Author: Dr Zijing Hu | University of Johannesburg
Introduction: Traditional Chinese Medicine (TCM) is believed to be not as good as western medicine in general, regardless of common diseases, emergency or epidemic diseases (ED). In this article, we are going to discuss some facts that have come to light in recent years on the contributions of TCM. This shall provide us a deeper understanding of TCM.
February 3, 2020, eight patients were discharged from Wuhan Jinyintan Hospital, the designated isolation hospital for the treatment of 2019 n-coronavirus pneumonia. These eight patients were all confirmed to be affected by the 2019 n-coronavirus and they were treated with TCM only, or a combination therapy of TCM and Western Medicine. Among them, 6 were female, 2 were male, 6 of them were in severe condition and 2 of them were mild.
On February 2, 2020, the medical team of Wuhan Novel Coronavirus Pneumonia Prevention and Control Head Office issued a notice titled "Notice of the use of recommending Traditional Chinese Herbal Medicine prescription in the treatment of the pneumonia infection by the 2019 n-coronavirus”. This was a historical event for TCM. This was the first time in more than 100 years that TCM had returned to the frontline of plague prevention, treatment and management.
According to the Annals of Chinese Epidemic Diseases, there were at least 321 large-scale epidemics in China between 206 BC to 1911 AD. The Spanish Flu and the Black Death had caused tens of millions of deaths in the past. However, not once had China had a severe epidemic with a death toll in the millions due to the efficacy of TCM.
TCM has always attached great importance to ED. Li Qian Suo, recorded on the bamboo slips dating back to 221 BC-207 BC was the earliest record of isolation hospitals in the world. The prevention and management of ED had been recorded in Huang Di Nei Jing, a TCM classic compiled around 475 BC-220 AD. Since 206 BC, ED has been given priority in medical books. These can be proved by the content in many medical books, such as Zhou Hou Jiu Cu Fang (284 AD - 364 AD).
Apart from treating the ED with herbal medicine, experiences in quarantine, disinfection, maintaining a good environment and personal hygiene have been accumulated in terms of the management of ED.
For thousands of years before 1911 AD, TCM independently undertook all epidemic prevention matters.
In 1910-1911, the prevention and management of the pneumonic plague epidemic in Northeast China was led by western medicine for the first time, and TCM was withdrawn from the frontline of epidemic prevention.
At the First Meeting of the Central Health Committee in March 1929, the proposal of "no diagnosis and treatment of epidemic diseases" by TCM was passed. Although the proposal was shelved after the March 17 protests by the Chinese medicine industry, the government's position of restricting and banning Chinese medicine has never changed, and Chinese medicine was discriminated against during the Republic of China.
After the founding of the People's Republic of China, the situation of TCM has been greatly improved. However, for a long time, the prevention and treatment of epidemics are mainly the responsibility of epidemic prevention departments and hospitals which have never included TCM in the process.
In 2003, when the Severe Acute Respiratory Syndrome (SARS) broke out, the world re-recognized TCM’s value in epidemic prevention. In 2020, when western medicine lacked effective treatment methods, TCM played an important role in treating 2019 n-coronavirus pneumonia, and showed significant efficacy.
According to the notice issued by the medical team of Wuhan Novel coronavirus Pneumonia Prevention and Control Head Office on February 2, 2020, all designated medical institutions shall:
set up special teams for the prevention and treatment with TCM according to the requirements of the State Administration of TCM, composed of officials in charge of TCM matters, related staff and experts, to strengthen the implementation of the clinical use of TCM.
set up a TCM expert team. Patients should be treated in accordance with the principles of TCM and recommended prescriptions. The records of the course of disease shall be kept in detail.
shall ensure that Chinese medicine (traditional Chinese medicine decoction or granules) is given to all patients before 12am, 4th of February,2020. The dosage used as well as any changes in the patient's condition after taking Chinese Medicine shall be reported to the Municipal Health Committee of TCM Management before 17:00 of each day.
This is a historical event that symbolizes the turning point of the fate of TCM for more than a century. It can be seen from the developmental process of TCM in the past hundred years that TCM has fully accepted the concepts and methods of modern public health and epidemic prevention. What’s more, TCM has its own unique advantages in the prevention and treatment of epidemic diseases.
The average mortality rate of SARS in 2003 was 11% in the world, 11% to 17% in Hong Kong, from 13% to 15% in Singapore, from 15% to 19% in Canada, 5% to 13% in mainland China, 17% in Hong Kong, 27% in Taiwan, 8% in Beijing and only 3.6% in Guangzhou, making it the lowest in the world. This low mortality rate in Guangzhou was due to the early intervention of TCM.
The Guangdong Provincial Health Department attached great importance to TCM and promptly proposed to add TCM experts to the Anti-SARS Provincial Medical Experts Group and add "Principles of TCM treatment" in the guidelines of SARS treatment.
Because of the remarkable effect of TCM in treating SARS, the Hong Kong Hospital Authority invited experts from Guangdong Provincial Hospital of TCM to Hong Kong in May 2003 to assist the Hong Kong medical community in treating SARS by combining TCM and Western Medicine.
In Beijing, TCM was initially excluded from SARS treatment because SARS, as an epidemic disease, should be treated by epidemic disease hospitals by law. After several leading TCM doctors signed a petition to the central government, TCM doctors were allowed to participate in the treatment. Of 680 SARS patients admitted to Xiaotangshan Hospital, the isolation hospital for SARS, more than 200 received TCM treatment with a significant curative effect.
Since 2003, the government has continuously increased its emphasis on and support for TCM, and a series of regulations, opinions and laws have been successively promulgated for the inheritance and development of TCM.
With the successful experience of fighting SARS in 2003, TCM has been involved in the treatment of 2019 n-coronavirus pneumonia from the very beginning. Academician Zhong Nanshan also appealed in an interview with Xinhua News on January 28, 2020: "Traditional Chinese medicine should be implemented at the beginning."
In Hubei, the worst-hit area of the 2019 n-coronavirus, the national medical team of TCM took over some of the wards of Jinyintan hospital (the isolation hospital). On February 3, 2020, eight patients were discharged in good health as mentioned above. Hubei Provincial Hospital of Traditional Chinese and Western Medicine has adopted the treatment of integrated TCM and Western Medicine, which has enabled many infected patients to reach the discharge standard.
In Beijing, all patients diagnosed with 2019 n-coronavirus pneumonia were treated by integrated TCM and Western Medicine. Many patients have been cured and discharged from hospitals.
On January 27, the Henan Provincial Health Committee required to ensure that all confirmed cases were treated with TCM as early as possible, in a timely manner and throughout the course of the disease.
In Guangxi, nearly 80% of the 2019 n-coronavirus pneumonia cases were involved with TCM treatment. Currently, all patients cured were cured through the combination of TCM and Western Medicine.
In Guangzhou No.8 People's Hospital, 50 patients who were diagnosed with mild pneumonia caused by 2019 n-coronavirus infection, and were treated with the Prescription of Pneumonia No.1. After one week of clinical observation, the body temperature of all patients returned to normal range, 50% patients’ cough symptoms disappeared, 52.4% pharyngalgia symptoms disappeared, 69.6% fatigue symptoms disappeared and none of them has developed to severe conditions. Experts believe that The Prescription of Pneumonia No.1 can significantly improve the clinical symptoms of pneumonia caused by mild 2019 n-coronavirus infection and has a tendency to reduce the occurrence of severe pneumonia with significant clinical value. On January 31, the Guangdong Food and Drug Administration planned to include the application of The Prescription of Pneumonia No.1 in an emergency approval process as a medical institution prescription.
On February 5, 214 confirmed cases were treated with Qingfei Paidu Decoction in 4 pilot provinces. A total effective rate of more than 90%, of which more than 60% patients' symptoms and imaging performance improved significantly, and 30% patients' symptoms were stable and without aggravation in a three days course of treatment.
The World Health Organization declared on January 29, 2020 that there were no drugs specially used to prevent and treat new coronavirus so far.
TCM treatment was included and introduced in the guideline of treating 2019 n-coronavirus pneumonia issued by The National Health Commission of the People's Republic of China. On the contrary, under the Western Medicine treatment section, it was mentioned that "there is no confirmed effective antiviral treatment at present" and "blind or inappropriate use of antibacterial drugs shall be avoided". Other treatment measures include: bed resting, strengthening support treatment, ensuring calories, oxygen support therapy, psychological counseling, strengthening respiratory and circulatory support for severe patients, etc.”
Therefore, the "integrated traditional Chinese and western medicine treatment" is actually applying TCM treatment as a dominant treatment, and plays a leading role in this process. TCM should be the first choice to fight 2019 n-coronavirus plague. The successful experience in history shows that TCM has protected us from plague and the 2019 n-coronavirus will be with no exception.
References:
China Academy of Chinese Medical Sciences. (2003). Annals of Chinese Epidemic Diseases. Beijing: Traditional Chinese Medicine Classics Publishing House
(2003). Update 49 - SARS case fatality ratio, incubation period. Available online: https://www.who.int/csr/sarsarchive/2003_05_07a/en/ .Accessed 5/2/2020.
(2020) Notice of the use of recommending Traditional Chinese Herbal Medicine prescription in the treatment of the pneumonia infection by the 2019 n-coronavirus. The Medical Team of Wuhan Novel coronavirus Pneumonia Prevention and Control Head Office