Traditional Chinese medicine (TCM) has thousands years history. It has unique basic theories and diagnostic methods. It is a very effective therapy in treating many chronic diseases and some acute diseases. If you are interested in TCM, welcome to pop in to this TCM forum, let's discuss on any topic about Chinese herbal medicine and acupuncture. If you have any health problem, you are welcome to visit my clinic Knowhow Acupuncture at No.1 Harley street, London. If you are far away from London, you can pop in my online clinic to get some help. If you like this blog please share it to your friends.

Thursday, 5 March 2020

Why this formula can be used to prevent and treat coronavirus infection?

Tiejun Tang
The epidemic of coronavirus is gradually getting under control recently in China. Chinese herbal medicine played a very important role in this battle against novel coronavirus in China. More than 85% of patients received herbal medicine treatment. Because the involvement of Chinese herbal medicine the cure rate was significantly increased and mortality rate significantly decreased.

The infection rate of coronavirus is increasing recently in Europe. Up to today over 4500 cases were diagnosed in Europe and 90 cases in the UK. It is estimated that this number will continue to increasein the near future. Can we introduce the treatment experience of China to fight the novel coronavirus in Europe? Unfortunately Chinese medicine hasn't got involved in the coronavirus treatment in Western countries. I think the main reason is because the majority of people and their governments do not believe in the effect of Chinese medicine. They believe Chinese medicine doesn't have enough scientific evidence. In this paper I would like to introduce Yupingfeng San which is widely used in China since the Yuan dynasty (1271AD) to build up healthy Qi and to prevent invasion of external evils. In Chinese “Yupingfeng mean jade screen and San mean powder. I don’t need to discuss the detailed history of this classic formula and treatment mechanism in term of traditional Chinese medicine. Let’s review some pharmacological research reports and randomized controlled clinical trials of Yupingfeng San (YPF). There are several hundred papers published about this formula. I only include the publications of recent years in English academic journals.

1. Immunoregulatory and anti-inflammatory function
To observe the Immunoregulatory and anti-inflammatory effects of YPF, Song J. applied YPF to treat a rat chronic bronchitis model. The results showed that the inflammation in the pulmonary tissue and the bronchus of rats was significantly reduced in the treatment groups.  In serum samples collected at different times from rats after administration of YPF, the result demonstrated increased proliferation of splenic lymphocytes within the area under the effect curve. Treatment of alveolar macrophages with serum samples in YPF group inhibited interleukin-8 (IL-8) in the cell culture media, and the effect was much better in the YPF[1]. To investigate the immunomodulating mechanism of YPF, a study  compared the immunomodulatory activity in vitro of the unfermented Yupingfeng dreg polysaccharides (UYDP) with that of the fermented Yupingfeng dreg polysaccharides (FYDP) obtained using Rhizopus oligosporus SH. Results consistently elucidated the duality of the immunomodulatory roles of UYDP and FYDP in regulating proliferation, and cytokines expressions in murine lymphocytes and macrophages. Compared with UYDP, FYDP effectively enhanced the proliferation of lymphocytes and promoted mRNA expression of inducible nitric oxide synthase (iNOS), IL-6, TNF-α, INF-γ, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and TLR-4 in lymphocytes and macrophages. Moreover, compared with UYDP, FYDP effectively normalized cell proliferation and down regulated mRNA expression levels of pro-inflammatory cytokines, NF-κB, TLR-4, and iNOs in lipopolysaccharide induced chronic inflammation cells. The results revealed that immunomodulatory effects in vitro of UYDP and FYDP are bidirectional.[2].
2.    Anti-virus effect function
To investigate the antivirus effect of YPF, Liu Q. applied real-time RT-PCR and western blotting technique to detect influenza virus (IFV) and the human respiratory syncytial virus (HRSV). The result showed YPF extract inhibited both IFV and HRSV in a dose-dependent manner when given before, during and after a viral infection. YPF was effective in blocking the entry of the virus. Furthermore, pre-treatment with YPF reduced the susceptibility of cells to the invasion of HRSV by inhibiting the expression of ICAM-1. Importantly, YPF extract increased the survival rate of lethal influenza-infected mice, prolonged the survival time and alleviated the virus-induced lung lesions, which is comparable with the effects of ribavirin treatment[3].
3.   Anti-asthma function
To detect anti-asthma effect of YPF, Wang Z applied flow cytometry technique to detect Tregs and Th17 cells in bronchoalveolar lavage fluid, and use ELISA assay to detect IL-4, TGF-β, and TNF-α in the serum of asthma model of mice. The result indicated that YPF could alleviate the inflammation in the lung tissue of mice, decrease the proportion of Th17 cells, and increase the proportion of Treg cells in bronchoalveolar lavage fluid, it could decrease IL-4 and TNF-α level and increase TGF-β level in blood[4].Liu X applied network pharmacology to explore potential mechanism of YPF on asthma. In vitro experiments showed that YPF significantly decreased the production of TNF-α and IL-6, as well as both mRNA and protein levels of IL-1β, NLRP3, Caspase-1 and ASC in LPS-stimulated U937 cells. In vivo experiment indicated that YPF treatment not only attenuated the clinical symptoms, but also reduced inflammatory cell infiltration, mucus secretion and MUC5AC production in lung tissue of asthmatic mice. Moreover, YPF treatment remarkably decreased the mRNA and protein levels of IL-1β, NLRP3, Caspase-1 and ASC in lung tissue of asthmatic mice.These results demonstrated that YPF could inhibit NLRP3 inflammasome components to attenuate the inflammatory response in asthma[5].
4.  Anti pulmonary fibrosis
Li L.applied total extract of YPF attenuates bleomycin-induced pulmonary fibrosis in rats. The result showed YPF treatment attenuated the alveolitis and fibrosis induced by bleomycin, reduced the loss of body weight and increase of lung coefficient. Meanwhile, YPF strongly decreased the levels of hydroxyproline and type I collagen, and reduced the over-expression of high-mobility group box 1 (HMGB1), transforming growth factor-beta 1 (TGF-β1), Col-I and α-smooth muscle actin (α-SMA) .YPF could ameliorate lung fibrosis by alleviating HMGB1 activity and TGF-β1 activation[6]. Cui W applied the total glycoside of Yupingfeng (YPF-G) to treat pulmonary fibrosis, the result found that both dose of YPF-G markedly reduced bleomycin-induced alveolitis and pulmonary fibrosis in rats. Besides, the levels of HMGB1, laminin, hyaluronic acid, and hydroxyproline were effectively reduced. Meanwhile, the increased protein expression of HMGB1 and the mesenchymal markers including vimentin and alpha-smooth muscle actin, and the decreased protein expression of epithelial marker E-cadherin were dramatically inhibited after YPF-G treatment[7].
      5.  Clinical randomized controlled trials
A meta-analysis aimed to evaluate the immunomodulating function of YPF in children with recurrent respiratory tract infections. Twelve trials with 1236 patients were identified. Adjuvant treatment with YPF significantly increased serum levels of IgA,  IgG , IgM and CD3(+) T-lymphocytes. YPF also reduced the frequency of recurrent respiratory tract infections and increased total effective rates of symptom improvement. Adjuvant treatment with YPF could improve total clinical effective rate and decrease the frequency of respiratory tract infections in children[8]. A randomized, double-blind, parallel, placebo-controlled study analysed 240 patients from eight centres in China. Participants were eligible if they had mild to severe chronic obstructive pulmonary disease (COPD). They were randomly assigned to receive 5g of YPF or placebo, three times per day, for 1 year. The result showed The YPF group had a significantly lower exacerbation rate than the placebo group and a significantly reduced risk of second exacerbation. After treatment, the mean change in the COPD assessment test score in the YPF group differed significantly from that in the placebo group[9].
In the article I published a few weeks ago, I mentioned a modified YPF decoction was used to prevent SARS of 2003 in Hong Kong. It significantly reduced infection rate of SARS in medical staff [10].  Novel coronavirus 2019 is different from SARS but has many similarities.  In early stage symptoms of novel coronavirus pneumonia are cough, fever and shortness of breath. In the severe stage it will lead to pulmonary fibrosis which is proved by autopsy.
YPF is a natural immune enhancer. Its immunoregulatory function can prevent viral infection. The anti-inflammatory and antivirus function can block the cytokine storm reaction of coronavirus pneumonia. The anti-asthma effect can release the shortness of breath. The anti pulmonary fibrosis effect can reduce the pulmonary fibrosis in the severe stages. Based on the above research evidence I highly recommended a modified YPF for prevention and treatment of novel coronavirus pneumonia.                                                

1.    Song J. Anti-inflammatory and immunoregulatory effects of Yupingfeng powder on chronic bronchitis rats.Chin J Integr Med. 2013;19(5):353-9.

2.    Sun H. Bidirectional immunomodulating activity of fermented polysaccharides from Yupingfeng.Res Vet Sci. 2017 Feb;110:22-28.
3.    Liu Q. Jiawei-Yupingfeng-Tang, a Chinese herbal formula, inhibits respiratory viral infections in vitro and in vivo.J Ethnopharmacol. 2013; 150(2):521-8.
4.    Wang Z. Yupingfeng Pulvis Regulates the Balance of T Cell Subsets in Asthma Mice.Evid Based Complement Alternat Med. 2016;2016:6916353.
5.    Liu X. Yupingfeng San Inhibits NLRP3 Inflammasome to Attenuate the Inflammatory Response in Asthma Mice.Front Pharmacol. 2017 Dec 22;8:944.
6.    Li L. Total extract of Yupingfeng attenuates bleomycin-induced pulmonary fibrosis in rats.Phytomedicine. 2015; 22(1):111-9.
7.    Cui W. Total glycosides of Yupingfeng protects against bleomycin-induced pulmonary fibrosis in rats associated with reduced high mobility group box 1 activation and epithelial-mesenchymal transition.Inflamm Res. 2015; 64(12):953-61.
8.    Song T. Adjuvant Treatment with Yupingfeng Formula for Recurrent Respiratory Tract Infections in Children: A Meta-analysis of Randomized Controlled Trials.Phytother Res. 2016;30(7):1095-103.
9.    Ma J. Effects of YuPingFeng granules on acute exacerbations of COPD: a randomized, placebo-controlled study.Int J Chron Obstruct Pulmon Dis. 2018; 4;13:3107-3114.
10.  Liu Dehui. Clinical Observation on the Preventive Effect of KangduBufei Decoction on AcuteSevere Respiratory Syndrome. Chinese Journal of Integrated Traditional and Western Medicine. 2004; 24(8): 685-688.

Tuesday, 4 February 2020

My ten year blogger journey

Tiejun Tang

Ten years ago, I opened my TCM blog Chinese Medicine Forum, during which I published over 80 posts. All the posts are related to Chinese medicine and acupuncture, and the topics range from clinical treatment to theoretical discussionand research review. I never expected this small blog could attract so many readers from all over the world. My readers include patients, TCM students & practitioners, doctors and researchers. Many readers received practical suggestion about their disease or health issues.
The pageviews of my blog have reached 318,253. 

The readers came from over 30 different countries.The top 10 countries are:

The following shows the posts concerning clinic treatment which received more pageviews.

The readers left 157 comments on my blog. Here are a few comments:

Williams wrote on Can acupuncture treat Parkinson’s disease?  "I wanted to thank you for this great Information and knowledge, I definitely loved every little bit of it. I have you bookmarked your web site to check out the latest stuff you post. Your blog is eye-catching. I get pleasure from it."

Alex wrote on How to treat Raynaud's Phenomenon with Chinese Medicine?  "It’s really nice and meanful. It’s really cool blog. Linking is very useful thing, you have really helped lots of people who visit blog and provide them useful information."

Leslie wrote on How to treat rheumatoid arthritis with Chinese medicine? I am really a big fan of Chinese medicine and I have been self studying about it. This article is very helpful. It gives total insight to the viewers when it comes to RA. It gives comparison and guide on how to deal with RA. "

Davy wrote on Acupuncture Pain Clinic in Whittington Hospital:  "Nice post. I read your article and found useful information regarding Acupuncture Pain Clinic. I would like to say thanks for sharing this. Keep sharing."

Anonymous wrote on Acupuncture Pain Clinic in Whittington Hospital: "This is a great posting of blog and thanks sharing, It was an one of the great treatment in acupuncture therapies, its useful for relaxation and infertility acupuncture etc."

Savannah wrote on Acupuncture Pain Clinic in Whittington Hospital:  "I have to say that the information here was the most complete that I found anywhere. I am definitely bookmarking this to come back and read later. Really impressed! "

Mendes wrote on Glandular fever and its TCM treatment: "This is a great article thanks for sharing this informative information. I will visit your blog regularly for some latest post. "

Williams wrote on How to treat urinary tract infection with Chinese herbal medicine?  "I have being researching about urinary tract infection and reading your blog, I found your post very helpful."

Greenjjade wrote on Hashimoto’s disease and its TCM treatment: "Hi Dr Tang, As a non-Chinese speaking student of TCM, I just wanted to express a very big thank you for freely sharing your clinical knowledge and expertise and writing about such interesting topics."

I am really appreciated all the comments.  Your feedback has encouraged me to keep on posting for the past 10years. I have been dedicated to TCM for more than 40 years, and deeply believe that Traditional Chinese medicine is a precious resource. The aim of this blog is to share my TCM knowledge and experience to English readers of the whole World. I will continue to post new articles in 2020, and readers are very welcome to leave their comments or share this blog with their friends. If this blog can make you and your family healthier, that is my best hope.

Thursday, 23 January 2020

How to prevent coronavirus infection?

Tiejun Tang

We are all aware of the new Coronavirus spreading from Wuhan across China and beyond.. This disease is very similar to the Severe Acute Respiratory Syndrome (SARS) epidemic of 2003 which originated in China and spread to 37 countries with 8098 cases and 774 fatalities. The pathogens are from a different subtype of coronavirus; Its incubation period is longer than SARS and its symptoms are slightly different.

SARS initially spread from Guangzhou in Southern China, and I was working in that city when SARS started to spread. Our hospital is one of the leading hospitals in Guangzhou, so we accepted and treated many patients. When patients were diagnosed with SARS they were isolated and treated with modern medicine. My PhD tutor, Professor Deng Tietao suggested to central government to use traditional Chinese medicine and after the Chinese herbal medicine was involved the mortality rate significantly reduced.
Chinese herbal medicine was widely used to prevent SARS infection. Many people took herbal decoction of Banlangen (Radix isatidis) which has proven to have an antiviral function.’[1] During the epidemic period of SARS in Hong Kong there were 2,601 medical staff administered with Kandu Bufei  DecoctionIt was confirmed that 1,063 people had taken it for a successive two weeks according to the request and had returned the questionnaire monitoring effectiveness They were regarded as the treatment groupThe control group consisted of 15,374 subjects who didn’t take Chinese herbal medicineResults: No one in the herbal treatment group contracted the SARS infection while in the control group, 64(0.4%) were infected.[2]
Extensive pharmacological research has shown that many Chinese herbal medicines have very good antiviral effects in their different ways.[3] Chinese herbal medicine could prevent the occurrence of coronavirus infection. It is possibly improving symptoms through enhancing the immunity of body. The ingredients of Kandu Bufei Decoction were based on the classical formula of Yupingfeng San, which is recorded from Yuan Dynasty in 1345 AD. Yupingfeng in Chinese means jade screen.  It means that like a jade screen this medicine can protect people from wind evils.  Modern research has shown that a modified Yupingfeng San formula can inhibit respiratory viral infections in vitro and in vivo.[4]
Coronavirus infection is preventable. Wearing a mask, washing hands and drinking plenty of water can help to prevent infection but the best way to prevent coronavirus infection is to take some Chinese herbal decoction. You can access your local Chinese herb clinic to get your jade screen. It will help you to stay safe from the risk of coronavirus.
1. Zhou W Research progress of Chinese herbal medicineRadix isatidis (banlangen).
      Am J Chin Med. 2013;41(4):743-64.
2. Liu Dehui. Clinical Observation on the Preventive Effect of KangduBufei Decoction on AcuteSevere Respiratory Syndrome. Chinese Journal of Integrated Traditional and Western Medicine. 2004; 24(8): 685-688.
3.  Jun Huang. Antiviral Herbs -Present and Future. Infectious Disorders – Drug Targets, 2014, 14, 61-73.