Traditional Chinese Medicine May Yield Better Result in Treatment for Dengue Fever

By: Dr. Jeffrey Chua Tse Fai  September 3, 2022

Millions cases of dengue infection occur worldwide each year. It is a common disease and cases are now rising in the Philippines. As of 16 July this year, there are already 82,597 cases and 319 deaths have been reported, an increase of 17,800 cases and 45 deaths since 25 June 2022.

Dengue fever is an endemic disease, and the risk of transmission is highest during and immediately following the rainy season, which typically occurs during May-November here in Philippines.

People of all ages can get dengue fever if they are exposed to infected mosquitoes, an illness caused by any of 4 dengue viruses, and mainly transmitted to people through the bites of infected Aedes species mosquitoes. 

The incubation period is about 5–7 days, and the symptoms are usually sudden onset of high fever, which may last from 2 to 7 day, with other flu-like symptoms. such as aching muscles and joints, red eyes, pain behind the eyes, lethargy, skin rashes, facial flushing, sore throat, headache, nausea and vomiting, and even difficult breathing. Symptoms may vary from mild to severe, from  dengue fever develops into dengue hemorrhagic fever, then progress to shock (dengue shock syndrome) of which is potentially lethal. The course follows 3 phases: febrile, critical, and convalescent. Approximately 75 – 90% of individuals may have acquired dengue without any symptoms, not even fever.

Dengue fever can result in a drop in your white blood cell and platelet counts. For patients presenting during the first week after fever onset, diagnostic testing should include a test for dengue virus (rRT-PCR or NS1) and IgM. For patients presenting >1 week after fever onset, IgM detection is most useful, although NS1 has been reported positive up to 12 days after fever onset

Dengue fever is caused by a virus, and there is still no specific drug to treat it. Supportive medication and care is given to control and relieve the symptoms and advised to stay well hydrated. Must avoid aspirin (acetylsalicylic acid), aspirin-containing drugs, and other nonsteroidal anti-inflammatory drugs (such as ibuprofen) because of their anticoagulant properties.

In traditional Chinese medicine, Dengue fever belongs to the category of "plague", and can be treated with reference to "epidemic rash", "damp-heat fever", "summer heat fever", "latent summer heat" and other disease syndromes in febrile diseases. The progression of the disease is classified into 3 stages: (1). Fever period- characterized as having heat congested with dampness and both the external defensive wei and internal body energy are both affected, the treatment objectives or principles are clearing away heat and dispelling dampness, detoxifying and eliminating pathogen. (2). Critical period, has subdivided into two subcategories (a). stagnation with toxic substance and blood channels are being disturbed, the treatment objectives are detoxification and removing blood stasis, and clearing the blood channels by blood cooling, and (b). summer heat with dampness that has injured the yang energy and the energy cannot control and get hold of the blood, the treatment objectives are warming the yang, benefitting Qi (energy) and regulating the blood movement , then (3). Recovery period, characterized as both yin and Qi (energy) have been depleted, treatment principles are clearing of heat and eliminating dampness, and strengthening the spleen and stomach.

When comes to treatment methods in TCM, moxibustion application and herbal decoction are often used. selection of acupoints and herbal medicines purposes in general are for purging heat, cooling the blood and promoting blood circulation, nourishing yin and clearing the blood channels, detoxification and eliminating blood stasis. In dengue, the kidney is primarily injured and affected that need for reinforcement. Recommended acupoints are: BaiHui GV20, DaZhui GV14 . ZhongWan Ren12, HeGu LI14, ShaoZeS11, ZhongChongPC9, ZuSanLi ST36, ShenSu BL23, YongQuan KD1.....

Below is a clinical case applying TCM herbal granules for a dengue patient:

A female housewife who has tested positive for dengue, Western medicine doctor had prescribed multi-vitamins and biogenic to her. She also took Euphorbia hirta, commonly known as "Tawa-Tawa" is a plant used in folklore medicine in the Philippines for the treatment of dengue. She came to our clinic on August 26, 2022 for consultation. Although her platelet count has escalated to normal range, but still have the following complains: aversion to cold, yet the center of the hands and feet have heat sensation, mouth is dried with thirstiness, urine is yellowish with heat sensation, heavy headed, stomach discomfort feel like to vomit and no appetite, lethargy, defecation is normal. Tongue diagnose: reddish and slippery. Pulse is weak with tightness, liver and spleen weakness, Palpation: body is covered with a thick layer of cold and dampness, can see white and red spots (rashes-like) on certain skin portion of the body.

August 26, 2022 Granules Formula:

Qiang Huo (Rhizoma seu Radix Notopterygii), Du Huo (Radix Angelicae Pubescentis), Fu Zi (Radix Aconiti Lateralis Praeparata), Dang Shen (Radix Codonopsis),Sheng Di Huang (Radix Rehmanniae), Zhi Zi (Fructus Gardeniae), Dan Dou Chi (Semen Sojae Preparatum), Chi Shao (Radix Paeoniae Rubra), Huang Bai (Cortex Phellodendri), Guang Huo Xiang (Herba Pogostemonis), Hou Po (Mangnolia officinalis), Sha Ren (Fructus Amomi), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Tu Si Zi (Semen Cuscutae). 7 sets

A follow-up consultation on September 2, 2022

The patient said has a big improvement, already not so much aversion to wind, and the heat sensation on center of the hands and feet have subsided a lot. Major complain was feeling of discomfort and tightness at the neck and head. Urine is yellowish with heat sensation and have thirstiness, not more easy to get tired, good appetite already, defecation is normal. Palpation found lessen damp-cold pathogen remain on the back of the body. Redness tongue has lightened, yet still slippery. Pulse strength improved.

September 2, 2022 Granules Formula:

Tai Zi Shen (Radix Pseudostellariae), Sheng Di Huang (Radix Rehmanniae), Cang Zhu (Rhizoma Atractylodis), Dang Gui Wei (Angelica Root), Ze Xie (Rhizoma Alismatis), Zhi Mu (Rhizoma Anemarrhenae), Ge Gen (Radix Puerariae) , Gui Zhi (Ramulus Cinnamomi) , Zhi Zi (Fructus Gardeniae), Dan Dou Chi (Semen Sojae Preparatum), Nu Zhen Zi (Fructus Ligustri Lucidi), Mo Han Lian (Herba Ecliptae), Zhi Gan Cao ( Prepared Licorice). 7 sets