世卫组织-新冠病毒中医药治疗评估专家会议（英）-17页_380kb

WHO Expert Meeting on Evaluation of Traditional Chinese Medicine in the Treatment of COVID-19 (28 Feb – 2 Mar 2022)

Core Content

The World Health Organization (WHO) convened an expert meeting from 28 February to 2 March 2022 to evaluate the role of Traditional Chinese Medicine (TCM) in the treatment of COVID-19. The meeting aimed to understand the methodology behind TCM-related reports, review clinical and research data, and assess the potential contribution of TCM in global pandemic responses.

Main Objectives

• To understand the methodology used in producing reports on TCM and its application in treating COVID-19.
• To review and analyze TCM-related randomized controlled trials (RCTs) across different phases of the disease.
• To evaluate the effectiveness of an integrated TCM and conventional medicine approach.
• To discuss ways to enhance the role of traditional medicine in global health systems, especially in pandemics.

Participants and Structure

• Participants: 21 international experts from six WHO regions, including members of the WHO Expert Advisory Panel, representatives of WHO collaborating centres, members of the WHO International Regulatory Cooperation for Herbal Medicines (IRCH), and experts from the China Academy of Chinese Medical Sciences.
• Co-chairs: Professor Harry Fong (USA) and Professor Elaine Elisabetsky (Brazil).
• Co-rapporteurs: Professor Charlie Xue (Australia) and Professor Heather Boon (Canada).
• Temporary Advisor: Dr. Huang Luqi (China Academy of Chinese Medical Sciences).
• Meeting Format: Virtual, from 13:00 to 16:00 Central European Time each day.

Key Reports Presented

Report 1: Clinical Use of TCM in China's Fight Against COVID-19

• TCM was integrated with conventional medicine from the early stages of the pandemic.
• TCM was used in clusters of infections and early stages of disease, with close collaboration between TCM and conventional medicine specialists.
• TCM interventions were reported to reduce the progression to severe disease, shorten recovery time, and improve symptoms in mild/moderate cases.
• TCM was used as an adjunct to conventional treatment in severe cases, potentially reducing ICU stays and mortality.
• TCM was also used in convalescence to improve quality of life and ease symptoms like fatigue and insomnia.

Report 2: Scientific Research on Prevention and Treatment of COVID-19 with TCM

• China allocated significant funding for TCM research during the pandemic, focusing on screening effective formulas, clinical and basic research, and rehabilitation.
• A total of 859 clinical studies were registered in China, with 213 specifically related to TCM.
• TCM interventions showed positive effects on symptom resolution, viral clearance, and prevention of disease progression.
• No serious adverse events were reported in TCM-related studies, though some studies noted mild side effects, such as changes in liver function.
• A multicentre RCT with 284 patients showed TCM reduced symptom duration and improved recovery.
• TCM was also linked to improved exercise tolerance and CT imaging outcomes in convalescent patients.

Report 3: Methodology for Selecting RCTs

• A team of experts selected 12 RCTs from 71 studies, based on criteria such as study design, peer-reviewed publication, and alignment with WHO guidelines.
• The selected RCTs included 2066 inpatients and covered both non-severe and severe disease stages.
• The methodology involved reviewing evidence types, TCM formulations, quality standards, and outcomes, using the PICO framework.
• The studies showed that TCM can reduce recovery time and disease progression, but there was limited evidence on its effects in severe cases.

Key Findings and Discussions

• Efficacy: TCM interventions were effective in reducing recovery time and preventing disease progression, particularly in mild and moderate cases.
• Safety: No serious adverse events were reported, though some studies noted mild effects on liver function, possibly linked to conventional medications.
• Care Continuum: TCM was used at all stages of the disease, including prevention, mild/moderate treatment, severe/critical care, and convalescence.
• Integrated Approach: The combination of TCM and conventional medicine was seen as beneficial, reducing the burden on conventional treatments and improving patient outcomes.
• Quality Control: TCM ingredients were sourced and processed according to GACP, SOPs, and GMP standards, ensuring consistency and safety.
• Blinding and Placebo: Some studies used saline as a placebo, ensuring blinding for TCM interventions.
• Symptom Differentiation: TCM's ability to differentiate symptoms and tailor treatment was highlighted as a key strength.
• Future Research: Experts recommended more international collaboration, multicentre studies, and the use of AI for data analysis.

Recommendations

• To WHO: Develop guidelines for the integration of TCM into global health systems, and support the standardization and regulation of TCM products.
• To Member States: Encourage the use of TCM in public health responses and promote research collaboration.
• To the Global Community: Share experiences and best practices in the use of TCM for pandemic management, and support the development of evidence-based practices.

Conclusion

The meeting concluded that TCM played a significant role in the treatment of COVID-19, particularly in reducing disease severity and recovery time. While the evidence for severe cases was limited, the integration of TCM with conventional medicine was seen as a promising model. The need for more rigorous, international studies and the use of advanced analytical tools like AI was emphasized to further validate TCM's role in global health.