The use of Traditional Chinese Medicines to treat COVID 19 may cause more good than harm

Tiejun Tang

This morning I read an article from the website of Professor Edzard Ernst. The article title is “The use of Traditional Chinese Medicines to treat SARS-CoV-2 may cause more harm than good”. I totally disagree with this opinion and after some investigation, I would like to change a few words in the title of his paper -- "The use of Traditional Chinese Medicines to treat COVID 19 may cause more good than harm."

Actually Mr Ernst is not the author of this article. This paper was originally published by two Australian doctors two month ago ^[1]. Their conclusion was mainly based on an article which was published by a group of Japanese doctors in 2017. It was a Meta-Analysis paper. The author using PubMed and Ichushi-Web-the database of the Japan Medical Abstracts Society to identify articles published between 1996 and 2015 describing patients with Japanese herbal medicine induced pneumonia. They found that 73 patients have been diagnosed with pneumonia after taking Japanese herbal medicine^[2] . The mean age at pneumonia diagnosis was 63.2 ± 15.5 years. The herbal formulas they used were sho-saiko-to (小柴胡汤) （26%）, sairei-to （柴苓汤）（16%）, seishin-renshi-in （清心莲子饮） (8%）and bofu-tsusyo-san (防风通圣散) （8%）.These formulas all are traditional Chinese medicine formulas which were widely used for hundreds or thousands of years in China, but not for early stage common cold or flu complaints.  Chinese medicine diagnosis for early stage common cold or flu is Taiyang syndrome and the treatment principle should be expelling wind cold or wind heat. The indication of sho-saiko-to is Shaoyang syndrome and of course it is not suitable for Taiyang syndrome. The other 3 formulas are all not suitable for this stage of Taiyang syndrome. If the treatment missed the target of diagnosis, it will not work at all.

In addition to the diagnosis problem, I noticed that the mean age at pneumonia diagnosis was over 60. Elderly people are easier to develop into pneumonia when they catch cold, that is common sense. The conclusion of Mr Enomoto’s article was against the basic principle of statistics -- age group differentiation.

Mr.Gray the author of that article believes that the Chinese herb Scutellariae Radix (Huangqin) is the cause of ARDS. Many of the Chinese medicine formulas which are used in Covid 19 treatment contain Huangqin. That is why he gets his opinion of more harm than good. His evidence for this also came from a Japanese report ^[3]. In this report only 5 patients have got ARDS after receiving the herbal treatment. He uses this very small sample report to against the report from Dr Ren^[4]  which includes 701 cases of Covid 19 with a positive result. From Mr Gray’s article I cannot find any evidence based on a large sample RCT research or laboratory research.

Mr Edzard Ernst is a very famous retired professor and critic of Chinese medicine. We all benefit greatly from constructive logically based criticism but this becomes wasteful and distracting if the criticism is not based on the principles of medical statistics, and is selective in it’s use of research results to support a personal agenda. I would like to be able to say that this paper made a useful addition to the discussion on the efficacy of Traditional Chinese Medicines in the modern world, but unfortunately I cannot.

Just a few days ago, we received some positive news from the US National Centre for Biotechnology Information (NCBI) who stated that “overall,” treatment with the Chinese herbal medicine Lianhua Qingwen for 14 days resulted in a “significantly higher rate of, and a shorter time to, symptom recovery.” Their conclusion is  "Traditional Chinese medicine can help COVID 19 patients recover faster” ^[5]

I hope that every reader can have a second thought about this topic. Always follow the science.

Reference:

1. Paul E. Gray. The use of Traditional Chinese Medicines to treat SARS-CoV-2 may cause more harm than good. Pharmacol Res. 2020 Jun; 156: 104776.
2. Enomoto Y. Japanese herbal medicine-induced pneumonitis: a review of 73 patients. Respir. Investig. 2017; 55:138–144.
3. Osamu Sakamoto. Clinical and CT characteristics of Chinese medicine‐induced acute respiratory distress syndrome.  Respirology 2003; 8(3):344-50. doi: 10.1046.
4. Ren J.L. Traditional Chinese medicine for COVID-19 treatment. Pharmacol. Res. 2020:104743.
5. https://www.onenews.ph/us-health-agency-says-traditional-chinese-medicine-can-help-covid-19-patients-recover-faster