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TCM Herbal Treatment for COVID: History, Current Research & Action Steps

Editor’s Note: With the fall season approaching, bringing a potential uptick in COVID cases with it, this article reviews the history and research support for herbal therapy; and next steps you and every member of the profession can take.

Since 2020, the world has been gripped by a pandemic generated by a flu-like virus. Management of this crisis has been fraught with controversy and some degree of hysteria. However, treatment resources have been largely ignored in favor of a vaccination policy. Several treatment options have been suggested by medical doctors treating large numbers of patients, resulting in much scientific debate and sadly, a dangerous amount of censorship.

One area that is largely ignored is the potential contribution of traditional Chinese medicine; specifically, the application of various herbal formulations to treat COVID-19 and other viral conditions.

A Long History of Treating Epidemics With TCM

Traditional Chinese medicine has an extensive history of treating epidemics and particularly respiratory infections. Over the past 2,000 years, China has experienced hundreds of documented epidemics.1 The earliest theories on the treatment of communicable disease began with Shang Han Lun (Treatise on Cold Disease), written by Zhang Zhongjing circa 150-219 CE.2 Shang Han Lun was written during and after a widespread epidemic had swept through the Han area of China, with an estimated fatality rate of two-thirds of the population including many of Zhang’s family members over a 10-year period. It remains a textbook taught and referenced in traditional Asian medicine schools even today.

Although Shang Han Lun made great strides in controlling infectious disease, there were more advances to be made. Wen Bing (Treatise on Febrile Epidemics) was written in 1642 CE by Wu You-Xing to address epidemics that were not responding to the classical Shang Han Lun protocol. Dr. Wu began to question the premise of the treatment approach of Shang Han Lun. Wu discovered that epidemics were more consistent with heat conditions and required an adaptation.1

The introduction of modern medicine and the development of the understanding that pathogenic causes are related to bacteria, viruses, fungi, and parasites changed the concepts of ancient Chinese medicine. However, herbal formulas remained an effective treatment for a variety of infectious diseases.

Furthermore, modern research reveals that many of the herbs used in the classical formulas have direct antiviral effects. These include Jin Yin Hua, commonly known as honeysuckle,3 and Ban Lan Gen (Rx Isatidis).4 Honeysuckle has been demonstrated to directly interfere with the viral reproductive process for in vitro (petri dish) experiments.

What can we conclude from nearly 1,800 years of clinical practice and new supporting scientific evidence indicating traditional Chinese herbs have antiviral effects? Are there modern research studies that support the effectiveness of Chinese herbs on viral infections? If so, can that be applied to the current pandemic caused by the COVID-19 virus?

Herbal Medicine in the Modern World

In a systemic review of research that combined herbs with allopathic medicine compared to allopathic medicine alone for the treatment of SARS, the combination group fared better for decreasing symptoms, including body temperature, cough and breathing difficulties, reducing dosages of corticosteroids, and improving absorption of pulmonary infiltration,5 concluding that combining traditional Chinese herbs with allopathic medications produced improved results. Additional studies with more stringent controls were recommended.

Multiple resources have focused on solving the COVID-19 pandemic, resulting in a plethora of research reviewing possible treatment options of this illness. China naturally led the way in terms of the application of TCM herbal applications.

Early reports and case studies translated and published on indicated success in treating COVID-19 using TCM herbs with and without the combination of allopathic medication.6 Zheng, et al.,7 also reported on two case studies that were successfully treated with traditional Chinese herbs and whose hospital unit now routinely employs the use of Chinese herbal medicine in treating COVID-19 patients.

One of the fundamental insights these early reports provided was the nature of the COVID-19 virus in terms of a TCM diagnosis. The symptom assessment indicated a “damp and cold” pathogenic factor. Therefore, “warm and damp dispersing” herbs were applied. There were three herbs deemed essential to eliminating the COVID virus: Ma Huang (aka Herba ephedra sinica), fresh ginger and cinnamon twig. It is noteworthy that the virus became so widespread initially in Wuhan during the winter season with a prevalence of cold and damp weather. Larger studies, including a meta study by Xiong, et al.,8 found that traditional Chinese herbs provided “improvements in several clinical parameters including lung CT, clinical cure rate, ranging from mild to critical cases, length of hospital stay, total score of clinical symptoms, fever reduction time, symptom score of fever, number of cough reduction cases, symptom score of cough, number of fatigue reduction cases, symptom score of fatigue, [and] disappearing time of fatigue.”

China Daily also noted the impact of TCM on controlling the COVID-19 epidemic, citing senior TCM expert Zhang Boli at a recent press conference. Zhang noted the positive effects of utilizing a combination of Western pharmaceuticals with TCM herbs in an innovative approach to successfully treat COVID cases and prevent fatalities and hospitalizations.9

A clinical trial is now underway through the University of California, San Diego, and University of California, Los Angeles, to study the effectiveness of the Chinese herb formula Qing Fei Pai Du Wan on COVID-19. This is an FDA-approved, double-blind, placebo-controlled, randomized study. This is the primary formula found to be most effective in China against COVID-19. The study is in progress and results are expected soon.10

The Issue of Research Vs. Clinical Results

The approach to health care in the United States is different from that of the People’s Republic of China. Apart from the obvious economics of the hybrid socialist-capitalist system of China versus the more market-driven approach that dominates health care and business in general in the U.S., health care policy in the U.S. changed in one distinct manner in the year 2000 with the introduction of a commitment to the practice of evidence-based medical practice.

This began to seep into public policy and third-party reimbursement decisions. The gradual result was a longer time to bring medical products and strategies into clinical practice, since product development may require years of research and randomized, controlled trials (RCTs) to be completed and approved.

It is quite clear that the Chinese government chose not to wait for the benefits of a RCT to implement a strategy that works based on clinical reports at the front line of the COVID pandemic. That strategy appears to have worked, as China began to “flatten the curve” of infection by late spring 2020 and were moving back into normal operations by late summer 2022.11

We need to ask ourselves if substantial clinical results, reported by health care providers, is enough to change public policy in an emergency epidemic? Or is it still necessary to require years of research to prove safety and effectiveness? Furthermore, what part should the professionally trained acupuncturist play in current research in the U.S.?

Three Action Steps

This data and progress strongly indicate that TCM herbal medicine can be an asset in the arsenal of tools to combat COVID-19 and quite possibly post-COVID-19 syndrome. However, more rigorous research is needed to move this tool into common clinical practice.

It is up to licensed acupuncturists to step up and get involved in the research process. No profession in the U.S. health care system is better qualified to translate the essence of the ancient medical practices into the modern world. Action in this regard needs to occur on several levels.

First and foremost, licensed acupuncturists need to understand the thinking of the scientific process while maintaining a deep understanding of the theories and practices of TCM that remain effective treatment tools. Action step: take CEU on research and subscribe to our peer-reviewed journals.

Second, support fellow acupuncturists who are inclined to participate in conducting and organizing quality research. Action step: join the Society for Acupuncture Research and make donations. Join your local state professional organization.

Third, reach out to other health care professionals to increase communication and mutual referrals.

The modern-day acupuncturist has the capacity – and opportunity – to stand tall with a foot in each world, uniquely positioned to help humanity find improved health and harmony.


  1. Hanson M. Speaking of Epidemics in Chinese Medicine: Disease and the Geographic Imagination in Late Imperial China. Routledge, 2011: pp. 12-13.
  2. Chen JK, Chen TT. Chinese Herbal Formulas and Applications: Pharmacological Effects and Clinical Research. Art of Medicine Press, 2009.
  3. Zhou W, et al. Honeysuckle-encoded atypical microRNA2911 directly targets influenza A viruses. Cell Res, 2015;25:39-49.
  4. Zhou W, Zhang X. Research progress of Chinese herbal medicine radix isatidis (banlangen). Am J Chinese Med, 2013:41(4):743-764.
  5. Liu X, Zhang M, He L, et al. Chinese herbs combined with Western medicine for severe acute respiratory syndrome (SARS). Cochrane Database Syst Rev, 2012;10:CD004882.
  6. Chen JK., Hsu L. “How COVID-19 (2019-nCoV) is Currently Treated in China With TCM.” eLotus webpage, 2020. Read Here
  7. Zheng ZZ, Ma NN, Li L, Jiang D. Efficacy of traditional Chinese medicine on COVID-19: two case reports. Med Acu, 2021;33(1):92-102.
  8. Xiong X, Wang P, Su K, et al. Chinese herbal medicine for coronavirus disease 2019: a systematic review and meta-analysis. Pharmacolog Res, 2020;160:105056.
  9. “Traditional Chinese Medicine Plays Important Role in COVID-19 Treatment: Senior Expert.” China Daily, last updated Sept. 28, 2021. Read Here
  10. “Groundbreaking FDA-Approved Study: Mushrooms and Chinese Herbs for COVID-19.” Pacific College of Health and Science, 2021. Read Here
  11. China COVID Cases, Fatalities and Recoveries. World Meter website, 2022. Read Here

Seasonal Tips for Spring

Over the past 6 weeks we have seen a different type of flu type pathogen pass through our community. Just as a refresher for everyone, Chinese divides and defines viral infection according to the symptom-sign presentation. The simplest way to think about this is hot vs cold and damp vs dry. Here is a quick reference chart to make it simple.

Symptoms of… 

Heat Cold
Feels hot Feels chilled
Burning painful sore throat Mild scratchy throat
Body ache severe Body ache, but mild
Exhausted but restless Tired but rests easily
Yellow or green phlegm/mucous Clear or white phlegm/mucous
Profuse or easy sweating Minimal sweating/clammy tight pores
Desires cold drinks Desires warm drinks

Symptoms of…

Dry Damp
Dry throat Excess saliva
Feels thirsty Not thirsty
Dry stuffy sinus Watery mucous and sinus
Phlegm is thick and difficult to move Phlegm is water and profuse

So how is this useful? Simple, once the effect can be identified the proper therapeutic approach can be utilized. Now here is one area where TCM is different from the western or allopathic medicine. Allopathic medicine now looks for a pathogen to “kill”. Works great for a bacteria with antibiotics. Not so good against a virus. 

The TCM approach seeks to change the internal environment. From cold to warm, from hot to cool, from dry to moist, or from moist to dry. Of course, the equation can get complicated for some cases, requiring a fairly well nuanced herb formula. But the basic concept is simplicity itself.

As it turns out many of the herbs used over the past 2,000 years happen to have actual antiviral effects. Herbs such as Jin Yin Hua (honeysuckle), Bang Len Gen, (Rx Isatis), have shown anti-viral effects in vitro (in the test tube), usually by stopping the viral reproductive process1. 

Here is a list of common, easy to obtain household herbs and the functions.

  • Peppermint – is cooling and dry, good for sore throat, liver, and allergies
  • Cinnamon – is spicy, warm, and slightly dry, counters wind and chill
  • Ginger – is spicy, warm to hot dispels clear and white phlegm, aids digestion, calms nausea, and regulates the liver
  • Garlic – is warm and spicy with antibiotic functions
  • Oregano – very warm, spicy with antibiotic, antiviral, and anti-fungal effects
  • Dandelion – Bitter cool with antiviral and antibiotic effects
  • Rice – is neutral with a mild dry effect

Are you plagued by this common factor that causes impotence, infertility and insomnia?

These are problems that can be quite bothersome for people and really deserve some attention. From a traditional Chinese medicine point of view, we look at these things a little bit differently than the rest of the western medicine in the Western world. To begin with, we always want to review the basic concepts of the balancing of the elements of Yin and Yang. Most folks have heard the terms before, and I’m sure all of my patients are quite familiar with the meaning of them, but just a quick review. Let’s remember that the Yin and Yang elements are defined with some universal terms, of course we want to know what do those terms mean for our own physical bodies?

In the broad sense, Yin is the more containing and more cooling, more moistening, nurturing, inward focused, feminine element. Yang is the more energetic, more expanding, more heat, outward focused, masculine element. According to the philosophy of Chinese medicine, you need both in balance. In other words, they’re not oppositional opposites, they are complimentary opposites. One does what the other one does not do, and when they work in harmony, you have life and balance and health. If they don’t work in harmony, you have illness and you have disharmony and that can be applied socially, that can be applied culturally and that can be applied to your health as well. Where there is a complete separation of Yin and Yang there is death. We always think in these terms when applying Chinese medical philosophy. Now, what does this mean in terms of the physical body?

Let’s take a look at what the Yin Element is. Cooling and containing basically, it is also the structure through which everything operates. In other words, your physical body is considered Yin.

What is the Yang? The Yang is the energy that moves everything. What does that energy actually mean? Well, if we break this down into biochemistry, for you folks out there who have had a biology class, the biological process called Krebs Cycle, especially the ATP – ADP cycle, adenosine triphosphate is the energy packet that your blood delivers to the cells, which then goes to the mitochondria in the cells. The mitochondria break that down and release actual energy that allows the cells to do everything from move your muscles to reproduce. You name it. That’s the Yang component in a chemical sense.

You need these factors to be in balance. Yang has to have a structure to work through. So interestingly enough, it’s not just that your whole body has to be balanced with Yin and Yang, but each independent organ has its own Yin and Yang balance.

So I find this extremely interesting because you could be in balance in one organ and out of balance in another organ. Now, most of you may have seen my discussion on five element theory and the function of the 12 organs present on our YouTube channel and on our web site, when an acupuncturist like myself refers to the organ systems, we are specifically referring to the traditional 12 organs that are noted in traditional Chinese medicine. They are for the most part, the standard organs we have in western medicine, the heart, small intestine, stomach, spleen, lung, large intestine, kidney, bladder, liver and gallbladder. Each organ has its own area of function. When Yin/Yang imbalance occurs in that organ, dysfunction occurs.

What is the root cause of most infertility, impotence or erectile dysfunction, as is being advertised all over television these days, and insomnia?

Now, who would have thought you could have a common factor? The common factor is actually the Kidney or what’s otherwise known in traditional Chinese medicine as the water element. When we take a look at kidney, according to Traditional Chinese Medicine, most modern acupuncturists now recognize the concept includes kidney / adrenal gland. The adrenal glands are little almond shaped glands that sit right on top of the kidney. Adrenal gland function is vital to considerable amount of the endocrine and hormonal function in the body. The adrenal glands actually produce estrogen and testosterone as well as a slew of other hormones, including regulating the cortisol levels, which is going to reflect on your energy throughout the day and many, many other endocrine functions that would be too deep to go into here, but we’re really focused on the fact that the kidney / adrenal or adrenal glands from a western point of view are directly responsible for the production of estrogen and testosterone.

When things go out of balance organ dysfunction occurs that leads to symptoms of fatigue and eventually to disease of one sort or another. Lack of testosterone has a lot to do with the reproductive drive for men. We all know that men over time, as they grow older, start to lose testosterone production. By the time they are in the fifties, sixties, and seventies, a lot of men are wondering what happened to their get up and go. This doesn’t just affect the sex drive but general energy, enthusiasm and inspiration. All because of a gradual decline of the function and the productivity of their testosterone produced by adrenals. This is what we call the Yang element of the Kidney. So if the Yang becomes deficient, there’s a problem for men. If the Yang becomes deficient for the gals, there’s still a problem because women have to have a certain amount of Yang energy or testosterone as well.

It turns out that testosterone is also has a lot to do with the sex drive for the gals, although there is a higher level of estrogen with the gals than with the men obviously, but, there’s a little bit of each hormone that needs to be present in both the male and the female in order to function normally and healthy. Chinese medicine has recognized this a long time ago, always balance the Yin and the Yang. The kidney also has an effect, according to Chinese medical theory, on the heart. The heart, according to Chinese medical theory is the seat of the soul, the seat of the consciousness. If the heart is not calm, the mind becomes restless. During sleep, the mind needs to be controlled, calm and a reduced effect of Yang Chi or heat of the heart.

If there’s a deficiency of Yin in either the kidney or the heart, then there’s an excess of Yang and the mind becomes restless. This condition becomes exacerbated at nighttime, and you have restlessness which then predominates causing insomnia. So again, the imbalance of Yin and Yang of the Kidney has a strong effect on the heart. That is what causes a large amount of the insomnia problems. Perhaps not 100 percent, but it is a large amount. As it turns out, if you balance the Kidneys Yin/Yang, sleep comes easier and deeper, the Yin actually contains the Yang. That allows us to be calm. Now, I’ve stated this all in terms of Chinese medical terminology, but leave no question in your mind that whatever is true in Chinese medicine is also true in Western medicine and there’s a parallel concept in western medicine.

In other words, if you look and study at the hormone balances and you look and study what’s causing insomnia for a lot of people with adrenal gland imbalance, the cortisol level, which is supposed to gear us up for action and for dealing with stress, becomes reversed and becomes excessive at nighttime and becomes deficient during the daytime.

This is the person who’s basically described accurately from a Chinese medicine point of view in terms of Yin deficiency and Yang excess. You want your Yang to be present in the daytime when we’re awake, alert, and doing things. And you want it to be calm at nighttime. You want your cortisol levels to begin rising in the morning and the peak in the afternoon and gradually subside as we get into the evening time, and by the time you’re ready to go to bed your cortisol levels should be really starting to bottom out. So you get a good restful sleep. So the parallels are between eastern and Western medicine are definitely there. They’re definitely apparent if you do a little research and study with this, but the cause of all three of these items always comes back to the balance of the Kidney Yin and the Yang, and there’s one more fundamental factor which is deeper than Yin and Yang in Chinese medicine, it’s what they call the kidney essence. And there’s something about the essence which is also called the Ancestral Qi or the energy you received from your parents and that generates the kidney Yin and Yang.

If the essence is damaged or injured, there’s a deeper problem in the kidney. So that’s a short analysis, but the question is what do you do about it? What is the common person do to rectify these imbalances? And there are a number of different strategies. There are foods we will look at foods that will tonify and strengthen the kidney essence, Kidney Yin and Kidney Yang. And more importantly, there are a whole categories of traditional Chinese herbs that take care of these matters as well. Now that brings up an interesting topic. A lot of times people will see herbal Viagra advertised and you wonder, well, is that true? Could that be real? And when I look at the companies that produce these herbal Viagra and I studied their formulas, this is what I find. Of course we have herbs that strengthen the kidney Yang.

We have herbs that strengthened the kidney Yin as well as herbs that do all the functions throughout all of the other organ systems. But let’s talk about the kidney. When I look at these herb formulas, what I see is a lot of herbs that tonify kidney Yang only. If you only tonify kidney Yang, you have too much heat, too much heat is going to throw people out of balance. In other words, a lot of the nutritional companies have no concept of balancing the Yin and the Yang. When you look at traditional Chinese herbal formulas, yin and Yang herbs are always balanced. Now, if somebody is extremely Yang deficient, an herb formula, heavily weighted in Yang herbs make sense, but what if the person is Yang excess? Would you want a lot of Yang herbs going into that system? No, of course not. It’s going to make it much worse. We do note douse a fire with gas.

So individual attention needs to be paid to exactly the precise formula for each individual. Is the person Yin or Yang deficient? Either of those conditions can cause these three problems that we’re discussing. So we recommend folks, if you want to get an accurate herb formula made, go see your family acupuncturist. Other modalities that we highly recommend for resolving these problems are meditation, yoga, Chi Gong. Acupuncture can of course help.

Hopefully this gives you a little insight in terms of thinking of balancing the kidney element for the solution to these three plaguing problems.

Food lists:

Support Kidney Yin:

  • Pork, duck, oysters, octopus, perch, carp, pears, grapes, cabbage, asparagus, carrots, barley, rice, wheat, black sesame, and walnuts.

Support Kidney Yang:

  • All smoked fish especially salmon, mussels, shrimp, tuna and oysters, venison, lamb, wild pig, duck, pork, cabbage with warm spices, leeks, radish, root vegetables, onions, cherries, grape, coffee, spiced tea, buckwheat, oats, millet, rice, ginger, garlic, black pepper, cinnamon, adzuki beans, lentils, black soy beans, chestnuts, lotus seeds, black sesame, sunflower seeds, roasted walnuts.