MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

It has been reported that, in China, patients affected by the coronavirus are being treated with Traditional Chinese Medicine (TCM). Treatments in Wuhan hospitals combine TCM and western medicines, said Wang Hesheng, the new health commission head in Hubei, the province at the centre of the epidemy. He said TCM was applied on more than half of confirmed cases in Hubei. “Our efforts have shown some good result,” Wang said at a press conference on Saturday. Top TCM-experts have been sent to Hubei for “research and treatment,” he said. Some 2,200 TCM workers have been sent to Hubei, Wang said.

Another website confirmed that TCM has been applied to more than half of the confirmed patients of corona or COVID-19 infection in Hubei. It’s also used in the prevention and control of COVID-19 at the community level. “Since the beginning of the outbreak, the government has attached importance to both TCM and Western medicine by mobilizing the strongest scientific research and medical forces in both fields to treat the patients,” said Wang Hesheng. “By coordinating the resources of traditional Chinese and Western medicine, we strive to improve the cure rate and reduce fatalities by the greatest possible amount to effectively safeguard the safety and health of the people,” Wang noted.

China Daily added that many of the medical workers also have participated in the fight against the SARS outbreak in 2003, said Huang Luqi, president of China Academy of Chinese Medical Sciences. Three national-level TCM teams, organized by the National Administration of Traditional Chinese Medicine, also have been dispatched to Hubei, said Huang, head of the TCM team at Wuhan Jinyintan Hospital.

The TCM workers have treated 248 confirmed and suspected novel coronavirus patients, and 159 of them have shown improvement and 51 have been discharged from the hospital, Huang said at a daily news conference in Wuhan. More than 75 percent of novel coronavirus patients in Hubei, and more than 90 percent of patients in other regions of the country, have received TCM treatment, he said. “We hope that Hubei province and Wuhan city can increase the use of TCM in treating confirmed and suspected novel coronavirus patients,” Huang said. TCM can shorten the course of disease for patients with severe symptoms, reduce the possibility of mild infections becoming severe, help with patient recovery and disease prevention and offer psychological support to patients, he noted.

__________________________________________________________________

No information is available on the nature of the TCM treatments used. Moreover, the reported response rate (159 of 248) sounds far from encouraging to me. In fact, it could reflect merely the natural history of the disease or might even hide a detrimental effect of TCM on the infection. What we need are controlled studies, without them, reports like the ones above are mere useless and potentially harmful propaganda for boosting China’s TCM-trade.

15 Responses to Coronavirus: useless and potentially dangerous propaganda for TCM from Chinese officials

  • “What we need are controlled studies” ~ Edzard Ernst

    You’re not fighting in the trenches with these clinicians, or do you have a specific protocol in mind you could suggest they use? Rather than try TCM, do you instead propose nothing be done while waiting for “controlled studies” results?

    • Rather than try TCM, do you instead propose nothing be done while waiting for “controlled studies” results?

      It is my policy when posting on this blog to remain as objective as possible and to refrain from anything that might be construed as a personal attack. My aim here is to educate and inform, not to voice opinions or to take part in arguments. As a doctor who has devoted a 30-year career to treating the sick, mainly in the realm of cancer care, my motivation comes from a wish to reduce the harm caused by unwise and uninformed decisions that people make about their health. I must also admit that I find it difficult to let something that is factually wrong go unchallenged.

      With that in mind, please don’t take it the wrong way when I say that your comment is one of the most stupid things I have ever heard. The risk that someone might take you seriously also makes it dangerous and irresponsible.

      It is ALWAYS better to do nothing than to bow to pressure to do something of unknown benefit and potentially harmful, except within the context of a clinical trial. This is the case with any new or unproven intervention, whether the aim is to control an epidemic, to treat cancer or any other medical problem.

      Adopting any non-standard treatment protocol without trialling it first is unethical, not only because the effects (good or bad) are unknown, but also because it passes over the opportunity to find out what they really are.

      In any case, putting people into a clinical trial isn’t doing nothing. The control group has the best treatment that you know about, and the interventional group(s) has (have) something that you think might be better, in the knowledge that it could turn out to be worse. If it proves to better than it becomes the new best treatment and is the control in the next trial.

      The doctors in Wuhan “on the front line” as you put it aren’t out in the sticks, but in a large city with modern medical facilities, albeit overstretched, and a world-class virus research laboratory on their doorstep.

      Since the optimum management of this new infection is unknown, the only way they are going to make progress is to subject EVERY intervention to clinical trials. This is going to include investigating what kind of ventilation technique is optimum for those with respiratory failure, what kind of immunosuppressive treatment may ameliorate the runaway inflammatory state (presumably cytokine-mediated) which is apparently responsible for most of the fatalities, whether any known antivirals, singly or in combination, can modify the course of the disease, whether it is better to give or withold steroids and at what stage… Among others we know that there is a clinical trial investigating the benefit of intravenous vitamin C in these patients, thanks to RG posting a link, and no doubt many more. The results (we hope) will be shared with virologists, infectious disease specialists, intensivists and other physicians around the world; if this disease spreads as widely as epidemiological modelling predicts then you, your friends and your family stand to benefit from this knowledge directly. In the meantime the actions of the Chinese Government, however draconian, seem (so far) to be effective in slowing down the spread and buying some time for the rest of the world.

      TCM, on the other hand, is something that has previously been promoted by the Government of the People’s Republic of China for political reasons, not medical ones, and this, helped by the fact that many Chinese people believe in it, is probably the reason it is being used here. Their main concern is not the welfare of the people, it is to remain in power, and they wil do whatever they think will promote that. How they are viewed by the rest of the world, while important for many reasons, is nevertheless of secondary importance.

      • “With that in mind, please don’t take it the wrong way when I say that your comment is one of the most stupid things I have ever heard. The risk that someone might take you seriously also makes it dangerous and irresponsible.”

        Dr Money-Kyrle. Welcome to the world of Sandra Hermann-Courtney. One of the most stupid people you will ever encounter.

      • “It is my policy when posting on this blog to remain as objective as possible and to refrain from anything that might be construed as a personal attack.”

        Spare me the white coat arrogance.

        Your arrogance aside, I agree with your presumption: “The actions of the Chinese Government (by including TCM in their treatment protocols) do seem to be effective in slowing the spread”

        • Dear Sandra Hermann-Courtney,
          Let me take a short moment to thank you for posting on this blog.

          Comparing your comments to the ones from Dr. Money-Kyrle vividly demonstrates the difference between an ideologically indoctrinated SCAM believer (with no scientific credentials whatsoever) and a highly educated expert in the field of medical profession.

          You may think that your beliefs & opinions are of equal value as the facts that experts present, simply because you post on the same platform as they do. Make no mistake.

          The huge gap of knowledge between you and experts like Dr. Money-Kyrle is painfully obvious for everyone following your exchanges on this blog.

          So again, thank you for continuously providing such great cautionary examples – please keep it up!

      • … your comment is one of the most stupid things I have ever heard. The risk that someone might take you seriously also makes it dangerous and irresponsible.

        Sandra Courtney has extensive experience in eliciting responses of this kind 😀
        If my recollection is correct, she is a former medical transcriptionist who has made homeopathy her passion as well as holy mission. She calls her twitter account “HomeopathyRocks! Skeptics not so much”. There she fights a fierce campaign in defense of Hahnemann’s decaying legacy, pumping out a steady stream of cherry-picked pro-homeo propaganda despite a steady headwind of rectifications and ridicule. A true zealot!

  • just got this email:
    Dear Researcher,
    I am NX Pi, editor of Traditional Medicine Research(Indexed in Web of Science, Embase, ISC, etc.).
    It is our great honor to present you with articles on novel coronavirus pneumoniapublished in Traditional Medicine Research.
    Traditional Chinese medicine for novel coronavirus pneumonia treatment: main force or supplement?
    The nationwide death toll from the coronavirus outbreak in China has risen to 491, with nearly 24,363 individuals infected, according to official figures released on February 5, 2020 [1]. With no proven drugs to treat the infection caused by the deadly coronavirus, China’s top health organization has advised hospitals to use various treatments, including traditional Chinese medicine (TCM) and artificiallungs,totackleit[2]. The National Health Commission of the People’s Republic of China and the National Administrationof Traditional Chinese Medicine of the People’s Republic of China issued a diagnosis and treatment plan (trial version 4th) for novel coronavirus pneumonia on January 27, 2020, providing specific recommendations for the treatment and prevention of the infection using TCM. Academician Zhang Boli, the President of the Tianjin University of Traditional Chinese Medicine, stated the following in an interview with Xinhua News Agency: “Chinese medicine plays an all-round role throughout the treatment of novel coronavirus pneumonia, but I stilladvocate integrated Chinese and Western medicine” [3]. However, interestingly, on the same day, the famous The New York Times put forward a contrasting view on the use of TCM for the treatment of this infection. The report quoted the opinion of Dominic Dwyer, a medical virologist at the University of Sydney, who said, “There has never beenagood antiviralagent,so thatmeansthatpeople would try things that have some effect. But there’s no evidence of significant benefits with any antiviral drugsorTCM”[4]. Infectious diseases have plagued China for a long time, and TCM has been used against these diseases since ages. In ancient Chinese medical book Huang Di Nei Jing (Inner Canon of the Yellow Emperor), methods and drugs (Xiao Jin Pill) for preventing plague have been mentioned [5]. In Shanghan Zabing Lun (Treatise on Cold Damage Diseases), written during the period of the Eastern Han dynasty (the third century C.E.), the concept ofWarm disease (plague) has been proposed and several prescriptions for Warm diseases have been mentioned [6]. In Zhou Hou Bei Ji Fang (Handy Therapies for Emergencies, 284 C.E.–354 C.E.), written by an Eastern Jin dynasty physician Ge Hong, a treatment method for malaria using Qinghao (Artemisiae Annuae Herba) has been mentioned: “A handful of Qinghao (Artemisiae Annuae Herba), soaked in 2 liters of water and ground into juice, then take the juice for oral use.” This treatment recommendation inspired Tu Youyou’s notion that high temperatures must be avoided in the extraction process of bioactive plant compounds, thus, a low-boiling-point solvent extraction method is now used in modern applications [7, 8]. In Dou Ke Jin Jing Fu Ji Jie (Smallpox Treatments Collection, 1727 C.E.), it was clearly mentioned that the vaccination methods originated duringthe Longqingemperor periodofthe Ming Dynasty (1567 C.E.–1572 C.E.), furthermore, Huang Baijia (the son of the Ming dynasty’s famous thinker Huang Zongxi) wrote that a man named Fu Sichuan wasknown for hisvaccination technique [9]. During the early Qing dynasty (1636 C.E.–1722 C.E.), the Chinese population plummeted due to a smallpox epidemic [10]. Feng (hemiplegic paralysis), Lao (tuberculosis), Gu (cirrhosis ascites), Ge (esophageal cancer) are known as the four major incurable diseases in TCM theory. Great writer Lu Xun recorded in the article Father’s Disease that his father died of cirrhosis and ascites, the doctor at that time used broken drumhead (In Chinese, the pronunciations of drum and Gu are same) in the prescription, and Lu Xun’s father eventually died withoutanyrelief[11]. On January 31, 2020, Xinhua Perspectives learned from the Shanghai Institute of Materia Medica, Chinese Academy of Science, that a joint study by
    this institute and the Wuhan Virus Institute has found that the proprietary Chinese medicine Shuanghuanglian oral liquid can inhibit the new coronavirus, but the study does not include any animal experiments [12]. In addition, in the “National Annual Report on Adverse Drug Reaction Monitoring (2014),” adverse drug reaction due to Shuanghuanglian oral liquid was ranked among the top five adverse drug reactions caused by oral preparations of proprietary Chinese medicines [13]. At present, Shuanghuanglian oral liquid is being clinically studied in the Shanghai Public Health Clinical Center and Tongji Hospital, which is affiliated to the Huazhong University of Science and Technology[14]. Citation: Mi Li, Xue Yang, Kai Li. Traditional Chinese medicine for coronavirus pneumonia treatment: main force or supplement? Traditional Medicine Research 2020,online.

    • That is an interesting post, albeit rather difficult to read.

      Infectious diseases have plagued China for a long time, and TCM has been used against these diseases since ages.

      Just because something has been used for a long time doesn’t, of course, mean that it is effective; blood-letting and exorcism also have a long history.

      a treatment method for malaria using Qinghao (Artemisiae Annuae Herba) has been mentioned: “A handful of Qinghao (Artemisiae Annuae Herba), soaked in 2 liters of water and ground into juice, then take the juice for oral use.”

      Artemesinin, derived from this plant, is now a widely-used and effective drug against malaria.

      In Dou Ke Jin Jing Fu Ji Jie (Smallpox Treatments Collection, 1727 C.E.), it was clearly mentioned that the vaccination methods originated duringthe Longqingemperor periodofthe Ming Dynasty (1567 C.E.–1572 C.E.), furthermore, Huang Baijia (the son of the Ming dynasty’s famous thinker Huang Zongxi) wrote that a man named Fu Sichuan wasknown for hisvaccination technique [9]. During the early Qing dynasty (1636 C.E.–1722 C.E.), the Chinese population plummeted due to a smallpox epidemic [10].

      I should point out that in the context of smallpox, strictly speaking, this was inoculation (from Latin inoculare – to transplant), also known as variolation (variola is the medical neame for smallpox), not vaccination. Inoculation was certainly used for a long time in Western medicine as a way of preventing smallpox – my family has correspondence dating from the early 19th century between my great-great-great grandfather and his wife (who was away from home at the time) discussing whether they should get the children inoculated. The procedure involves taking material from one of the pustules of a smallpox victim and introducing it into the skin by means of a smal incision. Of course this carried the risk of spreading the infection, rather than producing immunity from it, but it was partially effective.

      Vaccination was invented by Edward Jenner and is a similar procedure, except that the infective material is taken from the pustules of a cowpox infection. Vaccinia is the name of the infection (from Latin vacca, which means cos). It works because the two infections are closely related and an immune response to one will protect against the other. Vaccinia is generally a mild infection.

      Feng (hemiplegic paralysis), Lao (tuberculosis), Gu (cirrhosis ascites), Ge (esophageal cancer) are known as the four major incurable diseases in TCM theory

      That is a rather curious quartet. Hemiplegic paralysis, in most cases, would be what we know call a stroke, a CVA (cerebrovascular accident) or apoplexy. Ascites (distension of the abdomen by free fluid) is a feature of advanced cirrhosis, and although in the West this is usually a result of alcohol abuse, worldwide the commonest cause is hepatitis B infection. Ascites does occur in other conditions, such as congestive cardiac failure and ovarian cancer. I’m surprised that they considered TB to be incurable, as spontaneous recovery can occur (though death is more common) and I would have thought they might want to take credit for it. I also wonder why oesophageal cancer should be considered any more incurable than any other cancer, though maybe it was more common in ancient China, and it is certainly harder to confuse with other diseases than most cancers are (the symptoms being progressive difficulty in swallowing leading to complete obstruction, extreme weight loss and death – until very recently the 2-year survival was 5%, but improvements in treatment over the past 10 – 15 years have changed that).

  • The power of the Chinese State over its people is absolute. They closed down a city more populous than London at a stroke. They built two hospitals in three days. The Chinese authorities are not going to entrust their people only to the care of TCM in those hospitals. National treasure or otherwise.

    The great leader of the dictatorial regime has decreed TCM to be a national treasure the equal of “Western” medicine. Where “TCM” does show some potential, science may identify exactly what chemistry is providing the benefit and develop it into a safe and effective medicine – as in the case of Artemisinin. China develops modern medicines where it is able to. Tu Youyou tested thousands of traditional compounds before finding success with Artemisinin.

    For every Artemisinin TCM has a coronavirus. TCM animal markets are a national treasure trove of pandemics.

  • One ingredient in the TCM formula mentioned above has Chinese Skullcap (Scutellaria baicalensis) and there are a number of results in PubMed regarding it including this one:

    Anticancer activity of extracts derived from the mature roots of Scutellaria baicalensis on human malignant brain tumor cells

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560162/

    • petrol also kills cancer cells in vitro

      • The article states:

        Various flavonoids isolated from this traditional Chinese medicinal plant were shown to have antiandrogenic and growth inhibitory activity against prostate cancer cells in vitro and in vivo [19-26]

        • Leo,

          Have you read the paper yourself, or any of the references quoted?

          Reference 19: “Gene profiling and promoter reporter assays: novel tools for comparing the biological effects of botanical extracts on human prostate cancer cells and understanding their mechanisms of action.”
          This study is looking at gene expression in a culture of cells derived from prostate cancer, and the effects of treating them with PC-SPES.

          Reference 20: “Characterization of chemical constituents in Scutellaria baicalensis with antiandrogenic and growth-inhibitory activities toward prostate carcinoma.”
          This describes the analysis of one of the herbs found in PC-SPES by gas chromatography, and then the testing of four of the chemicals found on a cancer cell culture grown in nude mice (that is, specially-bred mice with no immune system, which also happen to be hairless). They found some activity, thereby identifying a compound (baicalain) which is worthy of further testing. Whether it will eventually prove useful as an anti-cancer drug remains to be seen. This is still a very early stage in drug development, and most candidates fall by the wayside before reaching clinical use (they may be inactive in a real cancer in humans, they may be unstable or impossible to deliver in adequate doses, they may be toxic…).

          Reference 21: “Induction of apoptosis in prostate cancer cell lines by a flavonoid, baicalin.”
          This looks at the effects of the same compound on cells grown in culture.

          Reference 22: “Effects of the flavonoid baicalin and its metabolite baicalein on androgen receptor expression, cell cycle progression and apoptosis of prostate cancer cell lines.”
          Another in vitro study, this time also lookiong at a chemical derivative of baicalin, baicalein.

          Reference 23: “PC-SPES: Molecular mechanism to induce apoptosis and down-regulate expression of PSA in LNCaP human prostate cancer cells.”
          This again looks at PC-SPES and cells in culture.

          Reference 24: “Effect of flavonoids on cell cycle progression in prostate cancer cells”
          This paper is hidden behind a paywall, and I don’t fancy paying $35 to read it. The last sentence of the abstract reads:
          “These results suggest that flavonoids are potent regulators of cyclin B and p21 for cell cycle progression, which may play some roles in prevention of carcinogenesis.”
          This sort of molecular study is always useful in furthering our understanding of what happens in cancer cells.

          Reference 25: “PC-SPES inhibits cell proliferation by modulating p21, cyclins D, E and B and multiple cell cycle-related genes in prostate cancer cells.”
          PC-SPES and cell cultures again.

          Reference 26: “Contaminants of PC-SPES are not responsible for cytotoxicity in human small-cell lung carcinoma cells.”
          The abstract begins:
          “PC-SPES is a mixture of herbs used in the treatment of prostate cancer. Batches of this product were found to contain traces of synthetic drugs, and the product was removed from the market. ”

          Most of these studies were testing PC-SPES itself, although two of them looked at baicalin and baicalein, chemicals derived from one of the constituents of PC-SPES. PC-SPES was on sale about twenty years ago as a herbal treatment for prostate cancer, and was described as being a mixture of several herbal extracts. Anecdotally there were many good responses to it in patients with advanced prostate cancer, and indeed a colleague of mine became involved in setting up a clinical trial to examine its effects in a more formal setting. All of this unravelled, however, when it turned out that PC-SPES also contained diethylstilboestrol, indomethacin and warfarin.

          Diethylstilboestrol (DES) is a powerful synthetic oestrogen, which also has anti-cancer properties in prostate cancer separate from its hormonal effects. It is not available for prescription in the USA (they had something much more toxic called estramustine), but it was commonly used in the UK (less so now that we have a lot of better drugs available). I used to prescribe it regularly. Unfortunately it increases the risk of thromboembolic events (blood clots, including strokes and coronary thrombosis as well as deep vein thrombosis) so has to be given with an anticoagulant; we used warfarin for a while, but aspirin proved to be safer.

          Warfarin was presumably included wit PC-SPES to reduce the thromboembolic risk. It is a powerful anticoagulant, also used in commercial rat poisoning. It has to be closely monitored as it has a narrow therapeutic window (i.e. the dose has to be precisely matched to the patient – too little is ineffective and too much is toxic; the amount required varies widely between individuals).

          Indomethacin is the most powerful NSAID (non-steroidal anti-inflammatory drug) on the formulary. It is used where other drugs such as ibuprofen are insufficient (gout, severe inflammatory arthritis…). However, it is also the most toxic drug in this group, causing kidney damage, gastrointestinal upset and perforation, and internal bleeding. Its use with warfarin is absolutely contraindicated as the combination is so dangerous. However, I would expect anybody with bone pain from prostate cancer to find immediate relief from it.

          Once the true nature of SP-SPES was publically available, the manufacturers claimed that there had been contamination of some batches with traces of synthetic medication…

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

If you want to be able to edit your comment for five minutes after you first submit it, you will need to tick the box: “Save my name, email, and website in this browser for the next time I comment.”
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories