Roles of Chinese Medicine in prevention and recovery from infectious respiratory tract disease

Presented by TCM Doctor Sudhisak Pawaradhisan in APEC TCM Seminar, Beijing 17-18 Oct. 2014 

   “Prevention is better than cure”,  the principle which means it is much better to prevent than to allow an evil to overtake us and subsequently try to remove it. Chinese Medicine provides the methodologies called “expel exterior pattern” or the prevention of evil pass from exterior to interior which be consisted within this principle. By the experiences of using Chinese Medicine in prevention infectious respiratory tract diseases in Thailand, we have got several satisfactory results. In addition, Chinese Medicine is also useful in the rehabilitating of the patient from the diseases as well.

 


                Purposes of Study

                This study aims to evaluate the effect of Chinese Medicine in reducing the utilization and/or using frequency of antibiotics, and to evaluate the recovery of patients from illness after western medicine therapeutics.

                Methods

                Retrospective studies were carried out during March 2012-February 2014 on 2 groups of patients, age 5-15 years old; the first group of 44 patients, with the history of frequent diagnosis of respiratory tract disease and with repeated uses of antibiotics (1-2 times a month or long term used) or the patients with recurrent admitted to the hospital, and another group of 12 patients whom possessed some residual symptoms after using antibiotics treatment.

                Chinese Medicine formulas those used were depending on differential diagnosis as follow:
                Feng Han Ganmao formula was used in wind-cold syndrome (chills predominate over fever, low-grade fever, clear mucus, slightly white coating on the tongue, floating pulse).
                Yinqiao san formula was used in wind-heat syndrome (sore throat, fever predominates over chills, and body ache, thick or yellow color mucus, slightly yellow coating on the tongue, float and rapid pulse).

                Symptoms not clear to wind-heat or wind-cold syndrome were classified to wind syndrome and treated by Guizhitang formula.

                The Combined of Guizhitang and Yupingfengsan formula was used in Exterior-deficiency syndrome (recurrent cold, lassitude, weakness pulse).

                Evil invades to interior (no aversion to cold but aversion to heat, high fever, thirsty, severe sore throat, severe cough and thick yellow mucus, dark yellow urine, dry yellow coating on tongue) was treated by Yinqiaojiedu combine with Chuanxinlianpian, or Huanglianjiedupian, or Qingjinhuotanwan or Ganmaotuirekeli formulas.

                Residual symptoms after using western Medicine treatment (Chronic cough and phlegm, low grade fever, lassitude) were treated by the combination of Guizhitang and Yipingfengsan, Zhikehuatanwan or Shensuwan formulas.

                Dosage forms and Usage

                The formulas those used were prepared in patent drug and the usages were depended on age, illness condition and/or personal favorite as follow:

                Powder form: Each bag contains 4 grams crude drug, used in mild symptom. Take 1-2 bags a time, 3-4 times a day.

                Concentrated granule: Each bag contain 4 grams equivalent to 16 grams crude drug, Take 1-2 bags a time, 2-3 times a day.

                Concentrated pill: Each pill 0.2 gram equivalent to 0.8 grams crude drug. Take 6-16 pills a time, 3-4 times a day.

                Adjustment to decoction form may be needed in some cases.

                Course of treatment
                3-10 days is 1 course, in some cases need to continue for 3-4 courses.

 

                Evaluation of treatment

  1. Exterior syndrome and Evil pass to interior syndrome group
    Satisfied: Accomplishment of antibiotics usage reduction, completely stop using antibiotics
                     within 3 months.
    Fairly: Accomplishment on some degree of antibiotic usage reduction, occasionally use of
                antibiotics within 3 months.
    Unsatisfied: Cannot reduce antibiotics using.
  2. Recovery group
    Satisfy: All of the residual symptoms gone in 10 days.
    Fairly: Residual symptoms cured in 11-20 days.
    Low satisfy: Residual symptoms need to treat more than 20 days.

Results

  1. Exterior syndrome and Evil pass to interior syndrome group (n=44)
    Satisfied: 17 or 38.6%
    Fairly: 19 or 43.2 %
    Unsatisfied: 8 or 18.2%
  2. Rehabilitation group (n=12)
    Satisfied: 4 or 33%
    Fairly satisfied: 6 or 50%
    Unsatisfied: 2 or 16.7%

 

Summary and outlook

                The onset of infectious respiratory tract diseases mostly is cough, sore throat, runny nose, nasal congestion, headache, fever and sneezing, usually begins 1-3 days after an exposure. The treatment to stop illness in early stage is the important key in preventing severe infectious respiratory tract diseases. In Chinese Medicine theory, the therapeutic procedure called “Exterior resolving and Clearing heat methods” which correspondent to this concept has been used widely. In this retrospective review the 44 patients have the history of recurrent suffering from cold or upper respiratory tract infection and have the history those frequency using antibiotics for treatment. Using Chinese Medicine depend on differential diagnosis. Patients whom had exterior syndrome with obviously heat manifestation were classified to wind-heat syndrome and treated by Yingqiao san formula. Patients with obviously possess cold manifestation were normally classified as wind-cold syndrome and treated by Feng Han Ganmao formula. Patients with unclear hot or cold manifests were classified to wind sundrome and treated by Ghizhi tang formula. Patients whom had progression of diseases which evil from Exterior invades to Interior, depend on symptom, were separately used Chuanxinlian pian, Huanglianjiedu pian, Qingjinhuatan wan, or Ganmaotuire formulas combined with Yinqiaojiedu formula.

                The study showed that Chinese Medicine could reduce antibiotics usage. The satisfactory and fairly satisfactory rate reached 80%. The best efficacy was shown in early stage treatment when Exterior syndrome appears, and when they have signs of Evil invade to interior, the appropriate formula in a proper timing was needed. Chinese Medicine is also effective in helping patient’s health recovery. In patients with incomplete remission after ill from respiratory tract diseases still have residual symptoms such as chronic cough and phlegm or weakness, using combination of Guizhitang and Yupingfengsan, Zhikehuatanwan or Shensuwan formulas showed good efficiency.

                On the other hand, Chinese Medicine formula those used in this study was prepared in patent drugs. The results shows Chinese Medicine patent drug with good efficacy. This would be benefit for hospitals in Thailand, since most of the hospitals are Western Medicine. Up till now, Thailand has about 500 TCM doctor and 150 new graduates every year and would be gradually increases to 300 graduates each year in the next 5 years. Unfortunately, in the modern hospitals, most of them work as acupuncturist and difficult to prescribe herbal medicine for decoction because the Western doctor does not understand about Chinese Medicine. They need to know about ingredients in exactly composition and the regular dosage of herbals those used. The problems also involve with the insurance companies which need to know the capital for calculating insurance premium for health. So Chinese Medicine patent drug will influence on the important rules in using in Thailand hospital and the coordination between Chinese Medicine and Western Medicine in the near future.