2021 Autonomic Neuroscience: Basic and Clinical

Acupuncture, via nerve stimulation, can be a promising treatment strategy for controlling inflammation and improving organ function during sepsis by activating immune reflexes.

The study used a neuromodulation approach, leveraging the technique of peripheral nerve stimulation through acupuncture. This was linked with known somatic-autonomous-immune reflexes with the aim to control inflammation and improve organ functions in sepsis cases. The local and systematic effects of this methodology were largely achieved through the activation of several reflexes. These included the somatic-sympathetic-splenic reflex, the somatic-sympathic-adrenal reflex, the somatic-vagal-splenic reflex, and the somatic-vagal-adrenal reflex. The activation of these particular reflexes is what sets acupuncture apart from other nerve stimulation techniques.

In terms of results, the method used for immunomodulation and inflammation control showed considerable promise for sepsis treatment. The acupuncture procedure achieved regulation by activating appropriate reflexes which in turn produced a systemic effect, thereby controlling inflammation and enhancing organ function. The research findings underscore acupuncture as an effective therapy, providing significant advantages for immunomodulation in acute inflammation such as sepsis, leading to a comprehensive, evidence-based therapy recommendation.

Acupuncture modulates immunity in sepsis: Toward a science-based protocol Pan WX, Fan AY, Chen S, Alemi SF.

2020 Frontiers in Pharmacology

Traditional Chinese medicine has unique advantages in relieving symptoms, shortening treatment time and reducing the development of severe viral pneumonia.

In the treatment of viral pneumonia through syndrome differentiation, traditional Chinese medicine (TCM) plays a variety of roles in inhibiting the proliferation, replication, adsorption and membrane penetration of the virus, promoting the expression of interferon in vivo, inhibiting inflammatory reaction, enhancing immunity, etc., which is one of the theoretical bases for the clinical application of TCM in the prevention and treatment of viral pneumonia.

Traditional Chinese herbal medicine and compound medicinals are characterized by multi-component, multi-pathway and multi-pathway complex networks. Therefore, drug resistance is relatively rare in the clinical practice of TCM. Moreover, in the process of diagnosis and treatment of TCM, treatment based on differentiation of symptoms and signs, especially treatment based on classification of symptoms and signs, can best reflect the overall concept of TCM. TCM has precise therapeutic activity and less adverse reactions. Accumulating evidence has demonstrated the competent therapeutic effects of TCM against viral pneumonia with a prominent safety profile.

Role of Traditional Chinese Medicine in the Management of Viral Pneumonia Xi S, Li Y, Yue L, Gong Y, Qian L, Liang T, Ye Y

2019 APMIS

Traditional Chinese medicine can restrain some infections induced by various drug-resistant bacteria.

A large number of studies have shown that multiple traditional Chinese medicine (TCM) compounds, single herbs, and monomers have effects on inhibiting drug-resistant bacteria in both in vitro and in vivo studies such as MRSA, Acinetobacter baumannii, and Pseudomonas aeruginosa.

The mechanism of treating drug-resistant bacteria in TCM mainly includes the following two aspects: eliminating plasmid and inhibition of the active efflux pump system. Forsythia decoction can inhibit the active efflux pump of A. baumannii, resulting in the variation of an adeB sequence of efflux pump coding gene.

In addition, TCM has a large impact on the production of the inactivating enzyme of antimicrobials to reverse the drug resistance. To inhibit the growth and reproduction of bacteria, Chinese medicinal herbs can alter the structure of bacterial cell wall to affect permeability. Some herbs such as rhubarb and berberine can restrain the formation of biofilms to inhibit the MRSA.

Notably, the antibacterial activity of TCM with little side effects is equivalent to that of antibiotics. A study showed that Chinese medicine, Mayushihuang decoction, has the same efficiency with teicoplanin for clearing MRSA; however, distinct adverse effects were not detected in the TCM group as compared to abnormal hepatorenal function in the teicoplanin group.

Prevention and treatment of infectious diseases by traditional Chinese medicine: a commentary Yuexia Ma, Ming Chen, Yali Guo, Jian Liu, Weitao Chen, Mengyue Guan, Yue Wang, Xuehui Zhao, Xu Wang, Haoyuan Li, Lingxin Meng, Yulong Wen, Yuguang Wang

2019 APMIS

Clinical efficacy can be improved by the combination of Chinese and Western medicine in the treatment of bacterial infectious diseases.

The combination of traditional Chinese medicine (TCM) intravenous preparations with conventional antibiotics can effectively improve the clinical efficacy of community-acquired pneumonia (CAP) and promote the early rehabilitation of patients, thereby reducing the rate of mortality of the patients. Previous studies showed that Xiyanping injection (TCM injections are approved by the China Food and Drug Administration for the treatment of respiratory infection; the main ingredient is andrographolide sulfonate) combined with piperacillin and sulbactam significantly improved the clinical efficacy of pulmonary infection in the elderly.

Pulmonary infection is the most common complication and cause of death in stroke patients. Compared to simple symptomatic support treatment, the recovery rate and efficiency of Qingjin huatan decoction (famous TCM recipe composed of Scutellaria baicalensis, Fructus gardeniae, Fritillaria thun-bergli, for clearing heat and reducing phlegm) combined with Xiaochengqi decoction (purgative prescription) in the treatment of apoplexy-related lung infection is greatly improved. The symptoms of patients with pulmonary infection complicated with sepsis were significantly improved after treatment with the addition of Shengjiang powder combined with basic Western medical treatment including antibiotics and expectorant application. Consequently, the APACHE2 score was significantly reduced, and the levels of inflammatory cytokines, such as CRP, TNF-α, and IL-6 were also significantly reduced.

Prevention and treatment of infectious diseases by traditional Chinese medicine: a commentary Yuexia Ma, Ming Chen, Yali Guo, Jian Liu, Weitao Chen, Mengyue Guan, Yue Wang, Xuehui Zhao, Xu Wang, Haoyuan Li, Lingxin Meng, Yulong Wen, Yuguang Wang

2019 APMIS

Traditional Chinese medicine has a generalized antiviral effect indicating the regulation on the direct inhibition of virus, body immunity, and inflammatory response control.

Present, several studies on the anti-virus activity of single Chinese medicinal herb, such as Fructus forsythiae, Radix isatidis, and Scutellaria baicalensis, using modern technology confirmed the effective constituent and materials, as well as the functional mechanism of the relevant parts. A systematic analysis found that TCM decoction and Ganmao capsule (a non-prescription Chinese patent medicine composed of some herbs for clearing heat and toxicity is commonly used in treating cold and flu) had better effects on the treatment of H3N2 and influenza B, respectively, than amantadine and ribavirin.

In terms of anti-inflammation, TCM can alleviate the damage caused by excess inflammatory reactions initiated by a virus. The single and compound Chinese medicinal herbs which can cause clearing heat and toxicity could decrease the cytokine storm resulting from the production of several species of pro-inflammatory cytokines and anti-inflammatory cytokines aim to improve the injury of tissue and organs. In turn, this phenomenon promotes blood circulation and removes stasis, thereby confining the inflammation and promoting its absorption. In the case of SARS, a rapidly spreading infectious disease, TCM combined with corticosteroids during the early stage of the outbreak could decrease the mortality by promoting innate immunity to relieve inflammation.

Subsequently, the TCM compounds of Chinese herbs analyzed based on the theory of strengthening healthy Qi and clearing pathogenic factors with the feature of multicomponent, multi-channel, and multiple targets exerted a synergistic effect on inhibiting the virus directly, relieving the immunopathological injury, and controlling the inflammatory reaction caused by virus infection.

Prevention and treatment of infectious diseases by traditional Chinese medicine: a commentary Yuexia Ma, Ming Chen, Yali Guo, Jian Liu, Weitao Chen, Mengyue Guan, Yue Wang, Xuehui Zhao, Xu Wang, Haoyuan Li, Lingxin Meng, Yulong Wen, Yuguang Wang

2019 APMIS

Traditional Chinese medicine rapidly relieves the clinical symptoms caused by viral infection with a remarkable antifebrile effect.

The overall characteristics of TCM in treating viral infectious diseases are that it can significantly lighten the symptoms and bring down the fever quickly; however, the time of viral nucleic acid to be negative in TCM is slower as compared to the chemical antiviral drugs.

Some randomized controlled trials showed that Maxingshigan decoction (a classical TCM recipe that is commonly used for pneumonia composed of Chinese ephedra, apricot kernel, gypsum, licorice), Yinqiaosan decoction (a famous TCM recipe mainly composed by Lonicera japonica and Fructus forsythiae is commonly used for cough and sore throat caused by virus infection), and modern Chinese patent medicine Lianhua qingwen capsules (a TCM capsule, which is approved by the China Food and Drug Administration for the treatment of flu) relieve the clinical symptoms of influenza patients and shorten the time of disease progression.

Prevention and treatment of infectious diseases by traditional Chinese medicine: a commentary Yuexia Ma, Ming Chen, Yali Guo, Jian Liu, Weitao Chen, Mengyue Guan, Yue Wang, Xuehui Zhao, Xu Wang, Haoyuan Li, Lingxin Meng, Yulong Wen, Yuguang Wang

2018 BMC Complementary Medicine and Therapies

Ma Huang Tang may lower the duration of fever when it is used alone or in combination with neuraminidase inhibitors and may be a well-tolerated treatment.

Twelve relevant studies were identified, including two randomised controlled trials (RCTs, N = 60) and ten non-randomised studies (NRSs, N = 1110). We found that maoto plus NAIs was superior to NAIs alone in terms of the duration of fever in one RCT and four NRSs. The duration of symptoms or virus isolation did not differ between maoto and NAIs. No severe side effects or adverse reactions were reported related to maoto or NAIs.

Although we could not reach a definitive conclusion because of the small sample sizes and high risk of bias in the analysed studies, maoto may lower the duration of fever when it is used alone or in combination with NAIs and may be a well-tolerated treatment. More RCTs are needed to determine the efficacy and safety of maoto.

The use of maoto (Ma-Huang-Tang), a traditional Japanese Kampo medicine, to alleviate flu symptoms: a systematic review and meta-analysis Yoshino, T., Arita, R., Horiba, Y. et al

2013 Cochrane Database of Systematic Reviews

Most Chinese medical herbs in the included studies showed similar effects to antiviral drugs in preventing or treating influenza.

This updated review assessed the therapeutic effects and safety of Chinese medicinal herbs as an alternative and adjunctive therapy to other commonly used drugs for influenza. Eighteen studies involving 2521 participants were included in the review. 'Ganmao' capsules were found to be more effective than amantadine in decreasing influenza symptoms and aiding recovery in one study (in which adverse reactions were mentioned in the amantadine group although no data were reported). There were no significant differences between 'E Shu You' and ribavirin in treating influenza, nor in the occurrence of adverse reactions. The remaining 17 Chinese herbal trials showed a similar effect to antiviral drugs in preventing or treating influenza. However, since these included studies were of poor quality, the evidence does not support or reject the use of any Chinese herbal preparations for influenza. High‐quality trials are required.

Chinese medicinal herbs for influenza Jiang L, Deng L, Wu T.