A Review of Traditional Chinese Herbal Medicine in the Management of COVID-19

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 59.65 million people worldwide and caused the deaths of over 1.4 million. The virus, first detected in late December 2019 in Wuhan, China, is the most significant public health problem since the 1918 Spanish flu pandemic. There are no effective and safe drugs that can be used to treat the disease. COVID-19 or vaccines 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.

Now researchers led by David Lee of the Bio-Organic and Natural Research Laboratory, McLean Hospital, Harvard Medical School, Belmont have summarized the experiences with the use of traditional Chinese medicinal herbs for the management of COVID-19. Their study titled “Traditional Chinese Herbal Medicine at the Forefront of the Battle Against COVID-19: Clinical Experience and Scientific Basis,” was published in the January 2021 issue of the journal Phytomedicine.

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China has a rich history of traditional herbal medicines. Traditional Chinese Herbal Medicine (TCM) has been used for over 5,000 in more than 300 outbreaks the nation has faced. When the COVID-19 pandemic emerged earlier this year, TCM treatment was reported to have been used with more than 90 percent effectiveness.

Details of the study

This study was a systematic review of several traditional Chinese herbal medicines used in Wuhan, looking at their effectiveness in managing COVID-19. Currently, patients admitted to hospitals (except TCM hospitals) are mainly treated with Western medicine as a first-line treatment.

Principles of use of TCM

Western drugs used include antibiotics and pain relievers. Currently, over 100 herbal TCM formulas are available for use in outbreak-related infections. The authors write: “TCM is now credited for successful battle against COVID-19 in China.”

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 meridian line of the lung functionally connects with the large intestine and controls the body fluid (water). The researchers write: “The expulsion of phlegm and the relaxation of the intestine with laxatives are common methods for treating lung disease. Therefore, maintaining a smooth and open channel is an important function performed by the meridian line of the lung.” of COVID-19 is basically to “expel toxic moisture from the upper respiratory system and improve intestinal obstruction.” They added that the TCM treatment method seeks to maintain the balance of the lung meridian system and to restore the balance of the lung and large intestine using acupuncture and herbal medicine.

Treatment of COVID-19 using TCM

TCM has been used as a first-line treatment for COVID-19 disease since the SARS-CoV-2 emergence. Qingfei Paidu the decoction, for example, was used over a three-day course which resulted in over 90% efficacy.

The team of researchers wrote: “The Chinese government has announced that TCM is one of the recommended treatment options for treating COVID-19 in the third version of the COVID-19 treatment guidelines, published on January 23, 2020.”

The two TCM formulas used in the initial stage of the infection

• Ma xing shi gan decoction (MXSG) – 4 herbs included Ephedra sinensis, Bitter apricot seeds, Glycyrrhiza, Gypsum fibrosum were used “for the treatment of lung heat, cough and asthma. “
• Gancao ganjiang decoction (GCGJ) – 2 herbs included Radix glycyrrhizae is Rhizoma zingiberis. “Used for epigastric pain, acid vomiting, intestinal pain, abdominal drainage, chest and back pain, dizziness, asthma, menstrual abdominal pain, etc.”

TCM for the treatment phase of COVID-19 infection

• Qingfeipaidu decoction (QFPD) – includes 21 components:
  • M.axingshigan decoction, Wcoal dust, Xiaochaihu decoctions and S.heganmahuang decoction. The authors explain that it is useful in patients with early, mild and heavy infection and also recommended for the treatment of critically ill patients. Overall effectiveness is over 92 percent
• Sheganmahuang decoction (SMD) – “9 herbs included Rhizoma Belamcandae, Ephedra sinensis, Rhizoma Zingiberis The recent; Asarum sieboldii, Radix Asteris, Flos Farfarae, Ziziphus jujube, PINELLIAE Rhizoma Prepare With Zingibere, Schisandra chinensis seeds ”, useful in asthma.
• Maxingshigan decoction (MXSG) – Reduces lung inflammation and improves general condition in influenza and pneumonia. The authors write: “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 therefore help in severe COVID-19.
• Lianhuaqingwen capsule (LH) – Contains “11 herbs including Fructus Forsythiae, Lonicera japonica, Ephedra sinensis, Bitter apricot seeds, Isatis tinctoria, Cortex dryopteridis often rhizome, Herba Houttuyniae, Agastache rugosa, Rheum palmatum, Rhodiola root and crenulatae rhizome, and Glycyrrhiza, along with menthol and a traditional Chinese mineral medicine, Fibrous gypsum“This is good as a flu shot” and has other properties as well, “antibacterial, antipyretic, analgesic, anti-inflammatory, antitussive, phlegm, and immune-regulating effects.” It has been shown to prevent replication of the SARS CoV-2 virus.
• Jinhuaqinggan granules (JHQG) – Contains Honeysuckle and other components. Honeysuckle reduces the “Toll-like receptor 3 and reservoir bound kinase 1” caused by respiratory syncytial virus infections.

Close up of Honeysuckle flowers. Image Credit: lenic / Shutterstock

TCM during the recovery phase

Ginseng is Shengmai San have proved useful among convalescent patients after recovery from COVId-19. Shengmai san improves blood circulation and heart function and helps recover from lung damage.

The TCM used above in COVID-19

• Glycyrrhiza
• Poria cocos
• Tangerine peel
• Ophiopogon japonicas
• Astragalus membranaceus
• Scutellaria baicalensis
• Saposhniovia divaricata root
• Atractylodes macrocephala
• Honeysuckle,
• Atractylodes lancea
• Wrinkled Agastache
• Platycodon grandiflorus
• Forsythiae fruit
• Rhizoma belamcandae
• Fritillary bulb from Sichuan
• Bitter apricot seeds
• sweet potato
• Radix glycyrrhizae,
• Poria cocos
• Menthae Haplocalycis herba

Conclusions and implications

This literature review on the use of TCM among COVID-19 patients showed that these herbal preparations may have direct antiviral activities. These preparations relieve two significant symptoms of COVID-19, pulmonary congestion and diarrhea. The authors write, “There is good reason to learn from ancient wisdom and accumulated clinical experience, combined with cutting-edge science and technology, to fight the devastating COVID-19 pandemic now and the emergence of new coronaviruses in the future “.