Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs

Journal article

Luo, H., Tang, Q-L., Shang, Y-X., Liang, S-B., Yang, M., Robinson, N. and Liu, J-P. (2020). Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs. Chinese Journal of Integrative Medicine. https://doi.org/10.1007/s11655-020-3192-6
AuthorsLuo, H., Tang, Q-L., Shang, Y-X., Liang, S-B., Yang, M., Robinson, N. and Liu, J-P.
Abstract

Objective: Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in
Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending
Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed
ancient classics and human studies. Methods: Historical records on prevention and treatment of infections in
CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1
influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were
retrieved from different databases and websites till 12 February, 2020. Research evidence included data from
clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.
Results: The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice
cited in Huangdi's Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3
studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM
contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than
the non-CM group (relative risk 0.36, 95% confidence interval 0.24–0.52; n=4). For prevention of COVID-19, 23
provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external
pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included
Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis
Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao). Conclusions:
Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal
formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous
population studies are warranted to confirm the potential preventive effect of CM.

This is a post-peer-review, pre-copyedit version of an article published in Chinese Journal of Integrative Medicine

Year2020
JournalChinese Journal of Integrative Medicine
PublisherSpringer
Digital Object Identifier (DOI)https://doi.org/10.1007/s11655-020-3192-6
Web address (URL)https://link.springer.com/article/10.1007/s11655-020-3192-6
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Online17 Feb 2020
Publication process dates
Accepted14 Feb 2020
Deposited14 Feb 2020
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Zanardelli, I and Robinson, N. (2018). Factors that influence patients’ decisions to discontinue with an acupuncture service—A qualitative study. European Journal of Integrative Medicine. 25, pp. 92-99. https://doi.org/10.1016/j.eujim.2018.12.004
If music be the food of life – play on ?
Bonde, LO and Robinson, N. (2017). If music be the food of life – play on ? European Journal of Integrative Medicine. 9 (1).
Women’s health and Chinese integrative medicine
Qu, F, Wang, FF, Robinson, N. and Hardiman, P (2017). Women’s health and Chinese integrative medicine. Journal of Zhejiang University: Science B. 18 (3), pp. 183-185. https://doi.org/10.1631/jzus.B17ed001
TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION IMPROVES THE OUTCOMES OF IN VITRO FERTILIZATION: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY
Qu, F, Wang, F-F, Wu, Y, Zhou, J, Robinson, N., Hardiman, P, Pan, J-X, He, Y-J, Zhu, Y-H, Wang, H-Z, Ye, X-Q, He, K-L, Cui, L, Zhao, H-L and Ye, Y-H (2017). TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION IMPROVES THE OUTCOMES OF IN VITRO FERTILIZATION: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY. Explore: The Journal of Science & Healing. 13 (5), pp. 306-312. https://doi.org/10.1016/j.explore.2017.06.004
The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis
Qu, F., Yan, W., Hu, X-Y., Barry, J.A., Zhou, J., Wang, F-F., Ye, Y-H., Han, S-P., Li, R., Taw, M.B., Hardiman, P.J. and Robinson, N. (2016). The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis. European Journal of Integrative Medicine. 8 (1), pp. 12-18. https://doi.org/10.1016/j.eujim.2016.02.001
The role of complementary and alternative medicine (CAM) in sexual and reproductive health
Qidwai, W, Wong, W, Nanji, K and Robinson, N. (2016). The role of complementary and alternative medicine (CAM) in sexual and reproductive health. European Journal of Integrative Medicine. 8 (1), pp. 1-3. https://doi.org/10.1016/j.eujim.2016.02.003
The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare?
Robinson, N. (2016). The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare? World Journal of Traditional Chinese Medicine. 2 (1), pp. 74 - 79. https://doi.org/10.15806/j.issn.2311-8571.2015.0029
Harmonising data collection from osteoarthritis studies to enable stratification: Recommendations on core data collection from an Arthritis Research UK clinical studies group
Kingsbury, SR, Corp, N, Watt, FE, Felson, DT, O'Neill, TW, Holt, CA, Jones, RK, Conaghan, PG, Arden, NK, Adams, J, Appleyard, I, Birrell, F, Blank, M, Callaghan, MJ, Cumming, J, Chapman, GJ, Halstead, J, Hamilton, DF, Hurley, M, Martin, K, Mason, DJ, Nuki, G, Redmond, AC, Reilly, K, Robinson, N., Roddy, E, Simpson, H, Smith, TO, Thomas, C, Thomas, E, Wilkinson, J and Wise, E (2016). Harmonising data collection from osteoarthritis studies to enable stratification: Recommendations on core data collection from an Arthritis Research UK clinical studies group. Rheumatology (United Kingdom). 55 (8), pp. 1394-1402. https://doi.org/10.1093/rheumatology/kew201
Introducing “Evidence for clinical practice” [Editorial]
Alper, BS, Malone-Moses, M, Manheimer, EW and Robinson, N. (2016). Introducing “Evidence for clinical practice” [Editorial]. European Journal of Integrative Medicine. 8 (3), pp. 147-149. https://doi.org/10.1016/j.eujim.2016.04.008
Pediatric integrative medicine needs research evidence to guide decision-making
Gardiner, P and Robinson, N. (2016). Pediatric integrative medicine needs research evidence to guide decision-making. European Journal of Integrative Medicine. 8 (2), pp. 79 - 80. https://doi.org/10.1016/j.eujim.2016.03.015
Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial
Ley, C., NI, Q, Liao, X, Gao, H-L and Robinson, N. (2016). Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial. Chinese Journal of Integrative Medicine. 22 (10), pp. 728-737. https://doi.org/10.1007/s11655-016-2521-2
General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study
Czarnawska-Iliev, I and Robinson, N. (2016). General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study. European Journal of Integrative Medicine. 8 (4). https://doi.org/10.1016/j.eujim.2016.07.004
Evidence is in the Eye of the Beholder: The case of the 2016 draft NICE Guidelines for Low Back Pain [editorial]
Hopper Koppelman, M, Bovey, M and Robinson, N. (2016). Evidence is in the Eye of the Beholder: The case of the 2016 draft NICE Guidelines for Low Back Pain [editorial]. European Journal of Integrative Medicine. 8 (4).
Common mistakes when using plant names and how to avoid them
Dauncey, EA, Irving, J, Allkin, R and Robinson, N. (2016). Common mistakes when using plant names and how to avoid them. European Journal of Integrative Medicine. 8 (5), pp. 597-601. https://doi.org/10.1016/j.eujim.2016.09.005
Integrating acupuncture: are there positive health outcomes for women?
Robinson, N. (2016). Integrating acupuncture: are there positive health outcomes for women? Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology). 18 (3), pp. 233-238. https://doi.org/10.1631/jzus.B1600260
Is traditional Chinese medicine recommended in Western medicine clinicalpractice guidelines in China? A systematic analysis.
Ren, J, Xun, Li, Sun,, J, Han, M, Yang, G-Y., Li, W-Y., Robinson, N. and Lewith, G. (2015). Is traditional Chinese medicine recommended in Western medicine clinicalpractice guidelines in China? A systematic analysis. BMJ Open. 5 (6), pp. e006572-e006572. https://doi.org/10.1136/bmjopen-2014-006572
Traditional Chinese Medicine - challenges for research
Robinson, N. (2015). Traditional Chinese Medicine - challenges for research. in: McCarthy, P.W. and Langweiler, M. (ed.) Methodologies for Effectively Assessing Complementary and Alternative Medicine (CAM) London Singing Dragon.
Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study
Trevelyan, EG, Turner, WA, Summerfield-Mann, L and Robinson, N. (2015). Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study. Trials. 16, p. 158. https://doi.org/10.1186/s13063-015-0668-3
The politics of integrative medicine: The case of CAM
Saks, M and Robinson, N. (2015). The politics of integrative medicine: The case of CAM. European Journal of Integrative Medicine. 7 (6), pp. 557-560. https://doi.org/10.1016/j.eujim.2015.11.019
GAP: From sound design to practical implementation in clinical trials for traditional chinese medicine
Shang, H, Zhang, B, Bian, Z, Li, Y, Clarke, M and Robinson, N (2014). GAP: From sound design to practical implementation in clinical trials for traditional chinese medicine. Evidence-based Complementary and Alternative Medicine. 2014, pp. 1-2. https://doi.org/10.1155/2014/560838
The quest for modernisation of traditional Chinese medicine
Xu, Q, Bauer, R, Hendry, BM, Fan, TP, Zhao, Z, Duez, P, Simmonds, MSJ, Witt, CM, Lu, A, Robinson, N, Guo, DA and Hylands, PJ (2013). The quest for modernisation of traditional Chinese medicine. BMC Complementary and Alternative Medicine. 13 (1), pp. 132-. https://doi.org/10.1186/1472-6882-13-132
A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy.
Franconi, G, Manni, L, Schröder, S, Marchetti, P and Robinson, N. (2013). A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy. Evidence-Based Complementary and Alternative Medicine (eCAM). 2013, p. 516916. https://doi.org/10.1155/2013/516916
The evidence for Shiatsu: A systematic review of Shiatsu and acupressure
Robinson, N, Lorenc, A and Liao, X (2011). The evidence for Shiatsu: A systematic review of Shiatsu and acupressure. BMC Complementary and Alternative Medicine. 11 (1), pp. 88-. https://doi.org/10.1186/1472-6882-11-88
The RCCM 2009 survey: Mapping doctoral and postdoctoral CAM research in the United Kingdom
Robinson, N and Lewith, G (2011). The RCCM 2009 survey: Mapping doctoral and postdoctoral CAM research in the United Kingdom. Evidence-based Complementary and Alternative Medicine. 2011, pp. 1-4. https://doi.org/10.1093/ecam/nep184
How parents choose to use CAM: A systematic review of theoretical models
Lorenc, A, Ilan-Clarke, Y, Robinson, N and Blair, M (2009). How parents choose to use CAM: A systematic review of theoretical models. BMC Complementary and Alternative Medicine. 9 (1), pp. 9-. https://doi.org/10.1186/1472-6882-9-9