Scientist from the Organic and Natural Products Research Laboratory, McLean Hospital/Harvard Medical School-U.S, Institute of Pharmaceutical and Biomedical Sciences at the Johannes Gutenberg University-Germany along with Traditional Chinese medicine experts from Henan University of Chinese Medicine at Zhengzhou-China have in a new study showed the effectiveness of certain herbs used in various Traditional Chinese Medicine (TCM) herbal formulations or preparations to treat COVID-19.
When COVID-19 ravaged the Wuhan district in China in early January 2020, without a deep understanding about the nature of COVID-19, patients admitted to the TCM Hospital in Wuhan were immediately treated with TCM and reported later with >90% efficacy.
The study team conducted conduct a systematic survey of various TCM herbal preparations used in Wuhan and to review their efficacy, according to the published clinical data; and, secondly, to find the most popular herbs used in these preparations and look into the opportunity of future research in the isolation and identification of bioactive natural products for fighting COVID-19.
Despite the fact that cretain bioactive natural products in these herbal preparations may have direct antiviral activities, TCM employed for fighting epidemic infections was primarily based on the TCM theory of restoring the balance of the human immune system, (immunomodulatory) thereby defeating the viral infection indirectly.
Interestingly, certain TCM teachings relevant to the meridian system deserve better attention. For instance, many TCM herbal preparations target the lung meridian, which connects the lung and large intestine. This interconnection between the lung, including the upper respiratory system, and the intestine, may explain why certain TCM formulae showed excellent relief of lung congestion and diarrhea, two characteristics of COVID-19 infection.
The study team comments that there is good reason for us to learn from ancient wisdom and accumulated clinical experience, in combination with cutting edge science and technologies, to fight with the devastating COVID-19 pandemic now and emerging new coronaviruses in the future.
The study findings were published in the peer reviewed journal: Phytomedicine.https://www.sciencedirect.com/science/article/pii/S0944711320301690
The current COVID-19 pandemic caused by the SARS-CoV-2 coronavirus has infected over 60.5 million people worldwide and claimed the lives of over 1.43 million individuals. The coronavirus, first detected in late December 2019 in Wuhan, China, is the most significant public health disaster since the 1918 Spanish flu pandemic. There are no effective and safe drugs that can be used to treat COVID-19 disease nor vaccine to prevent SARS-CoV-2 infection. Since the first cases were detected in Wuhan, several traditional Chinese herbal medicines have been used to treat this infection, something that inspired even Thailand Medical News to go deeply into Herb and phytochemical research and develop our own range of therapeutic teas for COVID-19. https://www.thailandmedical.news/news/new-therapeutic-teas-
Meanwhile also, researchers led by Dr David Lee from Bio-Organic and Natural Research Laboratory, McLean Hospital, Harvard Medical School, Belmont have summarized the experiences with the use of traditional Chinese herbal medicines for the manageme nt of COVID-19.
The Chinese have a rich history of traditional herbal medicines. Traditional Chinese herbal medicine (TCM) has been used for over 5,000 in over 300 epidemics that the nation has faced. When the COVID-19 pandemic emerged early this year, treatment with TCM was reported to have been used with over 90 percent efficacy. https://www.gov.cn/xinwen/2020-03/23/content_5494694.htm
The current study is a systematic review of several traditional Chinese herbal medicines that were used in Wuhan, looking at their efficacy in the management of COVID-19. At present, patients admitted to hospitals (except TCM hospitals) are primarily treated with western medicine as frontline treatment. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004882.pub3/abstract
In China at present, over 100 herbal TCM formulae are available for use in epidemic related infections. The study team states, “TCM is now credited for the successful battle against COVID-19 in China”. https://www.sciencedirect.com/science/article/pii/S075333222030473X
IN TCM, the ancient Chinese medical text Huangdi Neijing explains that 12 meridian lines run through the human body and help balance the immune system and provide good health. The lung meridian line interconnects with the large intestine functionally and controls the body fluid (water).
The study team writes, “Expelling phlegm and relaxing the bowels with laxatives are common methods for treating lung diseases. Therefore, maintaining a smooth and open channel is an important function served by the lung meridian line.” https://en.cnki.com.cn/Article_en/CJFDTotal-SJZA201404004.htm
According to TCM concepts, treatment of COVID-19 is basically to “expel the toxic moisture from the upper respiratory system and to improve intestinal obstruction.”
The team adds that the TCM method of treatment tries to maintain the balance of the lung meridian system and to restore the lung and large intestine balance using acupuncture and herbal medicine.
Importantly TCM has been used as a first-line treatment for COVID-19 disease since the emergence of SARS-CoV-2.
The Qingfei Paidu decoction for example, has been used in a three-day course leading to an over 90 percent efficacy. https://www.sciencedirect.com/science/article/pii/S075333222030473X
The study team said, “The Chinese government announced that TCM is one of the recommended therapeutic options for the treatment of COVID-19 in the third version COVID-19 treatment guidelines, published on January 23, 2020.” https://www.chictr.org.cn/index.aspx
Basically the two TCM formulae used in the early phase of the infection
Ma xing shi gan decoction (MXSG) - 4 herbs including Ephedra sinensis, Semen armeniacae amarum, Glycyrrhiza, Gypsum fibrosum had been used “for the treatment of lung heat, cough and asthma.”
Meanwhile the Gancao ganjiang decoction (GCGJ) contains 2 herbs including Radix glycyrrhizae and Rhizoma zingiberis and was used for “epigastric pain, acid vomiting, intestinal pain, abdominal drainage, chest and back pain, dizziness, asthma, menstrual abdominal pain, etc.”
Significantly, TCM for the treatment phase of COVID-19 infection
Qingfeipaidu decoction (QFPD) includes 21 herbs including Ephedra sinensis, Radix Glycyrrhizae, Semen Armeniacae Amarum, Gypsum fibrosum, Ramulus Cinnamomi, Rhizoma Alismatis, Polyporus umbellatus, Atractylodes macrocephala, Poria cocos, Bupleurum chinense, Scutellaria baicalensis, Pinelliae Rhizoma Praeparatum Cum Zingibere, Rhizoma Zingiberis Recens, Radix Asteris, Flos Farfarae, Rhizoma Belamcandae, Herba Asari, Yam, Immature bitter orange, Tangerine peel, and Agastache rugosa. It is suitable for early, lightly, and heavily infected patients. It was also recommended for the treatment of critical patients. Although the pathogenesis of COVID-19 is still not clear, the lung infection and the inflammatory process were cleared. It is conceivable that TCM has anti-influenza viral, anti-inflammation, cough-relieving and immune regulation activities.
Maxingshigan decoction, Wuling powder, Xiaochaihu decoctions, and Sheganmahuang decoction. The authors explain that it is useful in early, lightly, and heavily infected patients and also recommended for the treatment of critical patients. Overall efficacy is over 92 percent
Sheganmahuang decoction (SMD) which contains “9 herbs including Rhizoma Belamcandae, Ephedra sinensis, Rhizoma Zingiberis Recens, Asarum sieboldii, Radix Asteris, Flos Farfarae, Ziziphus jujube, Pinelliae Rhizoma Praeparatum Cum Zingibere, Schisandra chinensis seeds”, useful in asthma. https://www.sciencedirect.com/science/article/abs/pii/S1043661820311282
The Maxingshigan decoction (MXSG) reduces lung inflammation and improves the general condition in influenza and pneumonia.
Importantly the study team writes, “MXSG decoction acts on COVID-19 by targeting IL-6, TNF-α, MAPK-8, MAPK-3, CASP-3, TP53, IL-10, CXCL-8, MAPK-1, CCL-2, IL-1β, IL-4, PTGS-2, etc.” It can thus help in severe COVID-19.
Lianhuaqingwen capsule (LH).
The Lianhuaqingwen capsule (LH) contains “11 herbs including Fructus Forsythiae, Lonicera japonica, Ephedra sinensis, Semen armeniacae amarum, Isatis tinctoria, Rhizoma dryopteridis crassi rhizomatis, Herba Houttuyniae, Agastache rugosa, Rheum palmatum, Radix et Rhizoma Rhodiolae Crenulatae, and Glycyrrhiza, along with menthol and a traditional Chinese mineral medicine, Gypsum fibrosum”.
The team said that this is good as anti-influenza” and also has other properties, “antibacterial, antipyretic, analgesic, anti-inflammatory, cough relieving, phlegm and immune function regulating effects”. It has been shown to prevent the replication of the SARS CoV-2 virus.
The Jinhuaqinggan granules (JHQG) contains Honeysuckle and other components. Honeysuckle reduces “Toll-like receptor 3 and tank-bound kinase 1” caused by the respiratory syncytial virus infections.
Also Ginseng and Shengmai San were found to be useful among convalescent patients after COVId-19 recovery. Shengmai san improves blood circulation and heart function and helps recover from lung damage. These herbs also were found to reduce fatigue.
(Thailand Medical News have already covered studies on some of these and will also be publishing more on each specific herb studies against the SARS-CoV-2 coronavirus) https://www.thailandmedical.news/articles/covid-19-herbs
The clinical outcomes of the 102 confirmed cases, treated integrative medicine on the basis of qingfeipaidu decoction, were assessed by two chief physicians, majored in TCM and western medicine, respectively. The symptoms were stable in 5 cases, partially relieved in 31 cases, completely relieved in 64 cases, aggravated in 2 cases, and the total symptom relief rate accounted for 93%.
The results of network pharmacology showed that qingfeipaidu decoction includes 948 different kinds of chemical composition, which has effects on 790 potential target proteins. Interactions between these targets can form a molecular network, which may affect virus invasion, viral replication and secondary inflammation factors that cause multiple organ damage. The qingfeipaidu decoction is likely to target immune related pathways and suppress the activation of cytokines, and eliminate inflammation. These reports support the effects of TCM on lung-clearing and detoxification decoction. https://covid19.elsevierpure.com/en/publications/investigating-mechanism-of-qing-fei-pai-du-tang-for-treatment-of-
This detailed literature review from the use of TCM among COVID-19 patients has shown that these herbal preparations may have direct antiviral activities. These preparations relieve two significant COVID-19 symptoms, lung congestion and diarrhea.
The study team said, “This review article attempts to provide information for western health practitioner for a better understanding of TCM in treating epidemic infections including COVID-19, and the pharmacological effects of bioactive compounds used frequently in TCM formulae.”