🌿 Folk Prescriptions

China’s HIV/AIDS epidemic has spread across 31 provinces and municipalities, with 840,000 known carriers. To seek effective treatment methods, recent years have seen research into traditional Chinese medicine (TCM) for preventing and treating AIDS, yielding certain achievements. However, from current clinical practice, integrated Chinese and Western medicine shows even greater advantages. Recently, reporters interviewed Professor Wang Rongbing, head of the integrated Chinese-Western medicine program at Beijing Ditan Hospital.
Study Subjects and Methods
According to Wang Rongbing, Beijing Ditan Hospital began investigating TCM symptom patterns in HIV patients and carriers two years ago and started free herbal treatment in February of this year. To accurately assess TCM efficacy, the hospital conducted a preliminary comparative analysis of 32 HIV patients and carriers receiving integrated treatment (Western antiviral therapy plus TCM) versus 33 patients receiving only Western antiviral therapy with comparable baseline characteristics. All participants were treated at the hospital’s AIDS outpatient clinic between February and July 2005. Diagnostic criteria followed the 2004 guidelines issued by the Chinese Medical Association for AIDS diagnosis and the 2005 "Clinical Technical Guidelines for TCM Treatment of AIDS (Trial)" for TCM pattern classification. CD4 and CD8 counts were recorded as baseline observations after six months of antiviral therapy, when immune function entered a relatively stable phase. Follow-up results three months later served as endpoint indicators, with a three-month TCM treatment course.
Observation indices included demographic data, disease duration, medication history, complete blood count, liver function (ALT), renal function (Cr), CD4, CD8 counts, and CD4/CD8 ratio. T-cell subset analysis used flow cytometry, primarily conducted at the hospital. Some patients had pre-treatment viral load measurements. Primary symptoms in the integrated treatment group included cough, diarrhea, poor appetite, headache, spontaneous sweating, night sweats, fatigue, emaciation, and weight changes, recorded using TCM symptom scoring rules before and after treatment. Both groups received antiretroviral drugs as baseline therapy. TCM treatment followed the "Clinical Technical Guidelines for TCM Treatment of AIDS (Trial)" issued by the State Administration of Traditional Chinese Medicine, with individualized syndrome differentiation. Patients already on antiviral drugs continued antiviral therapy after adding TCM.
Integrated Treatment Superior to Monotherapy
Wang Rongbing stated objectively that after three months of TCM treatment, immune markers and quality of life significantly improved, showing statistically significant differences in self-comparison. The most notable improvements were in fatigue, diarrhea, and poor appetite. Post-treatment, CD4 T-cells increased significantly in self-comparison, and the CD4/CD8 ratio rose, though not statistically significant. Eleven patients gained weight after three months, 17 maintained stable weight. Among the six patients not using antiviral drugs, CD4 and CD8 T-cell counts increased slightly after three months of TCM treatment.
Patients receiving only Western antiviral therapy showed slight CD4 T-cell increases post-treatment, with no significant difference before and after. The CD4/CD8 ratio increased significantly after treatment. Between-group comparison showed superior CD4 T-cell increase in the integrated treatment group. Appropriate TCM treatment can not only improve symptoms and quality of life but also enhance the patient’s ability to resist disease.
Attention to Impact of Adding TCM to Therapy
Wang Rongbing offered her views on how to correctly use TCM in current HIV treatment. TCM integration is most suitable for early-stage patients, whose natural antiviral capacity still exists and who are in a phase of struggle between pathogenic and healthy forces. TCM demonstrates protective effects on cellular immunity and enhances antiviral capacity. Although TCM is not particularly effective in direct antiviral action, it has fewer side effects and is suitable for early monotherapy, potentially delaying the need for antiviral drugs and avoiding numerous adverse reactions, or used synergistically with antivirals.
She emphasized individualization, diagnosing based on patient constitution and main symptoms. Though symptoms vary, the tongue is often pale and dull, and pulse is mostly deep and fine. Fundamentally, this reflects qi-yin deficiency, weakened defensive Qi, pathogenic toxins consuming vital energy, long-standing illness affecting the collaterals, qi stagnation, and blood stasis. The underlying pathology is deficiency of vital energy and dominance of pathogenic factors, leading to multiple complications. Therefore, the core principle is reinforcing the body’s defenses, with the highest frequency of using herbs that strengthen the spleen, tonify qi, and nourish yin. Starting from improving the patient’s main symptoms, adjustments are made according to changing signs, and once improvement is achieved, the overall state is adjusted promptly, yielding good results. Most patients show good compliance.
Antiretroviral "cocktail" therapy has brought hope to AIDS patients. In the first half-year, viral load is rapidly suppressed, CD4 T-cells rise quickly, and general condition improves. Continued use leads to slower CD4 T-cell increase, with most patients’ CD4 counts stabilizing at a certain level without reaching normal values. Some late-stage patients, despite undetectable viral loads, suffer from long-term immune exhaustion, becoming the main cause of death. Therefore, applying appropriate TCM to patients with effective antiviral therapy and relatively stable immune systems aims to promote immune recovery. Preliminary results suggest the necessity and feasibility of early TCM use and co-administration with antiviral drugs. Due to limited case numbers and lack of viral load monitoring, further research is needed on how TCM best complements antiviral drugs to maximize synergy.
Regarding drug formulations, Wang Rongbing cited that decoctions yield the best results. Prepared medicines perform worse. If good processing techniques could preserve the efficacy of decoctions, more patients would prefer TCM. A crucial point to emphasize is that systematic, goal-oriented clinical observation is essential to fully substantiate the findings.
Wang Rongbing concluded: On one hand, some foreign scholars, based on pharmacokinetic and physicochemical analyses, suggest certain TCM components might interfere with antiviral drug efficacy. Our controlled study did not confirm this phenomenon. The complexity of human metabolism means in vitro and in vivo results may differ. China possesses vast TCM resources, and careful selection can avoid such issues. On the other hand, current evaluation methods are primarily designed for antiviral therapy, reflecting the essence of AIDS treatment but failing to fully capture TCM’s clinical characteristics. TCM’s ability to relieve symptoms and enhance antiviral capacity is widely recognized in clinical practice. TCM can play a better role. Therefore, we should develop effective TCM drugs suited to China’s context and expedite the establishment of standardized evaluation criteria for TCM treatment of AIDS.