In coronavirus, China weighs benefits of Buffalo Horn and other remedies

Sui-Lee Wee, The New York Times

Posted at Feb 06 2020 09:09 AM

As it races to treat patients infected with the new coronavirus, the Chinese government is seeing potential in a cocktail of antiviral drugs. It is also recommending the Peaceful Palace Bovine Pill, a traditional Chinese medicine made with the gallstones of cattle, buffalo horn, jasmine and pearl.

There is no known cure for the coronavirus that has sickened more than 24,000 people and killed at least 490 in China. The country’s National Health Commission said doctors should try treating patients mainly with a combination of Western drugs used to treat HIV and fight viruses, depending on the severity of illness.

But the government is also looking at ways to supplement the treatment with remedies that are integral to its national identity — traditional Chinese medicine. It has its supporters.

“I think it is the correct approach,” said Cheng Yung-chi, a professor of pharmacology at Yale University School of Medicine. “The evidence is going to come, and we have to give it the benefit of the doubt.”

There is no clinical proof that the roots of various plants, licorice, and the Peaceful Palace Bovine Pill can help combat the deadly disease. Practitioners said the regimen could help ease symptoms, such as swelling in the lungs, with fewer side effects. Critics said the use of such concoctions could raise concerns about patient safety.

The use of these ancient Chinese remedies dovetails with a push by Xi Jinping, China’s top leader, to harness them as a source of national pride. He has said that officials should place as much importance on traditional Chinese medicines as they do on Western medicines. His government has called for the remedies to be promoted in its “Belt and Road” trade route, China’s push to build ports, rail lines and other infrastructure around the world.

In turning to traditional medicine, China is relying on past experience. During the severe acute respiratory syndrome, or SARS, outbreak in 2002 and 2003, doctors found that steroids prescribed to reduce inflammation had harmful side effects such as bone destruction. Chinese medicine, they said, would mitigate some of these adverse reactions.

In its treatment plan for the coronavirus released Wednesday, the National Health Commission recommended traditional Chinese medicine remedies that could be used with antiretroviral HIV drugs like Lopinavir and Ritonavir. The national health department suggested trying the Peaceful Palace Bovine Pill for severe symptoms such as wheezing and respiratory distress.

Some hospitals are already using a combination of Western and Chinese medicines. In recent weeks, Beijing’s health department reported that two patients who were discharged had been treated with traditional Chinese medicines together with other unspecified drugs. And in Guangzhou, a major city in the south, health officials said 50 patients reported having no more fever and half of them said their coughs went away after using traditional Chinese medicines and other drugs.

Doctors are conducting clinical trials to test the efficacy of traditional Chinese medicine in Wuhan, the epicenter of the coronavirus outbreak, said Cheng, the expert at Yale, who is also chair of the Consortium for the Globalization of Chinese Medicine, a group of academics in the field.

Jiang Xianfeng, a traditional Chinese medicine practitioner at United Family Health, a top hospital for the affluent in Beijing, said these medicines are safe, effective and easy to get.

“Western medicine does not have better answers to this virus,” Jiang said. “The Chinese people have experienced these sort of plagues many times in our thousands of years of history. If traditional Chinese medicine was not effective, the Chinese people would already be destroyed.”

After the SARS outbreak, the World Health Organization studied the use of traditional Chinese medicine during that period and determined that they were safe and showed some potential in relieving symptoms such as fatigue and shortness of breath. Researchers from the United States and Taiwan found that certain herbs could suppress the virus if prescribed at specific concentration levels, while other studies said their findings were inconclusive.

That scientific uncertainty is not stopping the Chinese government. Since the second version of its treatment plan, the health commission has added more traditional Chinese medicines to the mix. Authorities in Wuhan said coronavirus patients with light or moderate symptoms should be treated with traditional Chinese medicine, the state-run Beijing News reported.

Zhu Mao, a representative of a traditional Chinese medicine manufacturer in Hubei, said he was producing more than 20,000 prescriptions per day at the request of the government. On Jan. 25, the State Administration of Traditional Chinese Medicine dispatched 25 teams of Chinese healers to Wuhan.

Traditional Chinese medicine teaches that disease arises from imbalances in the body and that some people have “hot” constitutions, therefore making them vulnerable to fevers and inflammations. When someone gets a fever or a respiratory illness, it is not uncommon to have Chinese people say, “You are on fire.”

Practitioners have determined that the coronavirus is a “hot” disease, and therefore, medicines should be prescribed to “clear the heat.”

It is unclear how the science works behind these medicines. Compounding the problem: There is no standardization for these herbs and regulation is poor.

Traditional Chinese medicine has also been linked to the consumption of exotic wild meats, though it is unclear whether the eating of the meats is really based on the practice. But some people, particularly in the south, believe that the way to achieving a balanced body is through eating certain meats. Wildlife markets such as the Huanan Seafood Market in Wuhan, the site that is believed to be the origin of the coronavirus, proliferated because of the demand for such meats.

Laurie Garrett, a member of the World Economic Forum’s global health security advisory board who covered the SARS outbreak in China, said that using traditional Chinese medicine in the new coronavirus outbreak could be risky because the approach is not rigorously backed by research.

“There’s no such thing as dosing,” she said. “It’s like being a chef in a kitchen.”

The prestigious science journal Nature pointed out that dozens of women who had taken Chinese herbs as part of a weight-loss program ended up with kidney failure in the 1990s. Proponents of traditional Chinese medicine said the herbs were misused. Still, Nature argued in a 2017 editorial, “Hundreds of years of use in clinics that don’t standardize or analyze the clinical data are no match for blinded, controlled studies.”

Doctors in neighboring Hong Kong, a semi-autonomous region of China, are not convinced that traditional Chinese medicines can help. “I am not trying to devalue their treatment, but this is not something we practice,” said Arisina Ma, president of the Hong Kong Public Doctors Association.

In China, people have searched anxiously for ways to protect themselves. In many Chinese cities, some stood in line for hours to buy “Shuanghuanglian” — a herbal concoction that mixes flowers such as honeysuckle and forsythia, among other ingredients — after two government-backed research institutes published a study that said it was effective in preventing the coronavirus.

Chen Xi, an assistant professor of health policy and economics at the Yale School of Public Health, urged Chinese news media to be more careful in its reporting, saying that the potential for traditional Chinese medicine to inhibit a virus is not equivalent to a form of prevention or treatment.

“If incidents like Shuanghuanglian happen again and again, it will lose the public trust, cause more panic and go against the authorities’ advice to avoid crowd gathering,” Chen wrote.

Qin Xi, a manager of a pharmacy in Beijing, said sales of some of his traditional Chinese medicines, including “Shuanghuanglian,” have been off the charts. “As for whether it works, who knows?” he said.

c.2020 The New York Times Company