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Traditional Chinese medicine in the treatment of SARS

Shi Ping Zhang, Liang Liu, Professor and Dean,Zhaoxiang Bian, Assistant Professor and Clinical Coordinator,School of Chinese Medicine, Hong Kong Baptist University   (21 July 2003)

Traditional Chinese medicine in the treatment of SARS 21 July 2003
Shi Ping Zhang, Assistant Professor School of Chinese Medicine, Hong Kong Baptist University, Liang Liu, Professor and Dean,Zhaoxiang Bian, Assistant Professor and Clinical Coordinator,School of Chinese Medicine, Hong Kong Baptist University Send response to journal: Re: Traditional Chinese medicine in the treatment of SARS	Editor-With the possibility of SARS returning before the arrival of an effective vaccine or anti-viral agent, there is a need to evaluate the treatment for SARS. Official figures showed that of the 5326 probable cases in China, 3104 had been treated with traditional Chinese medicine (TCM)[1]. Was TCM useful? Reports of clinical studies from Beijing, Guangzhou and Tianjin have recently been presented in conferences. One of these studies was a prospective, controlled trial, involving over 500 patients in 11 hospitals. Consensus from these studies suggested that, compared with Western medicine treatment alone, the addition of TCM treatment could help to reduce fatality rate, improve oxygen saturation in critically ill patients, and alleviate symptoms such as dyspnea[2]. The TCM treatment typically consisted of a dozen or so medicinal substances, mostly herbs. It was prescribed based on the pattern classification theory of TCM, directed to counteract the signs and symptoms associated with each stage of SARS. Most of the ingredients, such as herba houttuyniae, flos lonicerae and radix scutellariae, are in fact commonly used for relieving symptoms associated with viral or bacterial infections of the upper respiratory tract. TCM has a history of 3000 years in treating infectious diseases, and detailed documentation of treatment protocols can be found in many Chinese medical classics. The medicinal substances used are diverse, with properties such as anti-viral, anti-bacterial, anti-inflammatory, anti- pyretic or immunomodulatory. As natural substances they share one common advantage: they have been used on human for thousands of years without significant long term side effects. Maybe for this reason, tens of millions of people in China took TCM produces as a preventative measure during the SARS epidemic[3]. In contrast, the combination of ribavirin and steroid, which was the core of the Western medical treatment protocol, remains highly controversial because of their known side effects[4]. We have seen many post-SARS patients in Hong Kong left with symptoms of fatigue, dyspnea, insomnia, sweating, hair loss, amenorrhea and even mood disturbance. Although it is still not clear to what extent these symptoms are associated with damage by the organism(s) causing SARS, it is almost certain that some of them are iatrogenic. If the next SARS epidemic does eventuate, are we going to repeat the same combination, or will we try other unproven drugs? Perhaps it is time to learn more about the integration of TCM and Western medical treatment, as suggested by the WHO team at their visit to the Guangdong Provincial TCM Hospital in China this April. References: 1.Takungpao (A Chinese News Paper in Hong Kong), A16, 17-07-2003. 2.Prevention and treatment of SARS with TCM. Proceeding of a conference organized by the State Administration of TCM on 01-07-2003. 3.Chan M. Beijing imposes Sars-related price controls. South China Morning Post, 18-04-2003. 4.Cyranoski D. Critics slam treatment for SARS as effective and perhaps dangerous. Nature, 423(6935):4, 2003. Competing interests:   None declared