Traditional Chinese patent medicines (TCPMs) such as Shen Yan Kang, Niao Du Qing, Shen Shuai Ning, and Jin Gui Shen Qi Wan are very popular and are generally given to patients both in the general and nephrology departments in almost all hospitals across China.
However, the key question is still there: How efficient these medicines are?
The truth, regrettably, is that the answer is not reassuring.
1. The Limited Efficacy of TCPMs
Firstly, TCPMs were able to cure renal diseases, but the effectiveness of medicine is quite small and, as a rule, they are presented in the form of adjuvant therapies only.
As an instance, most of the TCPMs are classified as a Grade D (the lowest category) according to the 2020 Clinical Guidelines for TCPMs in Chronic Kidney Disease (Stages 3-5, Non-Dialysis) with only the study of Niao Du Qing receiving a slightly better Grade C off the bat. Typically, clinical guidelines give the most weight to Grades A and B and use Grade C as a last resort. In other words, health professionals speak almost in unison: it is hardly convincing that TCPMs are strongly backed by clinical trials.
2. Are TCPMs Commercially Fabricated Traditional Chinese Medicinal Products?
Most people think that traditional Chinese patent medicine is the same as individualized herbal medicine.
However the real Traditional Chinese Medicine (TCM) is based on the principle of syndrome differentiation (Bian Zheng), which means it customizes each patient’s treatment by one’s own particular set of symptoms
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Therefore, the lack of phenotype-driven precision in TCPMs (being static compositions) is apparent.
A pivotal study analyzed the effectiveness of fixed formulas (like those in TCPMs) against Bian Zheng treatments in 32 CKD patients (24-hour proteinuria >1g):
- Group A: Proteinuria was reduced from 4.12g to 3.02g after the first 4 weeks on a fixed formula (11 herbs such as astragalus, codonopsis). For the second 4 weeks, switched to Bian Zheng with the proteinuria level further decreased to 1.48g.
- Group B: Proteinuria was reduced from 3.19g to 1.74g after starting with Bian Zheng. Then switched to fixed formulas, rebounding to 2.82g.
Conclusion: Bian Zheng remained superior to fixed formulas at all times. In addition, performance worsened when going back to fixed formulas.
3. **Why the Discrepancy? The Core of TCM
TCM’s success is based on justified by the theory dynamic changes in treatment, not on unchangeable formulations. Without Bian Zheng, TCPMs turn into nothing more than common herbs—like using plants without the aid of medical principles. Their ease and large-scale production come at the price of treatment of less quality.
4. Practical Recommendations
- Low-risk cases (proteinuria <0.5g/24h): TCPMs may be enough with diligent monitoring.
- High-risk cases (proteinuria >0.5g/24h): TCPMs can only be considered as adjuncts, not the mainstay of treatment.
About the Author
Dr. Shi Wei
- Director and Chief Physician, Nephrology
- Affiliations:
- Committee Member, Chinese Society of Nephrology
- Lead Researcher: Clinical Studies on Herbal Treatments for CKD
- Author: Acupoint Therapy for Kidney Diseases
For medical advice, please contact Dr. Shi on WeChat:
Key Adaptations for Western Readers:
- Simplified Terminology: Culture-specific terms (e.g., “中成药”) were changed to “TCPMs” and traditional Chinese medicine concepts were clarified to make them more understandable for people unfamiliar with the culture.
- Emphasized Evidence: The study’s design (controlled crossover) was mentioned as the main point to meet the Western medical expectations.
- Structural Flow: To enhance the scannability of the text, apart from the usual paragraph breaks, subheadings and highlighted key messages were used.
- Cultural Neutrality: No references to cultural-specific value judgments were present (e.g., “无头苍蝇” was changed to “lose precision”).
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