EFFICACY & SAFETY OF TCM

Traditional Chinese Medicine

Herbalism Acupuncture

Moxibustion Cupping

Massage
Therapy
Herbal Chinese Medicine for COVID-19

Chinese official announced at a press conference that indications of four herbal

drugs were approved to be expanded to include COVID-19 symptoms.

This included HuoxiangZhengqi (HXZQ), Lianhuaqingwen (LHQW) and

ShufengJiedu (SFJD), and Xuebijing (injectable) for severe conditions.

The official claimed the patent herbal drugs can effectively relieve symptoms, such
as fever, cough, and fatigue, and reduce the probability of patients developing
severe conditions, but without giving further details

National Health Commission. Press conference of the joint prevention and control mechanism of the State Council on April
14, 2020
 Herbal Chinese Medicine
for COVID-19

Tong et al. Chin Med (2020) 15:51

Herbal Chinese Medicine for COVID-19
Hypothesis of mechanism LianhuaQingwen (LHQW)
Chin Med; 2020 May 24;15:51
Herbal Chinese Medicine for COVID-19 in e-commerce
Zeng M, Li L, Wu Z (2020) Traditional Chinese medicine Lianhua Qingwen
treating corona virus disease 2019(COVID-19): Meta-analysis of
randomized controlled trials. PLOS ONE 15(9): e0238828.
https://doi.org/10.1371/journal.pone.0238828
Xuebijing in COVID-19

RCT 3 arms (20 per arm): Xuebijing 50

mL or 100 mL (twice daily for 7 days)
vs. standard treatment

APACHE II score after treatment was

significantly lower than those in routine
treatment and Xuebijing 50 mL groups
(12.3±1.5 vs. 16.5±1.6, 15.9±1.4, both
P < 0.05).
Key chemical classes identified in Herbal Chinese Medicine as described
in pharmacopoeia monographs
Br J Clin Pharmacol 80:4; 834-843

Pyrones, quinones and

Alkaloids. Flavonoids other oxygenated Terpenes
compounds.

• Several alkaloids • Flavans, flavanones, • Some quinones form

derived from plant flavanonols, active oxygen radicals
sources have anthoxanthins and in vivo after
significant adverse anthocyanidins. biotransformation,
effects when they • They are considered which are toxic to
interact with the safe, apart from the body after
nervous system interactions with prolonged usage
• Some herbal Chinese anticoagulant with high dose,
medicine contain treatment. similar to paracetamol
pyrrolizidine alkaloids overdose poisoning.
that are hepatotoxic
 Intrinsic toxic chemicals found in certain Herbal Chinese
Medicine, only prescribed by experienced TCM practitioners

Aconitines.
• Aconiti kusnezoffii Radix Preparata (Zhicaowu), Aconiti Radix Preparata (Zhichuanwu) and Aconiti lateralis
Preparata (Fuzi) contain the toxin aconitine and related alkaloids.
• The Chinese monographs emphasize that the total content of the three alkaloids should not be >0.02%.

Strychinine and brucine.

• Processed Strychni semen (Maqianzi) contains 1.2–2.2% of strychnine and 0.8% brucine calculated with
reference to the dried drug

Pyrrolizidine alkaloids.
• Arnebiae seu Lithospermi Radix (Zicao), Senecio scandens (Qianliguang) and Tussilago farfara Flos
(Kuandonghua).
• Potentially cause human health problems, such as liver disease

Aristolochic acid.
• Caused end-stage renal disease cases
Most common Chinese herbal medicines with hepatotoxicity

Journal of Clinical and Translational Hepatology 2(3):170-175

Herbal
Induced Liver
Injury (HILI)

Journal of
Ethnopharmacology 233
(2019) 190–196
156 (8) June 2019: 2230-2241
 Problems with
the herbal
Chinese
products

Adv Pharmacoepidemiol Drug Saf 2016, 5:4

Adverse reaction associated with herbal Chinese medicines: little
known

Interaction with conventional drugs, foods and alcohol

Pharmacodynamics, pharmacokinetics effects on groups of patients: pediatric,

elderly, pregnant women etc.

Post marketing studies are rare

Evidence on the therapeutic effect of herbal remedies (clinical trial only for
Phytopharmaca)
THANK YOU