Health Articles

Use of Chinese Herbal Medicine in Covid-19

Traditional Chinese Medicine (TCM) has been widely used in hospital settings in conjunction with conventional medicine to manage the symptoms of Coronavirus disease (Covid-19) in China.  Xinhua news reported in early 2020 that approximately 90% of confirmed cases in China have received TCM treatment. (1) 

Studies evaluating the safety and efficacy of TCM as an adjunctive therapy for Covid-19 demonstrated that not only is TCM safe, it can help improve symptoms, slow or prevent progression of the disease, and boost the recovery of patients. (2-4)

According to statistics comparing Covid-19 deaths worldwide as of 26th January 2022, China recorded one of the lowest deaths per one million population at 3.5, as compared to Australia which is 127.3. (5)

What are Chinese herbs?

TCM is one of the world’s oldest medical systems dating back at least 2200 years.  The Chinese Materia Medica is primarily plant based and includes seeds, leaves, flowers, stems, roots and barks.  Chosen for their properties and functions, herbs and herbal formulas are carefully matched to the individual’s presenting condition and body constitution in order to help restore balance and harmony to disrupted functions, and to maintain health. 

2019 marks a major milestone for TCM as it became accepted in the World Health Organization (WHO)’s influential 11th International Classification of Diseases (ICD-11), signifying the recognition of TCM’s past contributions as well as the important role it plays in responding to current global needs in healthcare. (6)

Use of Chinese herbs in the different stages of Covid-19

Early stage

In TCM, before treating a disease, its depth is first determined.  As Doctors of Chinese Medicine we have to determine whether the condition is exterior, interior or in between.  An exterior condition is usually triggered by an external pathogen and affects the surface or exterior parts of the body such as the skin, mucous membranes of the nose, lungs and throat, external ears, scalp, muscles, tendons, and joints.  Covid-19 is classified in TCM as an external pathogen with a cold and damp nature.  When it first lodges at the exterior level, the following symptoms can result: fever and/or chills, runny/blocked nose, cough, sore throat, headache, body aches, stiff neck etc.  This is the best time to use Chinese herbs to drive out the pathogen, when the disease is still at the superficial level.  The sooner one takes action once they notice these symptoms, the more likely one can prevent the disease from travelling deeper into the body.  When Covid-19 progresses a little deeper, one can expect to see more symptoms including digestive troubles, such as alternating chills and fever, cough with phlegm, nausea, loss of appetite, diarrhea, loss of smell and taste, etc. 

Herbal formulas we commonly use in the early stage of the disease include:

Ge Gen Tang (kudzu decoction) – for fever and chills, dry throat, nasal congestion, joint pain, stiff neck and upper back.

Da Qing Long Tang (major blue green dragon decoction) – for fever, headache, body ache, cough, wheeze, shortness of breath (SOB), sore throat.

Chai Hu Gui Zhi Tang (bupleurum and cinnamon twig decoction) – for alternating fever and chills, epigastric discomfort, headache, nausea or vomiting, sore throat, SOB, phlegm, joint pain. 

Xiao Chai Hu Tang (minor bupleurum decoction) – for alternating fever and chills, bitter taste in the mouth, lack of appetite, dizziness, dry throat, chest fullness, epigastric discomfort. 

Xiao Xian Xiong Tang (minor sinking into chest decoction) – for chest distention, coughing up phlegm.

Recovery stage and Long Covid 

If a condition is not treated at its early stages when it is still at the superficial level, it has the potential to migrate deeper and become an interior disease.  Interior conditions often involve the stagnation of damp, phlegm and/or blood which can disrupt internal organs, deeper tissues such as bones, nerves and blood vessels, and mental stability. 

In the case of Covid-19, symptoms can linger for months if left untreated and develop into Long Covid, which is an interior condition according to TCM.  Blood cells can become more prone to clotting and block tiny blood vessels in the heart muscle, and in more severe cases, damage to the lungs, heart, kidneys and brain can occur.  Common signs and symptoms of Long Covid include fatigue, shortness of breath/difficulty breathing, cough, brain fog, headache, memory, concentration or sleep problems, chronic digestive problems, loss of smell and/or taste, dizziness, chest pain, fast or pounding heartbeat, depression or anxiety, body aches, etc. (7) 

At this stage, it is important to regulate and move blood stagnation, resolve dampness and phlegm, and restore damaged organ function especially of the lungs, heart and spleen-stomach.   Herbal formulas we commonly use to assist the recovery stage include:

Ban Xia Xie Xin Tang (pinellia epigastrium draining decoction) – for bloating, low appetite, nausea, epigastric discomfort, diarrhoea, phlegm. 

Ling Gui Zhu Gan Tang (poria, cinnamon, atractylodis & liquorice decoction) – for dizziness, heart palpitations, chest fullness, phlegm, SOB, digestive problems.

Wu Ling San (poria five decoction) – for urinary problems, headache, vertigo, water retention, SOB, diarrhoea.

Xue Fu Zhu Yu Tang (blood palace expel stasis decoction), Gui Zhi Fu Ling Wan (cinnamon & poria decoction) – for chest pains, brain fog, memory, concentration or sleep problems.

Prevention stage 

We can protect ourselves and minimize our risk of catching Covid-19 by taking the necessary precautions and strengthening our Wei Qi (innate immunity) with the guidelines set out in my previous blog article.  During this time of increased exposure to the disease, we can take even one step further and use TCM to help strengthen our Wei Qi.  Whilst there is no one formula that fits all, herbal formulas commonly prescribed include: 

Gui Zhi Tang (cinnamon twig decoction) – harmonises Ying (nutritive) and Wei (protective) Qi to strengthen immunity.

Gan Cao Gan Jiang Tang (liquorice and dry ginger decoction) – warms the lungs and stomach to dispel cold. 

Li Zhong Tang (regulate the centre decoction), Bu Zhong Yi Qi Tang (ginseng and astralagus combination) – tonifies Middle Jiao Qi (digestive function) to boost immunity. 

Yu Ping Feng San (jade windscreen powder) – stabilises the exterior defenses and tonifies lung Qi. 

As every individual’s condition and body constitution is different, it is best to consult your TCM practitioner to work out the best treatment program most suitable for you. 

Author: 

Dr Rachel Woo (TCM) 

Morningside Acupuncture & Natural Therapies Healing Sanctuary

January 2022

Disclaimer: Advice on this site is not a substitute for advice from a medical practitioner.  If you have concerns, consult your medical practitioner first.

References:

1. Xinhua. TCM treatment effective on over 90 pct of COVID-19 patients on China’s mainland: official 2020 [cited 2022 January 26]. Available from: http://www.xinhuanet.com/english/2020-03/23/c_138908334.htm.

2. Wu X, Li W, Qin Z, Xue L, Huang G, Luo Z, et al. Traditional Chinese medicine as an adjunctive therapy for mild and common COVID-19: A systematic review and network meta-analysis. Medicine (Baltimore). 2021;100(40):e27372.

3. Wang H, Xu B, Zhang Y, Duan Y, Gao R, He H, et al. Efficacy and Safety of Traditional Chinese Medicine in Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis. Front Pharmacol. 2021;12:609213.

4. An X, Zhang Y, Duan L, Jin, Zhao S, Zhou R, et al. The direct evidence and mechanism of traditional Chinese medicine treatment of COVID-19. Biomed Pharmacother. 2021;137:111267.

5. Statista. Coronavirus (COVID-19) deaths worldwide per one million population as of January 25, 2022, by country 2022 [cited 2022 January 26]. Available from: https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/

6. Lam WC, Lyu A, Bian Z. ICD-11: Impact on Traditional Chinese Medicine and World Healthcare Systems. Pharmaceut Med. 2019;33(5):373-7.

7. Australian Government Department of Health. COVID-19 disease, symptoms and variants 2022 [cited 2022 January 26]. Available from: https://www.health.gov.au/health-alerts/covid-19/symptoms-and-variants.