Prospective: Evolution of Chinese Medicine to Treat COVID-19 Patients in China

Abstract

During the outbreak of the novel coronavirus disease (COVID-19), the Chinese government took a series of public health measures to tackle the outbreak and recommended six traditional Chinese medicine (TCM) evolved formulas, collectively referred to as “3-drugs-3-formulas”, for the treatment. In this prospective article, we will discuss how these six formulas evolved from TCM and what their underlying mechanisms of actions may be by evaluating the historical usage of the component formulas, the potential targeted pathways for the individual herbs used by STAR (signal transduction activity response) database from our laboratory, and the pathogenesis of COVID-19. Five of the six recommended formulas are administered orally, while the sixth is taken as an injection. Five classic categories of herbs in the six formulas including “Qing-Re”, “Qu-Shi”, “Huo-Xue”, “Bu-Yi” and “Xing-Qi” herbs are used based on different stages of disease. All five oral formulas build upon the core formula Maxingshigan Decoction (MD) which has anti-inflammatory and perhaps antiviral actions. While MD can have some desired effects, it may not be sufficient to treat COVID-19 on its own; consequently, complementary classic formulas and/or herbs have been added to potentiate each recommended formula’s anti-inflammatory, and perhaps anti-renin-angiotensin system (RAS)-mediated bradykinin storm (RBS) and antiviral effects to address the unique medical needs for different stages of COVID-19. The key actions of these formulas are likely to control systemic inflammation and/or RBS. The usage of Chinese medicine in the six formulas is consistent with the pathogenesis of COVID-19. Thus, an integrative systems biology approach—combining botanical treatments of conventional antiviral, anti-inflammatory or anti-RBS drugs to treat COVID-19 and its complications – should be explored.

The Traditional Chinese Medicine Formula Jing Guan Fang for Preventing SARS-CoV-2 Infection: From Clinical Observation to Basic Research

“…Baicalein, which is purified from Scutellaria baicalensis Georgi, inhibits SARS-CoV-2 replication ( Huang et al, 2020 ). The extract from Bupleurum chinense DC exhibits anti-SARS-CoV-2 effects ( Wu et al, 2020 ). Extracts from Magnolia officinalis and Agastache rugose have an anti-inflammatory effect ( Seo et al, 2019 ; Ren et al, 2021 ).…”

Editorial: Ethnopharmacological Responses to the Coronavirus Disease 2019 Pandemic

“…also Brendler et al, 2021). The rest of the studies covered traditional medicine systems Ayurveda (Indian medicine), traditional, African, Unani, Kampo, and medicines from Bangladesh, Iran, Indonesia and Turkey ( Figure 1A ) ( Ai et al, 2020 ; Ayatollahi et al, 2021 ; Benarba and Pandiella, 2020 ; Chen et al, 2021 ; Fakhri et al, 2021 ; Ge and He, 2020 ; Jha et al, 2021 ; Kim, 2021 ; Kalhori et al, 2021 ; Lem et al, 2021 ; Li et al, 2020 ; Lim et al, 2021 ; Liu et al, 2020 ; Luo et al, 2020 ; Majnooni et al, 2020 ; Ma et al, 2021 ; Mandal et al, 2021 ; Peter et al, 2021 ; Qiu et al, 2020 ; Remali and Aizat, 2021 ; Ren et al, 2021 ; Silveira et al, 2020 ; Spicer, 2021 ; Verma et al, 2020 ; Wu et al, 2020 ; Wu et al, 2021 ; Yang et al, 2020 ; Zhang et al, 2020 ; Zhou et al, 2020 ).…”

Oral Chinese Herbal Medicine on Immune Responses During Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

“…CHM was believed to possess immunopharmaceutical effects by modulating lymphocyte functions and immune effector cells during COVID-19, based on absorption, distribution, metabolism and excretion evaluation, target prediction, network construction and functional bioinformatics analyses (9). The most common formulas utilized in COVID-19 treatments were "3-drugs-3-formulas" with multi-component and multitarget characteristics (10), and the most common herbs used in COVID-19 were Baical Skullcap Root (Huangqin, Radix Scutellariae Baicalensis) and Liquoric Root (Gancao, Radix Glycyrrhizae), which were also included in YIV-906 (PHY906), a safe prescription drug that inhibits several inflammatory processes with activation of innate and adaptive immunity, and would probably be the first Chinese medicine approved as an FDA prescription drug (6,11). Specifically, Baicalin, the active component of Baical Skullcap Root with antiviral and antibacterial effects, can inhibite inflammatory factors IL-6 and IL-1β, and activate the MAKP and NF-κB signaling pathways to induce IL-17 production, aiding the immune system (11).…”