Integrative Medicine Demonstrates Advantage in COVID-19 Treatment
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Integrative Medicine Demonstrates Advantage in COVID-19 Treatment Yung-Chi Cheng In December 2019, a cluster of patients in Wuhan, China with a new type of pneumonia with unknown etiology were found. The origin was subsequently discovered to be an infectious disease caused by a new coronavirus, SARS-CoV-2, and named COVID-19 by the World Health Organization (WHO). In China, the disease progression of COVID-19 is divided into 4 phases—mild, moderate, severe and critical. And in terms of pathogenesis, there are 3 phases—early infection, pulmonary and hyper inflammation. In addition to conventional and reductionist approaches to finding antiviral and anti-inflammatory drugs, Chinese researchers have also investigated experienced-based Chinese medicine (CM) to look for formulae or formula-based drugs used to treat respiratory-related diseases to deal with the complexities of COVID-19's disease, symptoms and complications. Learning through front-line experiences battling COVID-19, the Chinese government began recommending "3-Drugs-3-Formulations" for treating different phases of COVID-19, including Jinhua Qinggan Granule (金花清感颗 粒), Lianhua Qingwen Capsule (连花清瘟胶囊), Xuebingjing Injection (血必净注射液), Qingfei Paidu Decoction (清肺排毒 汤), Huashi Baidu Formula (化湿败毒方), and Xuanfei Baidu Formula (宣肺败毒方). With the exception of one injectable formula, the other 5 formulae are orally administered and are all evolved from CM with a long history of usage and still in use today. Each of the recommended for mulae uses more than 12 herbs. With more herbs, there can be more complexities, resulting in greater challenges for quality control. Among the many herbs used, at least one of the herbs, Ephedrae herba, is also heavily regulated. The clinical evidence to support each for mulae's efficacy claims is not well described in most incidences. Well-designed clinical studies using well-documented quality control of CM formulae [with or without Western medicine (WM)] are rare.
©The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature 2020 Henry Bronson Professor of Pharmacology, Yale University; Chairman and Founder of Consortium for the Globalization of Chinese Medicine E-mail: [email protected] DOI: https://doi.org/10.1007/s11655-020-3432-9
The manuscript by Wang, Xiao and colleagues (Exploring an integrative therapy for treating COVID-19: a randomized controlled trial. Chin J Integr Med 2020;26:648-655.) is an exceptional case. It describes a new 7-herb formula, Keguan-1, deducted from 3 CM formulae-Yinqiao Powder (银翘散), Sangju Drink (桑菊 饮) and Sanren Decoction (三仁汤), which were used for treating respiratory-related disease for more than a thousand years. And Keguan-1 does not include the regulated herb Ephedrae herba , simplifying its regulatory hurdles. Chemical analysis of the final product for Keguan-1 using chemical markers was welldefined and presented to describe the quality control. The phase Ⅰ/Ⅱ study was designed as a 2-arm trial, using a com
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