Du Bin, a member of the High-level Expert Panel of the National Health Commissio, said during a press briefing last week that he hoped that TCM will use the evaluation methods of Western medicine to prove its effectiveness in treating the novel coronavirus. What are the TCM treatment methods that are endorsed by the Chinese government? What evidence is there to prove their effectiveness? Thank you.
Professor Du Bin is a colleague of mine, and we are treating severe and critical patients together. We often discuss COVID-19 diagnosis and treatment as well as the combination of TCM and Western medicine in the treatment.
I myself practice Western medicine and I am an ICU doctor. As to how to evaluate the effectiveness of TCM, we can see that it is increasingly evaluated by internationally recognized evidence-based medicine methods. Also, we can see that more and more TCM, proprietary Chinese medicines and TCM injections are using internationally recognized randomized controlled trials to evaluate their efficacy. As we all know, the randomized controlled studies led by Academicians Wang Chen and Gao Runlin evaluated the treatment of influenza H1N1 and chronic heart failure by Chinese patent medicine Jinhua Qinggan Granule and Qiliqiangxin Capsule respectively. The sample sizes were 410 to 526 cases respectively. It was observed that, as compared to standard treatment solely, the additional use of Jinhua Qinggan Granule can significantly shorten the fever time of influenza patients, while Qiliqiangxin Capsule can significantly improve the cardiac function of chronic heart failure. These studies have been published internationally.
In addition, Xuebijing, a Chinese medicine injection, has been highlighted during COVID-19 treatment. The academicians and professors here today have been adopting the internationally recognized method of evidence-based medicine to make clinical research on this. Indeed, we know that TCM treatment is usually based on syndrome differentiation, and that prescriptions vary among individuals. However, we are increasingly using internationally recognized methods of evidence-based medicine to evaluate the efficacy of TCM.
TCM was used early on coronavirus treatment, especially for the treatment of severely and critically ill patients. According to our clinical observations, the treatment is mainly useful in the following circumstances: First, preventing patients with mild and moderate symptoms from becoming severely ill; second, preventing severely ill patients from developing into critically ill cases; third, treating severely and critically ill patients; fourth, helping severely and critically ill patients recover. TCM has played a very important role in the above four aspects. To reiterate, it works well in preventing moderate and severe symptoms from becoming worse, plays a certain role in the treatment of severely ill patients, and proves to be a very effective method for the rehabilitation from COVID-19.
Actually, TCM and Western medicine adopt quite different treatment models. In Western medicine, most chemical drugs are designed to hit a single target, while TCM drugs mostly act on multiple targets. That is to say, TCM works more like as a team. But, as far as the disease is concerned, there are many targets to hit. In the case of COVID-19, the virus can cause inflammation and immune disorder, leading to impaired organ function including that of the lungs and heart. In other words, the virus, inflammation and the organ damages caused by immune disorder are all targets. Western medicine relies on chemical drugs that attack a certain target for treatment, while TCM could hit multiple targets, that is, it might have an effect on curbing virus replication, the regulation on inflammation and immunity, later organ damages and coagulation, among others.
Here, I would like to take Xuebijing injection as an example. Xuebijing has been well studied in recent years, and has been proven to be effective with at least six chemical constituents by the Shanghai Institute of Materia Medica of the Chinese Academy of Sciences. Moreover, in vitro experiments have shown that the Xuebijing injection can inhibit the replication of novel coronavirus. In related animal experiments, we have also found that a Xuebijing injection can suppress inflammatory responses and restore coagulation disturbances. Based on these preclinical studies that show Xuebijing is effective in treating severe pneumonia, we decided to use it to treat severely and critically ill patients.
We know that there is no specific drug for the treatment of COVID-19. As such, would a TCM injection have therapeutic effects on it? First of all, the efficacy of Xuebijing has been widely demonstrated during the treatment of severe pneumonia and sepsis. For example, one study tested the Xuebijing injection on critically ill patients with severe community-acquired pneumonia (SCAP) in 33 Chinese hospitals. This study was led by Professor Bai Chunxue from Fudan University. Outcomes included an 8.8% lower 28-day mortality rate, and a significantly shorter duration of mechanical ventilation and ICU stay. This research, as well as research for treating patients with sepsis, revealed that a Xuebijing injection was effective in reducing mortality rates.
We have seen the therapeutic effects of Xuebijing in previous studies of SCAP and sepsis, so now we are observing whether it is effective for the treatment of severely and critically ill patients infected with the novel coronavirus. We have learnt that a study on 156 severely and critically ill patients in 32 hospitals has found promising results for the Xuebijing injection combined with basic treatment among some cases. However, final conclusions can't be made until the research is finished. At least given the current situation, the Xuebijing injection might be a very important therapy for the treatment of COVID-19, especially for the treatment of severely and critically ill patients.
Of course, there is also a lot of concern about the safety. However, the post-marketing safety research of the Xuebijing injection showed that its clinical adverse reaction rate was no higher than 1%, which is basically safe. As a multi-target therapy of the COVID-19 treatment, I believe that traditional Chinese medicine, combined with current traditional therapies, will certainly save more lives of severe and critical patients. Thank you.