Dr Amir Hooman Kazemi, Vice President of WFAS from Iran; Vice President of Traditional Medicine School of Tehran University of Medical Sciences
Q1: According to the Bian Zheng principles, the Qing Fei Pai Du Tang（QFPDT） is to treat which symdrome? Like damp heat? or damp cold?
Wang Wei: As for the syndrome type of QFPDT with better effect, it’s mentioned in the explanation just now. Because the condition of COVID-19 is very complicated, including cold-dampness, dry-heat, damp-heat and qi stagnation, etc. When formulating the prescription of QFPDT, each syndrome type has been considered. So it’s a comprehensive formula. It is not just for a certain syndrome. It is a universal prescription with a wide application range.
Ge You Wen: From the point of view of syndrome differentiation of TCM, QFPDT should be viewed from two aspects, one is the core pathogenesis of COVID-19 and the other is the external symptoms of COVID-19. The core pathogenesis of this disease is cold and dampness, and external symptoms may show dryness and heat. Since the beginning of the formulation of this prescription, the two aspects of core pathogenesis and symptoms were fully considered. We cannot rely on a certain symptom to judge the medication, but should pay attention to the mechanism behind the symptoms, which is very fundamental. So this prescription treats both the symptoms and root causes, taking into account the various syndromes.
Q2: Is there any contraindications for that? Is there any side effects? Is there any interaction with western medicine?
Wang Wei: At present, there is no special contraindications for taking QFPDT. As for the side effects, we can pay attention to the reaction of digestive tract. Of course, many COVID-19 patients are prone to diarrhea and other digestive tract problems after taking antitoxic drugs. In this case, after taking QFPDT, their bodies are intolerant and there may be reactions such as worsening diarrhea. According to the actual clinical situation, many COVID-19 patients have complications. If the patient suffers from severe hypertension, after taking this medicine, the heart rate and the blood pressure may increase, mainly because the blood pressure may fluctuate before the exterior symptoms are relieved (without sweating). Then QFPDT should be used with caution or taken in reduced doses.
Ge You Wen: In clinical practice, we gave this prescription to many children. Note that the dosage of children should be halved. At present, no adverse reactions have been found. In addition, it is not recommended for pregnant women infected with COVID-19.
Q3: Has Qing Fei Pai Du Tang used in any other country? If yes, which country and how about the results?
Wang Wei: QFPDT is also used in other countries outside of China. At present, it is used in Italy, the United Kingdom, the United States, Japan, Malaysia and other countries. It is mainly used by local Chinese TCM doctors. The feedback effect is good.
Q4: Which symptoms of COVID-19 are best treated by QFPDT?
Wang Wei: It was mentioned in the lecture just now that the most rapid improvement of QFPDT in COVID-19 patients is fever symptoms, followed by fatigue and asthma. And most other symptoms can be generally improved.
Dr Marek Kalmus, Honorary President of Polish Society of Traditional Chinese Medicine
Q5: Could you please provide us the official data on the effectiveness of the Qing Fei Pai Du Tang recipe? In the West, we need data from scientific publications confirming the extremely high effectiveness of this recipe. Without that we can’t talk with Western medicine doctors and authorities as well as institutions responsible for health care, because they will not trust us. We need published Evidence-Based Medicine papers or officially stated data by Chinese authorities as the argument about the effectiveness and safety of Chinese medicine in the COVID-19 treatment. It is the only way to introduce TCM treatment not only in Poland, but in most Western countries. It can give a chance for us to work together with Western medicine and introduce Integrative treatment for the benefit of the patients. The same applies to the use of acupuncture-moxibustion in COVID-19 treatment.
Wang Wei: In the early stage of the outbreak, we first wanted to treat patients as soon as possible, so treatment was the first, science was the second, and then clinical research integration. At present, we’re still observing the diagnosis and treatment of COVID-19 patients, including some imported cases abroad, and relevant scientific research data and detailed information about the treatment of this infectious disease are still under statistics. Just now, we reported the preliminary stage data. Now we are still actively collating and analyzing these, and we will continue to publish specific research data on TCM treatment of COVID-19 in some authoritative magazines, including the effectiveness and safety of TCM, optimal treatment time, etc. will be presented for reference by countries in the fight against the epidemic.
Q6: How long do you need to use the Qing Fei Pai Du Tang for the best healing effect? Is it proofed by any research or based only on your experiences?
Wang Wei: The duration of taking QFPDT depends on the specific conditions and symptoms of each patient. In general, mild patients have a significant improvement after taking one or two days, and ordinary patients need to take one to two courses to achieve the best treatment effect, and severe patients may require three courses of treatment with very good results.
Q7: There are several different Chinese preventive formulas advised to protect against COVID-19 infection. Some have been already published, others were given by Chinese TCM professors practicing TCM in the Europe. They are generally designed against external pathogens Cold-Dampness with toxins. Could you please give the main formula currently recommended for COVID-19 prophylaxis? How long should it be used - especially when we will have dry and hot weather soon?
Wang Wei: I think prevention is indeed a very complicated thing, we don’t talk about which prevention is very effective easily, and it’s difficult to prove. However, some views and understandings of TCM can improve people's immunity and resistance by supporting righteous Qi. We have no comparative research on which of these TCM formulas is the most authoritative, so it’s hard for us to judge now.
Q8: We know form research in Cambridge (UK) and Germany that another SARS-CoV-2 virus genomes occurs in the West (genome C) than in China (genome A and B). Wuhan’s major virus type, ‘B’, was prevalent in patients from across East Asia. Do you know if the formula Qing Fei Pai Du Tang – which was perfect for China and other Asian countries – will be equally effective in the West? Or some changes should be made according to TCM?
Ge You Wen: These problems were considered at the beginning of the preparation of QFPDT, just like I made an analogy before-water, it will show different forms at different temperatures, but its essence is water, which will never change. Treating the disease with traditional Chinese medicine is to seek the roots. To formulate QFPDT to treat the disease. First, the symptoms and clinical response of COVID-19 patients, and second, the roots of the theory of five movements and six qi, including what the disease is from the generation to the human body hazards, as well as seasonal changes. We have considered the aspects above when designing the prescription. Judging from the treatment of these imported cases abroad, cases were from Northern Europe, the Middle East and other countries have also taken QFPDT, and the treatment results are good. As for the change of seasons, the colder the weather, the more obvious the therapeutic effect of QFPDT; as the temperature increases, the lethality of this virus will also decrease. Therefore, QFPDT is treating the root of the disease, and it will not lose its effectiveness due to the change of the covid virus’ gene.
Ephraim Ferreira Medeiros，Director of the International Education and Research Department of Acupuncture and Alternative Medicine Study Centre-Brazil/China
Q9: COVID-19 is a new disease that is gradually being understood. Each day new information and transformations arise. Perhaps one of the most striking is the emergence of hematological manifestations such as clotting problems or even stroke in patients with no history of comorbidity. I would like to know if the professor has anything to share or suggest in terms of strategy specifically for patients with more evident hematological manifestations ?
Ge You Wen: This problem must come from the COVID-19 clinic, because the blood coagulation or stroke problems will certainly occur in the clinic. As I have said before, one of the bottom lines of the Gengzi year (2020) is wooden qi, i.e. human liver qi. Once the liver qi stagnates, the qi at the Taichong acupoint will be passed to Jueyin, and there will be problem with ability of conveyance and dispersion including the blood vessels. Then blood circulation, qi circulation, and water circulation will all be blocked. The wooden qi is blocked this year. So the herbs such as Guizhi(cassia twig), Xixin(Asarum), Mahuang(Ephedra) and Chaihu (Bupleurum) in QFPDT are used to deal with this major problem. This was taken into account when formulating the prescription at the beginning. So in clinic practice, I suggest that two needles can be put on one Taichong point to strengthen the meridian qi at this acupoint, which plays a very important role in the occurrence of critical phase or inflammatory storms during western medicine treatment. Moreover, according to a large number of tongue coatings and other information with four TCM diagnosis methods in the clinic of COVID-19, most patients have dark purple tongues and liver stagnation. Therefore, QFPDT together with the needling method of 18 matched acupoints can solve this problem.
The eighteen acupoints are:
SJ2(Yemen), SJ6(Zhigou), BL60(Kunlun), BL66(Tonggu), KI3(Taixi), GB43(Xiaxi), LR3(Taichong), LU7(Lieque), LU5(Chize), SP3(Taibai), SP9(Yinlingquan), ST40(Fenglong), SI3(Houxi), GB20(Fengchi), DU16(Fengfu), LU11(Shaoshang), LI1(Shangyang), and SJ1(Guanchong).
Q10: Following this reasoning I would also like to know if the professor suggests any special kind of manipulation on these points such as shāo shān huŏ（烧山火） or tòu tiān liáng（透天凉） or any other.
Ge You Wen: First of all, the reinforcing and purging effect of acupuncture points has been reflected in the selection of points, and the nature of these recommended acupoints has determined its reinforcing and purging effect, so when doing acupuncture, it is sufficient to use the Ping Bu Ping Xie (mild reinforcement and attenuation) manipulation technique. As for the acupuncture manipulation of “burning mountain fire(shao shan huo)” and “letting the sky cool(tou tian liang)”, I suggest that the manipulation of “burning mountain fire(shao shan huo)” can be applied to the triple energizer(sanjiao) meridian, and the Ping Bu Ping Xie (mild reinforcement and attenuation) manipulation technique can be used on the rest ones.