On February 13th, While Yan Fang, director of classic ward of Guangdong TCM Hospital, was making rounds at the isolation ward of COVID-19 in Wuhan Hankou Hospital, a patient raised the thumb to show his appreciation. The patient said: "I didn't believe in TCM before, but after taking two decoctions yesterday, there seems to be an amazing effect. TCM is so good that it came into effect in one day." Yan said "In fact, TCM has a very fast effect, instead being ‘slow’. The key is administering right medications for symptoms". This video conversation spreading on the Internet has attracted a lot of attention to the TCM treatment of COVID-19.
In-depth and whole process intervention of TCM
Intervening as early as possible, in the grassroots, and in the whole process, TCM is deeply involved in the whole process of diagnosis and treatment.
On February 17th, at the press conference of the joint prevention and control mechanism of the State Council, Jiang Jian, Director-General of the Medical Administration Department of the National Administration of Traditional Chinese Medicine, introduced that up to that day, 85.20% of the confirmed cases had been treated by TCM. Outside Hubei, 87% of the cases discharged or with improving symptoms were intervened by TCM.
According to the latest data of Hubei Health Committee, as of 24:00 on February 16th, among the 58182 confirmed patients in 225 designated hospitals in Hubei Province, the intervention rate of TCM reached to 83.3% (80% in Wuhan). Among the 4978 confirmed cases in 42 designated TCM hospitals in the whole province, the rate reached to 96.4%. The symptoms of fever, fatigue and cough, as well as the imaging results, were significantly improved, and the total effective rate was 81.3%. There are 8159 beds and 6966 patients in 9 operating Cabin Hospitals, and all the patients who should take TCM did it. At present, TCM decoctions and 5 TCM patent drugs are distributed in 11 Cabin Hospital.
Zhang Boli, academician of the Chinese Academy of Engineering and President of Tianjin University of Traditional Chinese Medicine, said that TCM was involved in the prevention and treatment of the epidemic, played its role in the whole process, and demonstrated its characteristics and advantages.
Statistics from Jiangxi Province shows that as of 24:00 on February 15th, 878 of 925 confirmed cases in Jiangxi Province were treated with TCM decoction or integration of TCM patent drugs and western medicine, accounting for 95%. 719 patients got better, with an effective rate of 82%; 218 of 239 discharged patients were treated by integration TCM and western medicine, accounting for 91%.
Driven by efficacy, the medical treatment group of Wuhan COVID-19 prevention and control command center issued Notice on Recommending the Conventional Prescriptions in the TCM Treatment of COVID-19, requiring the TCM medication among mild and moderate confirmed and suspected cases.
The National Administration of Traditional Chinese Medicine has established a joint working group mechanism with Hubei Province and Wuhan city. TCM Prevention and Treatment Scheme of COVID-19 in Hubei (Trial), Notice on Strengthening the Integration of TCM and Western Medicine of COVID-19 and Guidelines of TCM Prevention and Treatment for COVID-19 were successively issued in the whole province, providing technical guidelines for the prevention and treatment of TCM. The province has established a notification and accountability system, defined strict requirements, and promoted the full and in-depth integration of TCM into the overall situation of the epidemic prevention and control.
Tu Zhitao, Director General of the Beijing Administration of Traditional Chinese Medicine, said that, at present, mild cases can be cured only with TCM, which proved true in the clinical practice of prevention and control in Wuhan and Beijing.
Integrated diagnosis and treatment of TCM and western medicine uplifted to the national level
Since the outbreak, the central government has made it clear repeatedly to persist in the integration of traditional Chinese and Western medicine in the treatment of the outbreak. It was emphasized to continue to optimize the diagnosis and treatment plan, adhere to the integration of TCM and western medicine, increase scientific research efforts, and accelerate the screening and development of new drugs with better clinical efficacy according to the principle of gathering patients, experts, resources and treatment. We should strengthen the integration of TCM and western medicine, promote the deep intervention of TCM in the whole process of diagnosis and treatment, and timely promote effective prescriptions and TCM patent drugs.
On February 12th, Notice on Establishing and Improving the Cooperative Mechanism between TCM and Western Medicine in the Prevention and Treatment of Covid-19 and other Infectious Diseases, was jointly issued by General Office of National Health Commission and General Office of National Administration of Traditional Chinese Medicine, requiring the establishment of the working mechanism of integrated TCM and western medicine. It was required to establish a coordination platform between TCM and western medicine, integrate TCM into the hospital management, including the formulation of diagnosis and treatment plans, making rounds, multi-disciplinary consultation and case discussion. It was encouraged to involve local hospitals with good expertise in the cooperative mechanism for stronger medical workforce. It was necessary to strengthen the joint consultation of TCM and western medicine to ensure the timely medication of TCM to the patients.
At the same time, it was required to formulate and improve the diagnosis and treatment plan of integrated TCM and western medicine, optimize the treatment plan of integrated TCM and western medicine, for the fastest recovery, the lest rate of critical cases, the highest cure rate and the lowest fatality. At the same time, it is necessary to pay attention to the unique role of TCM in the rehabilitation.
Tong Xiaolin, academician of the Chinese Academy of Sciences and chief researcher of China Academy of Chinese Medical Sciences, said that TCM professionals often talk about "preventative treatment," including the ideas of "prevention before a disease arises", "guarding against progression when a disease arises ", and "protecting recovering patients from relapse". It helps patients to recover obviously through methods such as nourishing qi, strengthening spleen, nourishing yin, resolving sputum, and activating collaterals, including non-medicine therapy such as cupping, acupuncture, scraping, diet therapy, and psychotherapy.
Ren Yi, director of the Classic TCM Department of Chongqing Traditional Chinese Medicine Hospital, said that for mild and moderate patients, the main advantages of TCM are that it can significantly improve the symptoms of cough, fatigue, and diarrhea. For instance, it can slow, control and even stop the deteriorating process of the disease. For severe and critical patients, the treatment of integrated TCM and western medicine can reduce fever, lung inflammation and exudation, organ damage and hormone consumption. Especially for the infected persons without symptoms, in the theory of "preventative treatment" of TCM, they should be intervened early. Doctors mainly use TCM decoction to improve immunity and block disease progression.
Liu Liangji, an expert of Jiangxi Epidemic Prevention and Control Emergency Responding Command Center and head of Jiangxi TCM Prevention and Treatment Expert Group, believes that TCM has unique advantages in the prevention and treatment of COVID-19. For severe and critical patients, the main advantage of TCM is in improving symptoms, reducing fever, controlling disease progression, and reducing hormone use. "TCM is not a simply antiviral treatment, but importantly, it helps to improve immunity, prevent disease progression and reduce mortality."
Joint Epidemic Prevention and Control with Integrated TCM and Western Medicine
Seventeen years ago, the effect of TCM for SARS was affirmed by the World Health Organization.
According to Jiang Jian, after the outbreak, the National Administration of Traditional Chinese Medicine, as a member of the joint prevention and control mechanism, responded quickly and fully participated. NATCM recommended immediately 8 experts, including national TCM masters and academicians, to the national medical team. Meanwhile, a few experts were dispatched to Wuhan to study the condition, diagnose patients, summarize the experience, and guide the local TCM syndrome differentiation and treatment.
So far, more than 3,100 medical workers from more than 630 TCM hospitals in 28 provinces (autonomous regions and municipalities) have been sent to support Hubei. NATCM sent an expert team led by three academicians- Zhang Boli, Huang Luqi, and Tong Xiaolin, and four batches of national TCM medical teams to Wuhan, which were respectively stationed in Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan Jinyintan Hospital, Jiangxia Cabin Hospital and Leishenshan Hospital. In addition, TCM institutions nationwide were also active to participate in the prevention and control. TCM experts are involved in the provincial expert groups, and 26 provinces (autonomous regions and municipalities) and Xinjiang Production and Construction Corps have separately established provincial-level TCM expert groups.
Zhang Boli said that the integrated treatment of TCM and western medicine has achieved obvious results. With integrated TCM and western medicine treatment, patients were cured and discharged in Beijing and other places. Many patients hospitalized in the designated TCM hospitals of Wuhan have also been discharged through integrated TCM and western medicine treatment, especially for mild and moderate cases taking individualized TCM decoction. This is a good example of the integration and complementary advantages of TCM and western medicine in the course of disease control.
TCM treatment for COVID-19 is by no means an empty talk. Zhang Boli said that TCM has the effect of improving the symptoms of high fever, vomiting, and constipation. It also helps to control disease progression, blood pressure and blood oxygen saturation, target organ protection, and cardiopulmonary and renal functions.
Zhang Boli said that although compared with the situation in SARS outbreak, the intervention of TCM in this outbreak has been significantly earlier, but not early enough. He believes that TCM should intervene and play its role in the early prevention and treatment of the epidemic. Although there are designated TCM hospitals, the hospital number and beds are still quite small, and a systematic and comprehensive TCM diagnosis and treatment system is to be set up. The top design of TCM diagnosis and treatment scheme needs to be improved, and the coordination between clinical service and research still needs to be optimized to form a comprehensive force.
