In Wuhan: TCM and Western Medicine Works Not Only "Tongji" (Together), But Also "Union" (Harmoniously)

After the outbreak of the epidemic, Tongji Hospital and Xiehe Hospital, both affiliated to Tongji Medical College of Huazhong University of Science and Technology, experienced dark moments at the same time. Crowds of patients put great pressure on the two medical institutions even though they have relatively strong medical resources. The treatment of a large number of severe and critical COVID-19 patients become a tough problem facing the two hospitals.

Two months later, with the coming of spring, the two hospitals closed the isolation wards and are gradually back to normal medical order. How did they withstand the pressure and usher in a reversal? The answer is the integration of TCM and western medicine to fight the epidemic.

Most Searched topics: "Xiehe Black Tea" and "Tongji Coffee”

In general hospitals dominated by western medicine, TCM departments often run the risk of becoming marginal. However, in the two hospitals, TCM department is quite important. At the beginning of the outbreak, TCM prevention formulas prescribed by TCM departments in the two hospitals quickly gained unanimous approval.

On January 23, with the lockdown of Wuhan becoming the most searched topic, TCM guildeline in fighting COVID-19 published in the official Wechat of Xiehe Hospital was also on the list, with the number of clicks on that day exceeding 100,000+ and  readers reaching to 1 million. No one had expected that the 1st version of TCM guildeline was launched from a general hospital.

Fan Heng, director of TCM Department of Xiehe Hospital, took the lead in formulating the guildeline, in which 3 formulas were recommended by his team based on the actual situation of the epidemic. "Formula No.1" was used for prevention, "Formula No.2" was suitable for patients with fever and sore throat in the early stage of viral infection and "Formula No.3" was used in COVID-19 patients. The formulas, which everyone calls "Xiehe Black Tea", has been used more than 10,000 times since it was recommended to the public, especially " Formula No. 1", with the first batch of users exceeding 5,100.

Coincidentally, in Tongji Hospital, only 1.2 kilometers away from Xiehe Hospital, a formula named "Tongji Coffee" was also quite popular. This was an in-hospital preparation developed by Tongji Hospital as early as the 1970s. It is called "Jinye Baidu Granules", mainly composed of honeysuckle and Dayeqing, with antiviral, antipyretic and anti-inflammatory effects. In the face of the menacing epidemic situation, "Tongji Coffee" has protected the frontline medical staff of Tongji Hospital. Later clinical data confirmed that Jinye Baidu Granules can improve the negative rate of nucleic acid testing in respiratory pathogens and reduce inflammation of moderate COVID-19 patients.

As two hospitals with strong medical resources, after the outbreak of the epidemic, they quickly formulated western medicine prevention guildline and provided corresponding prescriptions. TCM and western medicine worked together in protecting the medical staff of the two hospitals, so that they have more time and energy to save patients.

Returning to Safety: Effective Rate of TCM treatment Is as High as 89.1%

In addition to responding quickly to provide the prevention formulas, TCM treatment formulas prescribed by TCM departments of the two hospitals also effectively “slammed on the brakes” for the hospitals that were about to face the risk of "out of control".

As the main force in Wuhan, Xiehe Hospital and Tongji Hospital can be said to be the frontline in the anti-epidemic frontline battlefield. After the outbreak, Xiehe Hospital earmarked two hospital areas as the designated hospitals for the treatment of critical patients. In the West area, as of February 24, a total of 2454 patients had been treated, of which 98.2% were severe and critical. As of February 29, the Cancer Center of Xiehe Hospital had also admitted 927 patients. The highest peak of the number of COVID-19 patients in Tongji Hospital has ever reached more than 2,000.

Such an overloaded number of hospitalized patients was already a heavy straw on camels for the two institutions with relatively strong medical resources. If at this time, a large number of patients' conditions further deteriorated, the consequences would be unimaginable.

At Xiehe Hospital, under the leadership of Fan Heng, the TCM department worked day and night, successively revising and upgrading treatment guildeline based on the 1st version launched on January 23 by the hospital, and formulated the 2nd and 3rd versions by incorporating with 1st to 7th versions of the national diagnosis and treatment protocol. The three prescriptions in the 1st version increased to seven in the 3rd version, covering prevention, diagnosis and treatment of moderate, severe, critical and convalescent patients. The guildeline of using TCM injections was also clearly formulated, and the use of Chinese Herb Medicine increased to over 90%.

At Tongji Hospital, Tu Shenghao, director of TCM Department, also led his team to work overtime, prescribing proprietary Chinese medicine or TCM decoction for more than 90% of COVID-19 patients. In response to the rapid progress of the disease with unsatisfying treatment effect and the slow recovery of lung function at the later stage, they prescribed 3 TCM agreement formulas. Among them, "Anti-COVID No. 1" and "No. 2" with Chaihu and Qinghao as the main ingredients are mainly applicable to severe and critical patients. “No. 3” (recovery formula) can help patients recover at the later stage.

For convenience and feasibility, the two hospitals promoted their prescriptions throughout the hospital, which was widely recognized by Western medicine experts. The data from the Tumor Ward of Xiehe Hospital showed that after the integrated TCM and western medicine treatment, the vast majority of patients were improved or cured, and the effective rate of TCM treatment was as high as 89.1%. Data from Tongji Hospital also showed that TCM has effectively relieved the symptoms of patients, improved the indicators of inflammation, and reduced the rate of mild cases turning into severe ones, making the two hospitals return to safety.

Collaboration: Effective Treatment Made TCM Recognized

After the outbreak of the epidemic, the TCM departments of the two hospitals performed brilliantly and effectively turned the tide. How did they do it? How could TCM and Western medicine work together to fight the epidemic in the two hospitals?
The nine-foot high rises from the base. In Tu Shenghao's view, it is through the accumulation of bit by bit in the daily work of TCM department in Tongji Hospital that made it quickly recognized after the outbreak.

Tu Shenghao said the accumulation includes three aspects: excellent talent team, excellent scientific research and excellent clinical efficacy.

Take TCM Department of Tongji Hospital as example The department has 4 national TCM senior experts as instructors of TCM experience and heritage, 2 provincial TCM masters and 2 national TCM talents. Tongji Hospital also harvested the first national award in its history because of "Artificial bezoar" of, the result of the integration of TCM and western medicine. In 2019 alone, the number of outpatient workloads reached 177,600.

Talents and scientific research can be measured with indicators, and the efficacy can only be achieved in daily work. Tu Shenghao described it as: "time-to-time appealing draws attentionfrequent communication gains understanding, and continuous efforts gets support." In his daily work, he often leads TCM department to provide professional TCM treatment advice to some complicated cases, and participate in consultation for those cases in the hospital, so to continuously show the efficacy and advantages of TCM treatment.

It can be said that TCM Department plays an important role in Tongji Hospital. This is exactly what happened when Tu Shenghao and TCM department prescribed the preventive formula and formulated the diagnosis and treatment guildeline.

But even so, on the battlefield of anti-epidemic, most of the hospitals that came to the rescue were general hospitals. At symposiums on patients' conditions, there were often differences between TCM and Western medicine experts. How to face the differences? "Curative effect speaks!" Tu Shenghao pointed out firmly.

"Patients already used a lot of body fluids, and using Shenmai Injection will increase the burden on the heart." At the end of February, at a symposium on a severe patient, disagreement arised between Tu Shenghao and a Western medicine expert.

Facing the emergency of respiratory failure of patients, Tu Shenghao put forward the idea of using 100ml Shenmai Injection for treatment, which was opposed by the westerm medicine expert. Tu Shenghao then proposed using 50ml first to observe the effect. After the use of it, patient's condition showed signs of improvement, Tu Shenghao's opinion was adopted, and then, another 50ml of Shenmai Injection was added to the patient. Soon, the patient turned to safety. "The curative effect of TCM is quite obvious." the western medicine expert who had expressed doubts said to Tu Shenghao. The coordination of TCM and western medicine soon turned critically ill patients into safety.

The efficacy of TCM was recognized by western medicine experts, which laid the foundation for the collaboration between TCM and Western medicine. On the battlefield of anti-epidemic, the two hospitals of Xiehe and Tongji relied on efficient coordination between TCM and Western medicine to fight the epidemic, and brough the dark moment into bright future. .

Harmony and Coordination: TCM and Western Medicine Efficiently Work Together

In the two hospitals, TCM and western medicine cooperated harmoniously to cure patients.

In Tongji Hospital, TCM experts, by “full and targeted intervention”, worked together with western medicine experts in the diagnosis and treatment of COVID-19 patients.

TCM experts in Tongji Hospital fully participated in the treatment of COVID-19 patients at all stages. In face of more than 2000 patients at the peak period, they used proprietary Chinese medicine and traditional Chinese herb medicine on more than 90% mild patients. As for severe patients, they used personalized TCM drugs base on different conditions and body constitution of the patients

They set up two TCM teams: one is the expert team consisting of professors and experienced associated professorswho fully participated in the discussion of critical, complicated and dead cases and the treatment methods of critical patients; the other is TCM consultation team composed of young associate professors and experienced doctors who participated the consultation of moderate cases. The two teams carried out rotating shifts to ensure the full TCM participation of treatment of COVID-19 patients at any time.

Different from Tongji Hospital in the full TCM intervention at all stages, Xiehe Hospital 

In addition, medical staff in the two hospitals who had participated in COVID-19 treatment were mostly western medicine doctors, many of whom are interested in TCM treatment and are willing to try it. However, they are not very clear about the treatment principle and methods. For example, lots of them do not know there are ingredients like Da Huang in Lianhua Qingwen Granule, which may cause diarrhea of some patients with weak constitution.

In view of it, Tongji Hospital especially formulated Advice on the Use of Proprietary Chinese Medicine in Treating COVID-19 for western medicine experts, and introduced it in different occasions. The Advice introduced the principle and methods in prescribing proprietary Chinese medicines with concise and easily understood language, so that western medicine doctors can correctly and effectively use them. Thus, the use of Chinese patent medicine reaches 94% to 97%.

With clear regulations and efficient coordination, the two hospital is gradually returning to normal after winning the battle against the epidemic. After all have been done, the experience of coordination between TCM and western medicine provides new direction for development in their future work.