TCM for Covid-19

Despite the many claims, there is no real evidence that traditional Chinese medicine (TCM) is effective for prevention or treatment of COVID-19.

There have been many claims for the efficacy (and even the superiority) of traditional Chinese medicine (TCM) compared to so-called “Western” medicine. The COVID-19 outbreak that started in Wuhan, China, could have been a unique opportunity for them to demonstrate to the world just how effective TCM could be. They might have cured COVID-19 with TCM, and they might have done controlled studies to show that herbal remedies were better than pharmaceutical remedies. But they didn’t. Here’s what happened instead.

They used “Western” pharmaceuticals

Based on evidence from a seriously flawed study, Chinese health organizations have officially recommended that COVID-19 patients take chloroquine. Chloroquine phosphate tablets (500 mg, 2 times per day) for a total of 10 days is the official recommendation of the Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province.

But a small controlled study subsequently showed no benefit.

Favipiravir (Avigan), a drug developed to treat new strains of influenza, was given to 340 COVID-19 patients in Wuhan, China.  Chinese authorities reported that it was safe and “clearly effective.” Patients who got the drug tested negative for the virus in four days, compared to 11 days for patients who did not get the drug. X-rays showed improvements in 91% of those who got the drug, compared to 62% of those who didn’t. The article describing that study appears to have been withdrawn.

They added TCM to other treatments

In one published study, four pneumonia patients were treated with both Western pharmaceutical and Chinese herbal antivirals (lopinavir/ritonavir (Kaletra®), arbidol, and Shufeng Jiedu Capsule). Three patients improved symptomatically and two were discharged with negative tests. But one of those had tested negative before treatment, so presumably the diagnosis of COVID-19 was wrong. There was no control group, so no way to know whether their clinical course might have been the same with pharmaceuticals alone – or with no treatment at all.

A Chinese healthcare institute claims that acupuncturists trained in herbal medicine have treated COVID-19 patients with “important results”. They reported a 90% success rate with Qing Fei Pai Du Tang, a remedy dating back to the Han dynasty. Qing Fei Pai Du Tang is a mixture of 21 herbs, two of which (Ma Huang and Xi Xin) have been banned or restricted in other countries due to toxic effects.

They did poorly designed studies and reported anecdotal data

An integrative medicine website lists published research papers related to the treatment of COVID-19 using traditional Chinese medicine (TCM). It claims that:

the core pathogenesis of COVID-19 is a dampness pestilence caused by external cold-dampness distressing lung and spleen, transforming to heat due to dysfunctional qi activity and endogenous stagnated heat.

That is not the language of science.

They recommend various herbal regimens for different stages of the disease. They report that the use of herbal medicine to treat COVID-19 was widespread in China, that 85% of confirmed COVID-19 cases were treated with herbal remedies. They provide a long list of recommended herbal decoctions, powders, pills, granules, capsules, and injections. They report several allegedly successful studies – retrospective cohorts, case series, and case studies – using different herbal formulations, sometimes “semi-individualized,” and different endpoints. Nothing resembling a well-designed clinical trial with an appropriate control group. They describe ongoing research on various proposed treatments including chloroquine, convalescent plasma, favipiravir, and stem cell therapy. None of these are TCM, but they recommend TCM. They recommend using TCM as an adjunctive therapeutic option but admit that “The clinical evidence of CM [Chinese medicine] on COVID-19 is far from conclusive.”

An article on MedicineNet reported that supplements suggested by the Chinese Journal of Integrative Medicine to treat or prevent coronavirus include:

  • Radix astragali (Huangqi),
  • Radix glycyrrhizae (Gancao),
  • Radix saposhnikoviae (Fangfeng),
  • Rhizoma Atractylodis Macrocephalae (Baizhu),
  • Lonicerae Japonicae Flos (Jinyinhua), and
  • Fructus forsythia (Lianqiao)

They also reported claims that Qingfei Paidu soup, made with ephedra and licorice root, had been effective in treating the symptoms of hundreds of COVID-19 patients; but they pointed out that those claims had not been verified by researchers or news reporters outside of China.

They repeat the NIH warning that not only are the claims inconclusive, but “some TCM herbal and supplement products may be adulterated with pesticides, industrial chemicals, prescription pharmaceuticals, or mislabeled herbs and other substances”. The NIH points out that even when studies show improvements, they are only of marginal benefit. The NIH has concluded that:

no evidence exists that any combination of herbs will cure COVID-19, or even lessen symptoms.

TCM hype and hope outweigh scientific evidence

TCM is gaining popularity in Africa because “TCM has so far played a substantial role in China’s fight against the novel coronavirus”.

YouTube videos claim that TCM has been proven effective, and Chinese doctors offer to share their expertise with overseas counterparts.

I don’t know what all these sources mean by “proven effective”, but the evidence is far below the standard that I would accept as “proof”.

Chinese government sources and news sources that follow the government-controlled narrative must be considered unreliable. TCM is important to the Chinese national agenda, and a propaganda campaign has “pumped up pseudoscience”.

Other bogus claims for COVID-19 treatments abound

I wrote an article for the Skeptical Inquirer website about how COVID-19 has provided a field day for scams and misinformation. Every kind of alternative medicine has jumped on the coronavirus bandwagon. Here are a few examples:

The bogus claims make the Internet sound like a duck farm at feeding time. The Center for Inquiry has developed a new resource to inoculate against coronavirus misinformation.

The bottom line: TCM is probably not effective for prevention or cure of COVID-19

The NIH commented on alternative treatments including herbal therapies and teas. They said “There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by COVID-19″. Instead of believing TCM claims, we should listen to the scientific experts and wait for real evidence.

This article was originally published in the Science-Based Medicine Blog.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine Blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.

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