TCM for Colds and Flu: Evidence for Herbal Formulas
What Cochrane and other reviews found for Chinese herbal formulas in colds, flu, sore throat and acute bronchitis, why most trials are weak, and when symptoms need medical care.
Content last updated . This page has not been medically reviewed.
Read this first
Most colds clear on their own, but some symptoms need a clinician. The NHS lists these reasons to see a doctor: a high temperature for more than 3 days, symptoms getting worse, shortness of breath or chest pain, a cough lasting over 3 weeks, symptoms that do not improve after 10 days, worry about a child, or having a long-term condition (such as diabetes or heart, lung or kidney disease) or a weakened immune system. [1] For flu, sudden chest pain or severe difficulty breathing needs emergency help (911 in the US). [2] Flu can seriously affect some people, and the NHS says to get the flu vaccine if advised. [2] See colds, flu and respiratory infections and vaccines and infection prevention.How TCM approaches colds and flu
The Cochrane review of Chinese herbs for influenza notes that these herbs are often given following a particular Chinese medical theory. [3] Many Chinese patent medicines have been authorized in China for the common cold. [4] The research question, though, is the same as for any treatment: compared with placebo, an antiviral or usual care, are recovery time, symptoms or complications different? Antibiotics do not work for colds, which are caused by viruses. [1] For how formulas are built, see formula structure.What the reviews found
| Question | What the source found | Strength of evidence |
|---|---|---|
| Influenza: Chinese herbs vs antivirals or placebo | Cochrane review, 18 trials (2,521 people). Methodological quality of 17 was poor. Most herbs showed effects similar to antiviral drugs; few were superior. The authors said evidence remains weak. [3] | Insufficient evidence |
| Common cold: Chinese patent medicines | Review found 5 trials, all at high risk of bias, all in children aged 6 months to 14 years. Two products had higher cure rates than antiviral drugs in single trials, but the authors said no confirmed conclusion could be drawn and safety was uncertain. [4] | Insufficient evidence |
| Sore throat: Chinese herbal formulas | Cochrane review of 12 trials (1,954 people): 10 were poor quality. Some formulas beat comparison drugs in single trials, but the authors said they could not recommend any formulation. [5] | Insufficient evidence |
| Acute bronchitis: Chinese herbs | Cochrane review: no studies met the inclusion criteria; one weak study was analyzed. There was insufficient quality data to recommend routine use. [6] | Proper evidence not found in the Cochrane review (2008) |
| Andrographis for acute respiratory infections | Review of 33 trials (7,175 people): improved cough and sore throat compared with placebo, mainly mild stomach side effects, but overall trial quality was poor. [7] | Promising but limited |
Andrographis (chuan xin lian) has its own page: Andrographis. The honeysuckle and forsythia pairing found in many "cold" formulas is described in Honeysuckle and forsythia.
Patent medicines and "Lianhua Qingwen"
A Chinese patent medicine is a premade product. For COVID-19, see TCM and COVID-19 in China. For the reading of labels, see reading a Chinese patent medicine label. The Lianhua Qingwen studies my search turned up were mostly Chinese-language reviews and trial protocols that I could not assess here, so I make no claim about that product.Where evidence is missing
Proper evidence not found for Chinese herbs preventing flu or shortening it better than modern antivirals, or for any herbal product reducing complications such as pneumonia. I searched PubMed for Cochrane reviews and systematic reviews on colds, flu, sore throat and bronchitis. For soothing a cough or sore throat at home, see cough and sore throat remedies; more uses are in TCM evidence by use.Frequently asked questions
Do Chinese herbs cure the flu?
No. A Cochrane review of 18 trials found weak evidence, mostly poor-quality trials comparing herbs with antivirals. [3]
Do Chinese herbs help a sore throat?
Some formulas beat comparison drugs in single trials, but the Cochrane authors could not recommend any formula because of poor trial quality. [5]
Is andrographis worth trying for a cold?
A review of 33 trials found improved cough and sore throat versus placebo with mostly minor stomach side effects, but trial quality was poor. [7]
Are antibiotics needed for a cold?
No. Colds are caused by viruses and antibiotics will not relieve symptoms or speed recovery. [1]
Is it safe to use ma huang for a cold?
No. The FDA banned ephedrine alkaloid supplements in 2004 because of serious safety risks. [8]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Safety
- Ephedra (ma huang). Ma huang has been used in China for colds and congestion. [8] The FDA banned dietary supplements containing ephedrine alkaloids in 2004; even at low doses ephedra has been linked to high blood pressure, heart attack, seizure, stroke and psychosis. [8]
- Contamination and wrong herbs. NCCIH reports Chinese herbal products with undeclared drugs, heavy metals or incorrect herbs. [9]
- Children, pregnancy, other medicines. The NHS notes that some cough and cold medicines are not suitable for babies, children and pregnant women. [1] Safety data in the trials above were often missing; most trials of cold products did not report adverse events. [4] See pregnancy and breastfeeding and Chinese herbs with prescription medicines.
- Do not give honey to children under 12 months. [1]
References
- NHS. Common cold. Read 2026-10-22.
- NHS. Flu. Read 2026-10-22.
- Jiang L, Deng L, Wu T. Chinese medicinal herbs for influenza. Cochrane Database Syst Rev. 2013. Read 2026-10-22.
- Chen W, et al. Chinese patent medicines for the treatment of the common cold: a systematic review of randomized clinical trials. BMC Complement Altern Med. 2014. Read 2026-10-22.
- Huang Y, et al. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev. 2012. Read 2026-10-22.
- Wei J, et al. Chinese medicinal herbs for acute bronchitis. Cochrane Database Syst Rev. 2008. Read 2026-10-22.
- Hu XY, et al. Andrographis paniculata (Chuan Xin Lian) for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis. PLoS One. 2017. Read 2026-10-22.
- NCCIH. Ephedra. Read 2026-10-22.
- NCCIH. Traditional Chinese Medicine: What You Need To Know. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.