J. Biomedical Science and Engineering, 2010, 3, 828-831 JBiSE
doi:10.4236/jbise.2010.38111 Published Online August 2010 (http://www.SciRP.org/journal/jbise/).
Published Online August 2010 in SciRes. http:// www.scirp.org/journal/jbise
Use of traditional Chinese medicine in HIV/AIDS in China*
Jian Wang, Wen Zou, Ying Liu
Traditional Chinese Medicine Center for AIDS Prevention and Treatment, China Academy of Chinese Medicine Sciences, Beijing,
China.
Email: 62tiger@163.com
Received 20 May 2010; revised 8 June 2010; accepted 22 June 2010.
ABSTRACT
This paper gives a general introduction of HIV/AIDS
treatment with Traditional Chinese Medicine (TCM)
in China during the past 20 years. Although the role
of TCM in treatment of HIV/AIDS is promising,
there is still a long way to go.
Keywords: HIV/AIDS; Traditional Chinese Medicine
(TCM)
1. INTRODUCTION
Since the early 1980’s over 40 million individuals have
infected with HIV worldwide and over 12 million have
died. In China there had by 2009 been 319,877 cases
were identified as HIV/AIDS [1]. The medical, social
and economic implications of HIV infection are devas-
tating.
In 1996, protease inhibitor therapy became widely
available for use in the treatment of HIV infection, thus
a decline in HIV-related morbidity and mortality had
been reported. Over the last decade, more and more
Chinese HIV/AIDS patients turn to seek TCM treatment,
among the reasons commonly cited for the use of TCM
by patients with HIV infection are: expectation of good
effect, reduction of symptoms from the disease or reduc-
tion of medicine side effect, or desire for improved qual-
ity of life and increased control over the disease process.
In all, there is a growing need in china for TCM to sup-
port people living with HIV/AIDS, to help to alleviate
some of the side effects of the drug therapy, to improve
quality of life and to assist in the treatment of individuals
who are either unwilling, unresponsive or resistant to
combination therapy.
This paper gives a general introduction of use of tradi-
tional Chinese medicine in HIV/AIDS in China over the
past 20 ye a r s .
2. TCM VS AIDS
TCM is a complete medical system with its own unique
philosophy, diagnostics and treatment methods which is
different from conventional therapy. As a kind of medi-
cal system with thousands years of history, the reason
why TCM could exist after such a long time is efficacy
in clinical practice that help ancient people alive under
arduous climate conditions. The basis of TCM theory is
Yin-yang and five elements which related to the whole
universe, so TCM views the human body and nature as
integral not divided. A healthy human is under the state
of relatively dynamic balance maintained by both inside
and outside of the body, if the balance is broken, the
illness occurs. TCM aims to recover the balance of hu-
man body, just as the old saying in TCM bible “The Yel-
low Emperor’s Classic of Internal Medicine”: once Yin
balances with Yang, there comes the harmony of the
body and the spirit.
Syndrome differentiation and integral regulation are
two main characteristics of TCM. TCM focuses on dif-
ferentiation of syndromes with the holistic and dynamic
perspective and aims to the pa tient with su ffering disease
instead of only the disease itself. The constitution of the
patient is different, the illness phase is various, the body
response is diverse, the manifestation is not the same,
and therefore the treating principle should be varied.
Because AIDS is a “new” disease, having only been
identified in 1981, there is no specific research on the
disease from the past or in the classics. TCM does pos-
sess a large body of information about infectious dis-
eases and epidemics, and ways to describe the symptoms
of those suffering from AIDS. AIDS can be defined in
several different ways according to TCM pattern identi-
fication. TCM uses the term “yi bing” (infectious epi-
demic diseases), to describe epidemic diseases such as
AIDS, which are caused by invading evils (viruses).
AIDS can also be thought of as a “pestilence,” The Chi-
nese term for this is “wen yi”, such a disease was
thought to have a long latency, sudden onset, and severe
symptoms. TCM methods used for treating AIDS is di-
*Granted Fund: State Major Science & Technology Specific Projects
(2008ZX10005-001)
J. Wang et al. / J. Biomedical Science and Engineering 3 (2010) 828-831 829
Copyright © 2010 SciRes. JBiSE
verse, such as herbal medicine, acupuncture and moxi-
bustion, Qigong, which aims to enhance immune func-
tion of the body, delay the development of disease, re-
duce or remove the symptom-signs, so as to improve
quality of life and prolong life expectancy. The purpose
of TCM is to support the strong energy and body resis-
tance so as to inhibit the progress of disease. Someone
has enough strong energy and body resistance in TCM,
even if infected with HIV, he can live with it, being a
long term HIV carrier, so as to postpone onset and death.
In all, from our point of view, the best time of interven-
ing in AIDS with TCM is: For asymptomatic stage (HIV
carrier) patients, the key aim of TCM is to maintain and
enhance the immune-function so as to delay its progres-
sion to AIDS stage. For AIDS stage, TCM treatment
focuses on relieving symptoms of patients who have
AIDS-related opportunistic infection so as to improve
the quality of life or combines with HAART therapy to
alleviate the side effect of biomedical drugs.
3. WHERE IS THE EFFECTIVE
EVIDENCE?
3.1. Chinese Herbal Medicine Screening
Tens of thousands of herbs have been screened for
anti-HIV activity. More than 140 kinds of herbs demon-
strated to harbor HIV inhibitory activity, such as Radix
Arnebiae, Herba Violae, Flos Lonicerae, Flos Chrysan-
themi Indici, Fructus Mume, Cortex Cinnamomi, Fruc-
tus Ligustri Lucidi et al. [2-5] Some bioactive materials
extracted or isolated from medicinal herbs showed inhi-
bition of HIV activity as well: polysaccharides (such as
polysaccharides of Radix Ginseng, Glossogyne tenui-
folia Cass, Radix Astragali, Ganoderma Lucidumseu
Japonicum, Radix Actinidiae); protein components (such
as glucoprotien in Aloe, a component from Radix
Trichosanthis, Alph and Beta Momordicines in Mo-
mordica charantia, Ricin bond A, cimigenol saponin);
alkaloids (such as castanospermine and colchicines);
lactones(such as baicalein and hypericin); terpenes(such
as glycyrrhizin and goddypol) et al. Mechanisms of ac-
tion included inhibition of reverse transcriptase, protease
inhibition and integrase inhibition or interference of in-
fection at the viral cell entry level. Among them,
Trichosanthin is a kind of prospective one that acquired
worldwide attentionit was shown to inhibit HIV rep-
lication in infected cells of lymphocyte and mononuclear
phagocytic lineage, with no measurable toxicity in unin-
fected cells, and it was applied in the treatment of pa-
tients with AIDS or AIDS-related complex in phase
and studies [6-11].
Many more herbs or herb extracts may attenuate the
course of HIV infection via immune enhancement, cyto-
kine or other pathways, such as Radix Astragali, Cordy-
ceps been reported to enhance helper lymphocyte T and
promote CD4/CD8 ratio. [12- 13] Shikonin was shown to
decline the expression of CCR5 and CCR5mRNA [14].
Many herbal compounds have been tested to have po-
tent HIV inhibitory activity and their experimental or
clinical manifestation may provide valuable leads for
further investigations. For instance, Xiao chaihu tang,
[15] Zhongyan-1, [16] Zhongyan-2, Zhongyan-4, Com-
pound SH [17], Tangcao Tab lets et al.
3.2. Clinical Trials
According to the r egulation of State Food an d Drug Ad-
ministration (SFDA) in China, new Chinese patent
medicine treating AIDS can be classified into anti-HIV
patent that testified through in vitro and in vivo experi-
ments and patent supplementary for AIDS treatment that
either adds synergistic effect or alleviates toxic-side ef-
fect on antiretroviral drugs already existed. Tangcao
Tablets is the first patent approved by SFDA for allevi-
ating symptoms and signs of HIV/AIDS patients, 5 other
relatively matured compounds (Qiankunning Tablets,
Keaite capsule, Chuankezhi injection, Zhongyan-2 Gran-
ule and Compound Sanhuangsan) are still under clinical
trials.
Tangcao Tablets: Wu Hao et al. [18] recruited 173
HIV/AIDS participants for randomized double blind
placebo controlled clinical study in 5 medical centers for
6 months, result showed that Tangcao Tablet could sig-
nificantly raise CD4 count, increase weight and CD4/
CD8, and it was possible to delay the rep lication of HIV.
Zhongyan-4 Granule: Wang Jian et al. [19] recruited
72 HIV/AIDS participants for a randomized dou-
ble-blind placebo-controlled trial for 6 months. Results
showed that 15 out of 30 patients in Zhongyan-4 group
had their CD4 counts increased by 7.70 ± 150.96/mm3,
markedly higher than that in placebo group, no adverse
reaction was found.
Qiankunning Tablets: Shi Dan et al. [20] recruited 36
HIV/AIDS participants for a randomized double-blind
placebo-controlled trial for 7 months. The results showed
that significant difference of plasma HIV-1RNA level
was found between patients treated with Qiankunning
Tablet and those treated with placebo for control after
they were medicated for 7 months, suggesting the
Qiankunning tablet was effective in reducing viral load.
Moreover, in the next 3 months open treatment, it illus-
trated further the evident effect of Qiankunning Tablets
in reducing plasma level of HIV-1RNA, and raising CD4
dose-dependently. Symptoms and QOL in patients were
improved as well.
Xiaomi Granule: Chen Jizhong [21] recruited 34
HIV/AIDS patients with oral candidiasis for a two weeks
RCT trial, Participants were randomized into two groups,
the 34 cases in treatment group received Xiaomi Granule,
830 J. Wang et al. / J. Biomedical Science and Engineering 3 (2010) 828-831
Copyright © 2010 SciRes. JBiSE
and the 34 cases in control group received Nystatin. The
result showed that Xiaomi Granule group had better ef-
fect than the controlled group, and a lower reoccurrence
rate was found after two weeks follow-up.
3.3. Medical Care
TCM intervention on HIV/AIDS treatment started from
2004, a pilot project named National Free TCM HIV/
AIDS Treatment Program had been launched by The
State Administrative Bureau of Traditional Chinese
Medicine, and quickly scaled up from 5 provinces (He-
nan, Hebei, Anhui, Hubei, Guangdong) to 19 provinces,
autonomous regions, and municipalities in China in-
cluding some places with high prevalence, 9267 cases
have been treated with TCM accumulatively. The thera-
peutic effects on 8946 cases from pilot project are as
follows: most of the cases maintained stable immune
function; main symptoms and signs like fever, cough,
fatigue, poor appetite, diarrhea had significantly been
improved (P < 0.001), no adverse reaction was found in
TCM treatment.
4. HOW TO EVALUATE THE
EFFECTIVENESS?
Current used effectiveness evaluation gold standard:
viral load and CD4+T cell count seemed to be not proper
for TCM. Some AIDS patients had improved quality of
life or prolonged life after TCM treatment, but their viral
load might be still in a high level and CD4+T cell count
can’t see significant elevation. As to patients, improve-
ment in quality of life rather than biomedical parameters
changes matters so much to them. So if TCM clinical
effectiveness evaluation take items such as patients re-
ported outcomes (PRO), quality of life, clinical end
points (morbidity, mortality, life span), activities in daily
life (work ability) et al. into consideration, or even let
those items play key part in the evaluation, that might be
more appropriate for TCM evaluation.
From 2008, China State Major Science & Technol-
ogy Specific Projects granted about 100 million on
TCM research on HIV/AIDS, which posed big oppor-
tunity to TCM researchers. In other words it is also big
challenge. Although TCM appears to be associated
with improvements in immune function, quality of life,
and some AIDS related opportunistic diseases. Defini-
tive conclusions were limited due to variation in de-
signs, comparisons, heterogeneous outcomes and in-
adequate controls. High-quality, well-controlled, longer
randomized trials are needed to better inform clinical
decisions in the coming works.
REFERENCES
[1] Wang, L., Wang, N., Wang, L., Li, D., Jia, M., Gao, X., et
al. (2009) The 2007 estimates for people at risk for and
living with HIV in China: Progress and challenges.
Journal of Acquired Immune Deficiency Syndromes, 50(4),
414-418.
[2] Luo, S.D. and Ju, P. (2006) Compared traditional Chinese
medicine and western medicine to treat AIDS. Journal of
Henan University of Chinese Medicine, 21(3), 1-3.
[3] Lam, T.L., Lam, M.L., Au, T.K., et al. (2000) A com-
parison of human immunodeficiency virus type-I prote-
ase inhibition activities by the aqueous and methanol ex-
tracts of Chinese medicine herbs. Life Science, 67(23),
2889-2896.
[4] Au, T.K., Lam, T.L., Ng, T.B., et al. (2001) A comparison
of HIV-1 integrase inhibition by aqueous and methanol
extracts of Chinese medicine herbs. Life Science, 68(14),
1687-1694.
[5] Kobayashi, Y., Watanabe, M., Ogihara, J., et al. (2000)
Inhibition of HIV-1 reverse transcriptase by methanol
extracts of commercial herbs and spices. Journal of the
Japanese Society for Food Science and Technology, 47(8),
642-645.
[6] McGrath, M.S., Santulli, S. and Gaston, I. (1990) Effects
of GLQ223 on HIV replication in human monocyte/
macrophages chronically infected in vitro with HIV.
AIDS Research and Human Retrovirus es, 6(8), 1039-1 043 .
[7] McGrath, M.S., Hwang, K.M., Caldwell, S.E., et al. (1989)
GLQ223: An inhibitor of human immunodeficiency virus
replication in acutely and chronically infected cells of
lymphocyte and mononuclear phagocyte lineage. Pro-
ceedings of the National Academy of Sciences, 86(8),
2844-2848.
[8] Byers, V.S., Levin, A.S., Malvino, A., et al. (1994) A
phase II study of effect of addition of trichosanthin to
zidovudine in patients with HIV disease and failing anti-
retroviral agents. AIDS Research and Human Retrovi-
ruses, 10(4), 413-420.
[9] Mayer, R.A., Sergios, P.A., Coonan, K., et al. (1992)
Trichosanthin treatment of HIV-induced immune dys-
regulation. European Journal of Clinical Investigation,
22(2), 113-122.
[10] Byers, V.S., Levin, A.S., Waites, L.A., et al. (1990) A
phase I/II study of trichosanthin treatment of HIV disease.
AIDS, 4(12), 1189-1196.
[11] Kahn, J.O., Kaplan, L.D., Gambertoglio, J.G., et al. (1990)
The safety and pharmacokinetics of GLQ223 in subjects
with AIDS and AIDS-related complex: A phase I study.
AIDS, 4(12), 1197-1204.
[12] Gai, L., Song, C.Q., Hu, Z.B., et al. (2001) Review of
anti-HIV plants. Foreign Medical Sciences, 23, 139.
[13] He, J.H. and Mai, E.D. (2004) Review of AIDS treatment
with Chinese medicine. Chinese Pharmaceutical and
Clinical R esearch, 4, 454.
[14] Chen, X., Yang, L., Zhang, N., et al. (2003) Shikonin, a
component of C hinese he rbal medi cine, inhibit s chemokine
receptor function and suppresses human immunodefi-
ciency virus type 1. Antimicrobial Agents and Chemo-
therapy, 47(9), 2810-2816.
[15] Zhang, Z.J. (1995) The phagocytosis of HIV infected
cells by Xiao chaihu tang extracts. Foreign Medical Sci-
ences, 17, 64.
[16] Guan, C.F. (1995) Experimental study of SIV infected
monkey model treatment by Zhongyan-1. Chinese Jour-
J. Wang et al. / J. Biomedical Science and Engineering 3 (2010) 828-831 831
Copyright © 2010 SciRes. JBiSE
nal of Information on Traditional Chinese Medicine, 2,
42-46.
[17] Kusum, M., Klinbuayaem, V., Bunjob, M., et al. (2004)
Preliminary efficacy and safety of oral suspension SH,
combination of five Chinese medicinal herbs, in people
living with HIV/AIDS; the phase I/II study. Journal of
the Medical Association of Thailand, 87(9), 1065-1070.
[18] Wu, H., Zhang, F.J., Yao, C., et al. (2004) Clinical study
of Tangcao tablet in treating HIV/AIDS. Compilation of
Theses of Treatment and Research on AIDS, 3, 95-103.
[19] Wang, J., Yang, F.Z., Zhao, M., et al. (2006) Randomized
double-blinded and controlled clinical trial on treatment
of HIV/AIDS by Zhongyan-4. Chinese Journal of Inte-
grative Medicine, 12(1), 6-11.
[20] Shi, D. and Peng, Z.L. (2003) Randomized double blind
placebo paralleled clinical research on HIV/AIDS with
Qiankunning tablets. Study Journal of Traditional Chi-
nese Medicine, 21, 1472-1474.
[21] Chen, J.Z. (2009) Xiaomi granule on HIV/AIDS patients
with oral candidacies. Guangming Journal of Chinese
Medicine, 24, 633-636.