In August the Annals of Internal Medicine published Chinese research on the efficacy of an herbal formula versus the drug Oseltamivir for the treatment of mild H1N1 flu in the 2009 season. The randomized study included 400 patients between 15 and 59 years of age with laboratory-confirmed cases of H1N1 at 11 different hospitals. There were four arms of the study: patients treated with Oseltamivir, those treated with an herbal decoction*, those treated with Oseltamivir and the herbal decoction, and a control group that was not treated. The main measurement of efficacy for the researchers was the time from starting treatment to the time the fever broke. All three of the treatment groups showed reduction in time to fever resolution compared to the control group. Oseltamivir brought the fever down in 20 hours, the herbal decoction in 16 hours, and combined treatment in 15 hours. The untreated group took 26 hours to fever resolution. All four groups reported equal misery in their symptom scores. Two of the patients receiving the herbal decoction had nausea and vomiting (those of you who know how this stuff tastes will not be surprised). The conclusion was that the herbal decoction was a reasonable alternative treatment. (1,2)
The herbal decoction formula that was used in this research was a combination of two classical formulas, yin qiao san and ma xing shi gan tang, and included 12 herbs, one of which – honey fried ephedra – is banned in the United States. From a Traditional Chinese Medicine standpoint, the herbs in the combined formula release the exterior to vent heat, clear heat toxins, generate and protect fluids, and disperse and descend lung qi. From the Western point of view, the herbs have fever-reducing qualities for the fever associated with H1N1. (2)
In my opinion, the greatest strengths of Chinese herbal medicine are in prevention and in customization. Many formulas can be used prophylacticly at the time of exposure, or at the onset of earliest symptoms, to prevent the full-blown disease. Basic formulas can easily be combined and customized to fit the situation of the specific patient, mitigating side effects and achieving the best whole-body results for the individual. However, in this trial, a generalized Chinese herbal formula was used as a one-size-fits-all disease management tool, like a Western medication, and shows itself to be a viable alternative to the standard of care (Oseltamivir).
One of the base formulas from this study, yin qiao san, is available as a patent medicine (lower potency, but in an easy-to-take pill form), you can get it in some health food stores and on Amazon.com. It’s a great thing to have in your bag of tricks if you fly a lot or are exposed to people who have cold or flu symptoms. The idea is to take it as soon as you have the vaguest feeling that you might be getting sick. It works best on “wind heat” type presentations (this is the kind of cold/flu that has been dominant in the last three years). If your co-worker is complaining of a sore throat, this is the right stuff for you. If you have on-going health issues that need to be taken into account, you would be better off with a stronger customized formula. Since the formula’s efficacy as a preventative depends on taking it in the window before symptom onset, you may want to consult your herbalist and get a supply to have on-hand before the fall cold and flu season gets into full swing.
* An herbal decoction is the liquor resulting from concentrating the essence of a plant part by heating or boiling.
1) Annals of Internal Medicine, vol. 155 no.4 217-255, August 16, 2011
2) Journal Watch – Physician’s First Watch, August 16, 2011