Total Harmony Medicine

Respiratory tract

Respiratory tract diseases

Morbidity and mortality from diseases related to the respiratory tract is high worldwide and 90% of respiratory infections are caused by viruses., the majority of which are RNA viruses, such as orthomyxoviruses, paramyxoviruses, and coronaviruses, and rhinoviruses, and some of which are DNA viruses, such as adenoviruses.

Respiratory viruses are highly contagious and transmitted mainly through respiratory secretions, stools, urine, droplets, air and contact. Most respiratory viruses occur in seasonal outbreaks, with infants, the elderly, and immune-compromised populations at high risk and the prevalence and severity vary across geographical regions and populations Infection often causes oral, nasal, and pharynx discomfort, airway inflammation, and lung injury, and serious cytokine storms may result in acute respiratory distress and multiple organ failure, and even lead to death of patients.

Thus, the prevention and treatment of respiratory virus diseases is a crucial global health issue. Guided by the basic theory of TCM, TCMs have unique advantages in the prevention and treatment of respiratory viruses through the overall regulation of human immune function due to its multi-component and multi-target characteristics.

The basic theory of TCM has “holism” as its guiding principle and “syndrome differentiation and treatment” as its method of diagnosis and treatment, guiding the use of TCMs against viruses. The principle of holism regards the body as an organic whole and understands the occurrence and development of local diseases as related to the whole; thus, local diseases can only be treated effectively by considering the whole body. The concepts of syndrome differentiation and treatment are defined as follows. Syndrome differentiation is the process of proving and distinguishing the type of disease, that is, knowing the location, etiology, properties, and the relationship between the “zheng (energy)” and “xie (evil)” of the disease, which reflect the nature of pathological changes. Treatment is the process of identifying the appropriate treatment methods according to the results of syndrome differentiation.

According to TCM theory, there are two main ways that antiviral TCMs work, which are “dispelling evil” and “fu zheng”. Dispelling evil refers to the elimination of viruses, which is usually direct inhibition or killing of viruses by Chinese herbs. The mechanism of action of this kind of herb is like that of direct-acting antiviral drugs in Western medicine (direct-acting antivirals). Fu zheng refers to improving the body’s physical fitness and ability to resist evil and to rehabilitation; zheng qi is stored in the body, and prevents evil, which is also an important aspect of the antiviral mechanisms of TCMs. These two modes of action are also reflected in the mechanism of TCM treatment of respiratory viral diseases.

We discuss treatment of COVID-19 with TCM as an example of using the principles of holism and syndrome differentiation and treatment. In TCM theory, COVID-19 belongs to the category of epidemic disease. COVID-19 is caused by the invasion of the exogenous pathogen SARS-CoV-2 and the deterioration in human immune function, which exacerbates the imbalance in the body (excessive immune inflammatory reaction) and causes organ dysfunction. From the perspective of holism, COVID-19 is a struggle between the virus and the immune system, which leads to an imbalance in the homeostasis of the human internal environment. From the perspective of syndrome differentiation and treatment, the progress of the disease can be divided into the initial stage, the intermediate stage, the severe or critical stage, and the recovery stage. Different treatments target different stages of the disease; for example, clearing heat and detoxification in the early stage are part of dispelling evil in TCM. The latter three stages require the suppression of an excessive immune response and inflammation, regulation of balance in the body, and coordination of the functions of the viscera, all of which are part of fu zheng in TCM. Clinical results have shown that TCM treatment is effective for COVID-19, especially in significantly reducing the number of patients transitioning from the early and middle stages of the disease to severe and critical illness.

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