1 Editorial Office of Chinese Medicine and Culture, Institute of Science, Technology and Humanities, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
2 Geriatric Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, China
|Date of Submission||26-Apr-2021|
|Date of Acceptance||18-May-2021|
|Date of Web Publication||30-Jun-2021|
Dr. Yu- Chao Liu
Geriatric Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chang XY, Li HY, Wang EL, Liu YC. Interview with Dr. Liu Qingquan: Traditional Chinese Medicine for COVID-19 Diagnosis and Treatment. Chin Med Cult 2021;4:124-6
|How to cite this URL:|
Chang XY, Li HY, Wang EL, Liu YC. Interview with Dr. Liu Qingquan: Traditional Chinese Medicine for COVID-19 Diagnosis and Treatment. Chin Med Cult [serial online] 2021 [cited 2021 Jul 27];4:124-6. Available from: https://www.cmaconweb.org/text.asp?2021/4/2/124/320171
To many of us, 2020 was a remarkably difficult and challenging year. The whole world experienced a sudden, unexpected outbreak of COVID-19. According to the Zhong Guo Yi Bing Shi Jian (《中国疫病史鉴》 History of Epidemics in China), there have been a total of 321 pandemics throughout the history of China ever since the Western Han dynasty (202 BCE–8 CE). Unlike the Spanish Flu, European Black Death, and global plague that killed millions of lives, epidemic disease in China had been contained soon after the outbreaks, thanks to the effective prevention and treatment in traditional Chinese medicine (TCM). These successful experiences contributed to an established system to infectious diseases intervention using herbal medicine, nondrug therapies, and numerous single or compound formulas or techniques, which played a significant role in combating COVID-19.
The COVID-19 pandemic is not over and will have a long-lasting impact on all aspects of our life. How to prepare for potential small-scale outbreaks of COVID-19 variants? How to build a more complete and diverse medical model? What can TCM physicians do in such a context? To find answers to these questions, we interviewed Dr. Liu Qingquan (刘清泉) on March 19, 2021 [Figure 1].
Dr. Liu Qingquan is a hero in combating COVID-19. He is the president of Beijing TCM Hospital affiliated with Capital Medical University. In this interview, he shared his experience and reflections on the role of TCM in combating COVID-19, his understanding of distinctive features of TCM diagnosis and treatment, integration of TCM and Western medicine, as well as future challenges and opportunities for TCM [Figure 2].
This interview has been edited for length and clarity.
Q1: Dr. Liu, as a TCM expert in emergency and critical conditions as well as respiratory diseases, what was your diagnosis and treatment principle in the front-line battle against COVID-19? What are the modifications of diagnosis and treatment protocol in different geographic regions? Were there any modifications in different seasons?
Dr. Liu Qingquan: I was mentally prepared for this pandemic because I am a TCM emergency physician and I have done a lot of researches on contagious diseases. Since the 1918 flu pandemic, the world has seen numerous outbreaks of contagious diseases. It might be inevitable that the world will continue to see new, unknown pandemics in the future. The battle against COVID-19 once again confirmed the accuracy of classical TCM theories.
To deal with the pandemic, we first need to identify the etiological factors and clinical features. I arrived in the city of Wuhan on January 21, 2020. According to the climatic features of Wuhan, coronavirus pneumonia was first classified as an epidemic disease, which is contagious and caused by epidemic qi. Historically, epidemic qi can be classified into cold or heat. “Epidemic cold” was mentioned by Zhang Zhongjing (张仲景) in his Shang Han Lun (《伤寒论》 Treatise on Cold Damage), while “epidemic heat” was recorded in Qian Jin Fang (《千金方》 Prescriptions Worth a Thousand Gold Pieces) by Sun Simiao (孙思邈) and books by Li Dongyuan (李东垣) or Liu Wansu (刘完素). Wu Youke (吴又可), a well-known expert on epidemic diseases, mentioned in his Wen Yi Lun (《瘟疫论》 Treatise on Pestilence), says “epidemic qi is one of the pathogenic factors; however, it causes more severe problems and this pathogenic qi is therefore known as pestilence qi.” He believed that pestilence often results from the retention of turbid epidemic qi in between the exterior and interior. As a result, he treated pestilence with Da Yuan Decoction (达原饮) to remove pathogenic factors out of the interior. The COVID-19 needs to be differentiated into the epidemic cold, heat, or in combination with turbid qi.
Second, we need to pay close attention to the patients' fever. Observation over 100 days showed that patients often have a low-grade fever at first and then get worse over 7–10 days. In addition, the fever may come and go, and clinical symptoms linger for a long period of time. At the same time, we also found that fever in mild or ordinary cases is very similar to “a sensation of fever (without temperature) that aggravates in the afternoon” in TCM.
Third, after contracting the COVID-19, most patients present with fatigue, some may experience a poor appetite and chest fullness or stuffiness, and some may experience loose stools. In terms of the tongue manifestations, most patients present with an enlarged, tender tongue with a greasy coating. Based on the signs and symptoms, the pathogenic factor of COVID-19 is epidemic dampness. The weather at Wuhan in January is cold and humid. Consequently, we can say that external cold and humid as well as epidemic dampness contributed to the COVID-19 outbreak.
Patients in different geographic regions did show different symptoms. For example, patients in Guangzhou presented with damp-heat symptoms, while patients in Northwestern China presented with dry symptoms. At the end of last year, I was at Northeastern China to help with the anti-COVID-19 battle. Since the weather was extremely cold in Northeastern China (−30°), we may assume that patients may present with cold-related symptoms; however, this was not the case. Actually, patients there mainly presented with dry heat symptoms, because cold generates dryness, and dryness may, in turn, damage yin fluids. What's more, it is worth noting that epidemic dampness remains a major pathogenic factor, thus causing more complicated conditions. In TCM, we diagnose and treat patients according to geographic regions, individualized constitution, and seasonal changes. This also verified the TCM classical theories - epidemic qi (dampness) is the etiological factor and seasonal change is the inducing factor. Specifically, at an early stage, epidemic dampness affects the lung and spleen. Dampness affecting the lung and spleen may disturb the ascending of spleen qi and descending of stomach qi and result in internal heat, which in turn goes up and affects the dispersing of lung qi, resulting in chest tightness and difficulty breathing. Immediate and appropriate treatment can present disease progression. In other words, active treatment of dampness affecting the lung and spleen at an early stage can prevent mild conditions from developing into severe or critical conditions.
Q2: How do we achieve the goal of integrated TCM and Western medicine in COVID-19 treatment?
Dr. Liu Qingquan: As a matter of fact, TCM and Western medicine were integrated for combating COVID-19. It is also essential for Western medicine to identify the pathogens of the coronavirus. The core issue for both TCM and Western medicine is to block the disease progression, prevent it from developing into severe or critical conditions, and reduce mortality. For Western medicine, there are no specific treatments for COVID-19. Despite a complete theoretical system, TCM lacks effective first-aid techniques. Through its development process, the failure of TCM to connect with modern science and technology resulted in disconnection between its fine theories and scientific evidence. To me, now is a good time to integrate TCM and Western medicine with modern science, and this is the right track to future TCM development. It is like studying TCM in a high-speed train and reflecting on TCM in a rocket. To modern science and technology, there is neither TCM nor Western medicine, there is only medicine. For example, the ventilator in modern medicine can supplement qi, prevent collapse, and warm yang from a TCM perspective; and extracorporeal membrane oxygenation (ECMO) in modern medicine can tonify qi and reduce heat from a TCM perspective. To sum up, a better integration of TCM and Western medicine needs better knowledge in modern technologies and an inclusive mindset.
Specifically, the underlying theory behind TCM treatment for COVID-19 is to treat both the lung and large intestine, supplement qi to prevent collapse, and get patients off the ventilator and ECMO faster. There have been numerous examples of treating both the lung and large intestine in the history of Chinese medicine: Cheng Qi Decoction (承气汤) recorded in Shang Han Lun (《伤寒论》 Treatise on Cold Damage) by Zhang Zhongjing (张仲景), Da Yuan Decoction (达原饮) and Bai Hu Decoction (白虎汤) by Wu Youke (吴又可), and Xuan Bai Cheng Qi Decoction (宣白承气汤), Zeng Ye Cheng Qi Decoction (增液承气汤), Niu Huang Cheng Qi Decoction (牛黄承气汤), and Xin Jia Huang Long Decoction (新加黄龙汤) by Wu Jutong (吴鞠通).
TCM and Western medicine are like two sides of a mountain - one on the shady side and the other on the sunny side. They both aim for the top of the same mountain. The two can blend in beneficial harmony and take advantage of the best features of each system and compensate for certain weakness in each as well.
Q3: What do you think about the role of TCM in coping with major health emergencies in the future? How can we build a long-term mechanism for control and prevention?
Dr. Liu Qingquan: Actually, I have been thinking about these questions ever since I started studying medicine. First, TCM physicians should be confident enough to explain or demonstrate the TCM efficacies. If we, as TCM practitioners, do not adequately understand its classical theories, we will be at a loss as to dealing with unexpected pandemic or other intractable diseases – this is horrible. Therefore, we really need TCM experts to carry on the legacy and connotation in traditional or classical TCM theories. The poor problem-solving ability using TCM theories is caused by two reasons - one is the impact of modern Western medicine and the other is lack of confidence in TCM theories. Let me put it this way, be confident, but do not be cocky and demonize TCM. It is important to have a solid theoretical foundation and effective treatment methods. As far as this pandemic is concerned, I believe that TCM works well in both theory and practice, and it did play an active role in the diagnosis and treatment of COVID-19.
Q4: In your opinion, will TCM be more influential and recognized nationally and internationally in a postpandemic world? Do you think the pandemic will shed new light on TCM inheritance and innovation?
Dr. Liu Qingquan: We are not saying that what is traditional is the best; as a matter of fact, tradition also needs renewal and progress. It is true that the COVID-19 incidence has been dropping and people tend to recognize the efficacy and value of TCM. However, it is still a long way to go in terms of cultural acceptance and clinical use. In the spirit of optimism, this pandemic can turn a big challenge into a good opportunity for TCM to go global. But, first, it needs to be fully recognized in China. How can it go global if medical doctors in China do not truly approve TCM? Second, we cannot force others to use TCM therapies. Take Chinese food, for example, not everyone loves it – it is plain and simple. We just cannot impose our cultural beliefs on others. Cultural diversity is all about merging different cultures, and it takes time to understand a different culture.
The interview with Dr. Liu made us think more about the challenges and uncertainties of tomorrow. Today, our fight against the pandemic is far from over. The new COVID-19 variants are still running rampant. We must remain vigilant against the virus and be well prepared for unexpected changes and major health emergencies. This is a historical stress test for TCM as well as for the global medical community. This global pandemic needs a world effort to end it because none of us will be safe until we all are safe.
Translator: Chou-Ping Han (韩丑萍)
Xin-Yue Chang drafted manuscript preparation. Hai-Ying Li and Er-Liang Wang reviewed and edited the writing. Yu-Chao Liu was in charge of overall direction and planning. All authors discussed the results and contributed to the final manuscript.
The authors have no ethical conflicts to disclose.
Conflicts of interest
Hai-Ying Li is the executive editor-in-chief of Chinese Medicine and Culture. Er-Liang Wang is an editor of Chinese Medicine and Culture. The article was subject to the journal's standard procedures, with peer review handled independently of the editor-in-chief, this editor, and their research groups.
[Figure 1], [Figure 2]