the Differences in Qingguan Treatment: A Patient's Inquiry

Questions about Qingguan No. 1?

Hello, Doctor: My boyfriend and I were diagnosed almost three months apart, and we both consulted the same traditional Chinese medicine clinic via video for Qingguan treatment.
My boyfriend had more severe symptoms when he was diagnosed (he had a fever, a very sore throat, and persistent coughing), while I only experienced a fever and a dry throat, which was uncomfortable but not painful.
The Chinese medicine doctor prescribed my boyfriend "Hua Tuo" Qingguan, advising him to take one packet, which contains only 5g, for three days (although he could take more, the doctor said one packet was sufficient unless he felt it was ineffective; he generally took one packet, only taking two packets once due to blood-tinged phlegm).
However, I received "Keda," which has a dosage of 10g per packet, and I am instructed to take it three times a day for five days, with the doctor emphasizing that I should complete the full five days.
We are both patients of the same clinic and the same doctor, so I am confused as to why my boyfriend was prescribed only three days while I was prescribed five.
This difference has made me worry that my boyfriend, whose symptoms were more severe, may not have taken enough medication...
(or am I taking too much?? I tend to have cold hands and feet in winter, but I forgot to mention this during the video consultation).
Since I am still in quarantine and cannot visit the clinic for a pulse diagnosis, I would like to ask: (1) Is the difference in the Qingguan treatment simply due to different brands and dosages? (2) Is it insufficient for my boyfriend to have taken only three packets of Hua Tuo? (3) Should I complete the full five days of treatment? Thank you for your assistance.

Pi Er, 30~39 year old female. Ask Date: 2022/08/22

Dr. Gao Peiyi reply Traditional Chinese Medicine

(1) Similarly, for the issue concerning Huatuo, the recommended dosage is three times a day, with two packets each time, totaling 5 grams per packet, which amounts to 30 grams a day.
The same applies to Keda, which also has a daily dosage of 30 grams.
The brands covered by the National Health Insurance for Qingguan No.
1 are almost all prescribed at 30 grams per day (for individuals over 40 kg).
I believe the prescribing method over five consecutive days is clearly a personal issue.

(2) For individuals who are not elderly or do not have chronic diseases, their immune systems are generally sufficient, and there is no need to worry.
Younger individuals with better immunity may experience more severe initial symptoms, but they recover quickly and are unlikely to develop chronic conditions.
Once recovery occurs, there is no need to be concerned about previous inadequate intake.
(3) Regarding the experimental design of the Qingguan No.
1 study, patients took the medication continuously for an average of 8 days to achieve a negative test result.
The reason for the five-day prescription is that the National Health Insurance only covers Qingguan No.
1 for five days.
This is not an indication of overdose; many individuals take it for more than five days.
However, five days should be sufficient for younger individuals.
Chronic conditions are almost exclusively seen in the elderly or those with chronic diseases.

Reply Date: 2022/08/22

More Info

When it comes to traditional Chinese medicine (TCM) treatments like Qingguan, variations in prescriptions can often lead to confusion among patients, especially when comparing treatments for similar conditions. Your inquiry touches on several important aspects of TCM, including dosage, duration, and the rationale behind different treatment plans.

1. Differences in Brands and Dosages: The differences in the Qingguan formulations, such as "Hua Tuo" and "Ke Da," can be attributed to the specific ingredients and their concentrations. Each brand may have a different composition, which can affect the dosage and the duration of treatment. In TCM, the choice of herbs and their proportions are tailored to the individual’s condition, constitution, and response to treatment. Therefore, it is not uncommon for two patients with similar symptoms to receive different prescriptions based on their unique health profiles.

2. Duration of Treatment: Your boyfriend's treatment with "Hua Tuo" for three days may have been deemed sufficient by the practitioner based on his symptoms and overall health condition at the time. TCM practitioners often assess the severity of symptoms, the patient's constitution, and their response to treatment when determining the duration of herbal therapy. If your boyfriend had a more severe presentation, the practitioner might have felt that three days was adequate for his recovery, especially if he was responding well to the treatment. However, it’s also possible that he could have benefited from a longer duration, depending on how his symptoms evolved.

3. Your Treatment Plan: As for your treatment with "Ke Da," the recommendation to take it for five days suggests that your practitioner believes this duration is necessary to address your symptoms effectively. It’s essential to follow the prescribed duration, as stopping treatment prematurely can lead to incomplete recovery or a resurgence of symptoms. Your concern about having a constitution that tends to be cold (as you mentioned experiencing cold hands and feet in winter) is valid, as TCM often considers these factors when prescribing treatment. If you feel that your constitution might influence your treatment, it would be beneficial to communicate this to your practitioner in future consultations.

In summary, the differences in treatment plans between you and your boyfriend can be attributed to the specific formulations of the Qingguan treatments and the practitioners' assessments of each patient's condition. It is crucial to adhere to the prescribed treatment duration and dosage, as these are tailored to your individual needs. If you have ongoing concerns about your symptoms or the appropriateness of your treatment, consider scheduling a follow-up consultation with your TCM practitioner. They can provide further insights and adjustments to your treatment plan based on your current condition and any new symptoms that may arise.
Lastly, it’s always a good practice to maintain open communication with your healthcare provider, whether in TCM or Western medicine, to ensure that your treatment aligns with your health needs and concerns.

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