Alternative Treatment Protocols for Covid-19

# Traditional Thai, Chinese (TCM) Medicine, etc.

DISCLAIMER: This information is for educational purposes only. It is not intended to serve as a substitute for diagnosis, treatment, or advice from a qualified, licensed medical professional. Any treatment you undertake should be discussed with your physician or other licensed medical professional.

NOTE: The information in this tabulation about dosages is primarily for adults. The dosages for children have been mentioned in the case of a few over-the-counter remedies where the data was available.

# 1. Traditional Chinese Medicine: Qing Fei Pai Du Tang (QFPD), a Lung Cleansing and Detoxifying Decoction

# Objective:

Treatment of Covid-19 in the mild to severe stages, and to clear congestive ailments of the lungs.

# System:

TCM.

# Can be used alongside other allopathic treatments:

Yes.

# Status of authorisation:

The Chinese Government is an ardent promoter of TCM. Qingfei Paidu decoction. QFPD has been widely used in treating COVID-19 in China, and is reported, in fact, to be the most commonly used decoction in the clinical treatment of Covid-19 in mild, moderate and severe stages.

The traditional remedy is not authorized in the US by the FDA.

# Protocol and treatment approach:

QFPD is the medication that is found to be most commonly used in the clinical treatment of Covid-19 in all of its stages, mild, moderate or severe, reportedly with very good results. In addition, it has been clinically established to be an adequate prophylactic as well in low dosages (verified at 1/30 of therapeutic dosage).

Qing Fei Pai Du Tang is comprised of multiple concordant prescriptions, including Maxing Shigan decoction, Shegan Mahuang decoction, Xiaochaihu decoction, and Wuling powder, which contribute to the symptomatic efficacy of QFPD. It is based on 21 herbs from 4 different herbal formulas, originally found in the Shang Han Lun (Treatise on Cold Damage Diseases). This Han dynasty clinical textbook was compiled by Zhang Zhongjing prior to 220 CE. A study of the pharmacological action of QFPD demonstrated that the therapy possessed five functional modules including immune regulation, anti-infection, anti-inflammation, and multi-organ protection, which is attributed to the multi-component, multi-target, and multi-pathway characteristics of QFPD.

The herbs in Qing Fei Pai Du Tang are the following:

  1. Ma Huang 9g (Ephedra sinica)
  2. Zhi Gan Cao 6g (Glycyrrhiza glabra / Liquorice)
  3. Bai Zhu 9g (Atractylodes macrocephala)
  4. Shan Yao 12g (Dioscorea / Red yeast rice)
  5. Ku Xing Ren 9g (Semen armeniacae amarae / Bitter apricot seed)
  6. Shi Gao 15-30g (Gypsum fibrosum / Gypsum)
  7. Gui Zhi 9g (Ramulus cinnamomi cassiae / Cinnamon twig)
  8. Ze Xie 9g (Rhizoma alismatis / Water plantain rhizome)
  9. Zhu Ling 9g (Polyporus / Umbel polypore mushroom / Pig fungus)
  10. Fu Ling 15g (Sclerotium Poriae Cocos / Tuckahoe / China-root / Indian bread)
  11. Huo Xiang 9g (Herba agastaches / Pogostemonis / Patchouli / Wrinkled giant hyssop / Rugose giant hyssop)
  12. Chai Hu 16g (Radix bupleuri / Hare's ear root / Thorowax root / Asian buplever root)
  13. Huang Qin 6g (Radix scutellariae / Baical skullcap root / Scutellaria / Scute)
  14. Jiang Ban Xia 9g (Pinelliae rhizoma / Pinellia tube or root)
  15. Zi Wan 9g (Radix asteris / Aster root / Purple aster / Tatarian aster)
  16. Sheng Jiang 9g (Rhizoma zingiberis recens / Fresh ginger root)
  17. Kuan Dong Hua 9g (Flos farfarae / Tussilago flower / Coltsfoot flower)
  18. She Gan 9g (Rhizoma belamcandae / Belamcanda rhizome / Blackberry lily rhizome)
  19. Xi Xin 6g (Herba cum radix asar / Asarum / Chinese wild ginger / Manchurian wild ginger / Seoul wild ginger / Siebold wild ginger)
  20. Zhi Shi 6g (Fructus aurantii immaturus / Immature or unripe bitter orange)
  21. Chen Pi 6g (Pericarpium citri reticulatae / Aged or ripe tangerine rind / Orange peel)

# Typical duration of treatment:

1-2 weeks.

# Outcome:

Conclusions: The integration of TCM with Western medicine has significantly improved the treatment for COVID-19 patients compared to Western medicine treatment alone. Combined therapy using TCM and Western medicine revealed the potential adjunctive role of TCM in treating COVID-19. A review of 483 studies on tens of thousands of adult patients, including a Randomized Controlled Trial, revealed that the combination with QFPD could significantly shorten the length of hospital stay compared with conventional treatment. Treatment started within a week of symptom onset was significantly associated with a reduction in the median duration of hospital stay of 1–4 days compared with later treatment. A non-randomized study also found that the median length of hospital stay (16 days) in a combined group was significantly longer than the QFPD alone group (9 days). For the in-hospital mortality, studies indicated that the crude mortality was 1.2% among patients receiving QFPD and 4.8% among those not receiving QFPD. After adjustment for patient characteristics and concomitant treatments, the use of QFPD was associated with a relative reduction of 50% in in-hospital mortality.

# Significant side effects:

TCM is, in general, and like other traditional systems of medicine, known to have fewer adverse effects than conventional allopathic medicine.

Some herbs in the concoction are known to be toxic, and therefore it is necessary to consult with a knowledgeable physician or buy certified products with therapeutic quantities of the herbs. However, when therapeutic dosages are administered, no serious adverse reactions related to QFPD were observed. A systematic review of hundreds of existing research articles revealed the rate of overall adverse reactions of QFPD to be low, often ranging from 3-6 %, including diarrhea, nausea and vomiting, skin itch, and symptoms were mild.

Recommended to stock QFPD for at least 60 servings for one individual, for a twice daily dosing for a month in the presence of symptoms.

# Price:

Expensive, INR 1300 - 4600 if bought from suppliers in the US.

# Suggested suppliers:

This herbal formula is unavailable in the USA because the US FDA (Food & Drug Administration) has severe restrictions on the sale of Ma Huang and has made Xi Xin a banned herb. Xi Xin is a type of wild ginger that is toxic and must only be used by licensed acupuncturists trained in proper usage. For well over a thousand years, this herb has been safely used in Chinese herbal medicines by highly trained Chinese medicine physicians; however, widespread consumer access to this herb presents legal complications and challenges.

# Further references:

# 2. Jinhua Qinggan (JHQG) granules and Lianhua Qingwen (LHQW) capsules, recommended during medical observation

Qingfei Paidu or Lung Cleansing and Detoxifying Decoction (QFPD or LCDD), recommended for the treatment of both severe and non-severe patients; Xuanfeibaidu (XFBD) granules, recommended for treating moderate cases; Huashibaidu (HSBD); Xuebijing (XBJ) injection, used in managing severe cases effectively.

# Objective:

The mitigation of Covid-19 in asymptomatic, mild and sevre stages of the diseases.

# System:

TCM.

# Can be used alongside other allopathic treatments:

Yes.

# Status of authorisation:

These six Traditional Chinese Medicine (TCM) recipes have been shown to be remarkably effective for treating patients with COVID-19. In guidelines on fighting COVID-19, the Chinese National Health Commission (NHC) has recommended some traditional Chinese medicines (TCM), including Jinhua Qinggan granules, Lianhua Qingwen capsules, XueBijing injections, a Qingfei Paidu decoction, a Huashi Baidu decoction, and a Xuanfei Baidu decoction.

One review, published in Phytomedicine in May, 2021, notes: TCM is effective in preventing COVID-19, and medical staff can prevent an iatrogenic infection by taking a decoction made based on the principles of TCM. As of March 13, 2020, new cases of COVID-19 in China have decreased in number to single digits. TCM's curative effect was outstanding, with a national participation rate of over 90%. More than 70,000 people were cured of COVID-19 and discharged from the hospital. Only approximately 10,000 patients are currently being treated, and the total treatment time is approximately 2 months.

# Protocol and treatment approach:

There is detailed information about these 6 medications in the following scientific publication that appeared in Pharmacology & Therapeutics, Sep, 2021: Traditional Chinese Medicine (TCM) in the treatment of COVID-19 and other viral infections: Efficacies and mechanisms; Kai Huang et al. (opens new window)

QFPD is the medication that is found to be most commonly used in the clinical treatment of Covid-19 in all of its stages, mild, moderate or severe, reportedly with very good results. In addition, as QFPD contains Ganjiang Gancao, it has been clinically established to be an adequate prophylactic as well in low dosages (verified at 1/30 of therapeutic dosage).

In these six highly effective TCM recipes, Chinese formula medicines of Jinhua Qinggan granules (JHQG) and Lianhua Qingwen capsules (LHQW) are recommended for treating patients during medical observation/early stage of disease development, when fatigue and fever are presented as the primary clinical manifestations (Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia [Trial Version 7], 2020). Lung Cleansing and Detoxifying Decoction (LCDD) (also known as Qingfei Paidu, QFPD) is recommended for treating both severe and non-severe patients. Xuanfeibaidu granules (XFBD) on the other hand, are recommended for treating moderate cases; while Huashibaidu granules (HSBD) and Xuebijing (XBJ) have been used in severe cases.

HSBD and XFBD were specially formulated for Covid. HSBD can be used in the treatment of mild, moderate and severe infection.

Summary of treatment modality options with the 6 key medications recommended for the treatment of Covid-19 in TCM: Safety indicator values, rating out of 1.0, attributed to each medication is specified next to it, according to one AI-driven study of adverse effects associated with these 6 medications:

Safety indicator values of the six key medications could be used to guide treatment choices, and the safety study cited deduced that QFPD, HSBD and XFBD are the medications here that are the least associated with adverse effects, but disease development may require the use of other medications.

# Typical duration of treatment:

1 week to 2 months.

# Outcome:

Studies have identified these six traditional herbal medicines as being the most effective at treating Covid. TCM's curative effect was outstanding, with a national participation rate of over 90%. More than 70,000 people were cured of COVID-19 and discharged from the hospital.

TCM is also effective in preventing COVID-19, and medical staff can prevent an iatrogenic infection by taking a decoction made based on the principles of TCM. Studies reveal that none of the medical staff was infected in the TCM hospitals or when using a TCM method like prophylaxing with a decoction containing Ganjiang Gancao.

# Significant side effects:

The commonly prescribed effective drugs with the least rating on the safety indicator scale are JHQG granules (recommended also during medical observation), graded 0.06, and XBJ (used in managing severe cases), graded 0.01.

From these analyses, it would appear that QFPD and HSBD are suitable to be selected as a main line of therapy in the mild and severe stages of the disease, coupled with XFBD used in the treatment of moderate infection.

At the same time, the outcome of treatment with TCM along with conventional therapy seems better with respect to longer term prognosis than Standard Of Care treatment.

# Price:

TCM medications may be expensive to procure in India and other States outside China.

# Suggested suppliers:

# Further references:

# 3. Thai traditional / indigenous medicine, Fah Talai Jone / Green Chiretta / Echinacea / Andrographis Paniculata (Kaalamegha / Kiraayat / Nilavempu in Sanskrit / Hindi / Tamil, respectively)

# Objective:

Effective early treatment of Covid-19.

# System:

Indigenous or traditional herbal medicine.

# Can be used alongside other allopathic treatments:

Probably can be used alongside Standard Of Care therapy, as it is found that herbal medications are suitable to be used as adjunct therapy.

# Status of authorisation:

Fah talai jone or green chiretta (Andrographis paniculata) has been widely used for centuries in Thailand and some neighboring countries as a treatment for acute respiratory tract infection and to reduce inflammation and coughing.

Evidence-based data from clinical trials in Thailand suggest that the treatment is reported to have been effectively used to treat over 69,000 prisoners with Covid-19 in a large-scale clinical trial. The prisoners themselves work to grow the crop, harvest, dry and grind the mature stem into a dark green powder, which is then packed in capsules to be shipped to other prisons. In July, 2021, Thailand's cabinet approved Green chiretta for use in people with asymptomatic or mild coronavirus infections following a successful trial in prisons.

The suitable dosage of andrographolide for patients is reported to be still debatable, and needs further studies to verify its efficacy and side effects. Two more trials of green chiretta involving COVID-19 patients with mild symptoms are being conducted on 1,400 people, with initial results due next spring.

Andrographis paniculata or Indian echinacea or Kaalamegha (Sanskrit) or Nila is, in fact, an important medicinal herb in Ayurveda and Siddha Vaidya, for its anti-inflammatory, antiretroviral and anticoagulant properties. It has an inhibitory effect on spike glycoproteins, and is effective in healing colds, flu, sinusitis and upper respiratory tract infections.

# Protocol and treatment approach:

Research suggests that Green chiretta has a substance called Andrographolide that helps limit the spread of the virus. "Andrographolide is a substance found in Green chiretta that helps suppress viruses and inflammation," says Associate Professor Dr Mayuree Tangkiatkumjai, of the Cepartment of Clinical Pharmacy at Srinakharinwirot University.

The recommended dosage, according to some literature, is 1-2 g of the powder (when consumed as capsules) twice daily after meals.

# Typical duration of treatment:

1-3 weeks, when treatment is commenced soon after onset of symptoms.

# Outcome:

The government claims that out of 11,800 inmates who took it to treat Covid-19 in July, 2021, 99.02% recovered. Often overcrowded and cramped, the virus has spread rapidly in Thailand's jails.

Around a quarter of the country's prisoners tested positive in the six months from April 2021. During an outbreak of COVID-19 in August, more than 700 inmates took 15 pills a day for five days. Staff say all of them recovered. Jail medic Chitsanuphong Saublaongiw believes the traditional tablet was effective in easing mild symptoms.

After taking the Green chiretta, the prisoners are reported to have had better chest X-ray results, fewer symptoms, the disease was less severe, and they returned to normal quickly. Asymptomatic patients didn't develop any severe symptoms. Thus the inexpensive and readily available Green chiretta has offered Thailand an alternative option for those in the early stages of COVID-19 at a time when the country has been tackling a surge in cases.

The suitable dosage of Andrographolide for patients is reported to be still debatable, and needs further studies to ascertain its efficacy and side effects.

# Significant side effects:

Fah talai jone is a widely used traditional herbal medicine for respiratory inflammation in Thailand and no significant side effects have been reported in large-scale clinical trials conducted thus far. However, it is known in Ayurveda to cause dizziness, heart palpitations and infertility in higher doses. Pregnant women are recommended not to have it.

1-2 containers of these products could be stocked for prophylactic use after exposure.

# Price:

About INR 200.

# Suggested suppliers:

# Further references:

# 4. Prescription of Rhizoma Zingiberis Recens or fresh ginger root and Fructus jujube or jujube fruit

# System:

TCM.

# Can be used alongside other allopathic treatments:

Yes.

# Further references:

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