COVID-19 Chinese Medicine Treatment Plan (Trial Version 8) - China National Health Commission
Mar 18, 2022
COVID-19 Chinese Medicine Treatment Plan (Trial Version 8) - China National Health Commission
Published: August 18, 2020
For more information: ali.ma@wecistanche.com
This disease belongs to the category of "epidemic" in Chinese medicine, and the cause of the disease is the feeling of "epidemic hostility", each place can refer to the following scheme for evidence-based treatment according to the condition, local climate characteristics, and different physical conditions. If the dosage is over the pharmacopeia, it should be used under the guidance of physicians.
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I. Medical observation period
Clinical manifestations 1: Weakness with gastrointestinal discomfort
Recommended Chinese medicine: Huo Xiang Zheng Qi capsule (pill, water, oral liquid)
Clinical manifestation 2: Lethargy with fever
Recommended Chinese patent medicines: Jinhua Qingqi Granules, Lianhua Qingfei Capsules (granules), Shufeng Detoxification Capsules (granules)
II. Clinical treatment period (confirmed cases)
(I) Lung clearing and detoxification soup
Scope of application: Combined with the clinical observation of doctors in many places, it is applicable to light, ordinary, and heavy patients, and can be used reasonably in combination with the actual situation of patients in the rescue and treatment of critical type patients.
Basic formula: Ephedra 9g, roasted licorice 6g, almond 9g, raw gypsum 15-30g (decoction first), cinnamon stick 9g, zedoary 9g, Poria 9g, atractylodes 9g, poria 15g, chai hu 16g, Scutellaria 6g, ginger hemihsia 9g, ginger 9g, aster 9g, winter flower 9g, echinacea 9g, pseudostellaria 6g, yam 12g, hedgehog 6g, chenpi 6g, patchouli 9g.
Dosage: Traditional Chinese medicine, decoction with water. Take one dose per day, once in the morning and once in the evening (forty minutes after meals), warm, three doses for one course of treatment.
If available, half a bowl of rice soup can be added after each dose, and those with dry tongue and fluid deficiency can take up to one bowl more. (Note: If the patient does not have a fever, the dosage of raw gypsum should be small; fever or strong fever can increase the dosage of raw gypsum). If the symptoms improve but are not cured, take the second course. If the patient has special conditions or other underlying diseases, the prescription can be modified according to the actual situation for the second course, and stop the medicine if the symptoms disappear.
Prescription source: General Office of the National Health Commission and the Office of the State Administration of Traditional Chinese Medicine, "Notice on the Recommended Use of "Clear Lung Detoxification Soup" in the Combined Treatment of New Coronavirus Infection in Pneumonia" (State Office of Traditional Chinese Medicine, Medical Policy Letter [2020] No. 22).
(II) Light
1. Cold and dampness in the lung
Clinical manifestations: fever, weakness, body aches, cough, phlegm, chest tightness, breathlessness, nausea, vomiting, sticky stools. The tongue is light, fat, toothed, or light red, with white, thick, greasy, or white fur, and a moist or slippery pulse.
Recommended prescription: Cold and damp epidemic formula
Basic formula: 6g raw ephedra, 15g raw gypsum, 9g almonds, 15g Qiangwu, 15g scape nemerosa, 9g Guanzhong, 15g Dilong, 15g Xu Changqing, 15g Huo Xiang, 9g Perilla, 15g Atractylodes, 45g Yun Ling, 30g raw Atractylodes, 9g each Jiao Sanxian, 15g Hou Pu, 9g Jiao Betel nut, 9g simmered Cao Guo, 15g ginger.
Dosage: 1 dose daily, 600ml in water, divided into 3 doses, 1 in the morning, 1 in the afternoon and 1 in the evening, taken before meals.
2、Dampness and heat in the lung
Clinical manifestations: low-grade fever or no fever, slight cold, weakness, heavy head and body, muscle aches, dry cough with little phlegm, sore throat, dry mouth without the desire to drink, or with chest tightness and abdominal stuffiness, no sweating or poor sweating, or vomiting, nausea, loose stools or sticky stools. The tongue is light red, the coating is white, thick and greasy or thin yellow, and the pulse is smooth or moist.
Recommended prescription: Betel nut 10g, Cao Guo 10g, Hou Pu 10g, Zhi Mu 10g, Baicalin 10g, Chai Hu 10g, Radix Paeoniae Alba 10g, Forsythia 15g, Artemisia 10g (later), Atractylodes macrocephala 10g, Rhizoma Atractylodis Macrocephalae 10g, Radix Glycyrrhiza Uralensis 5g.
Dosage: 1 dose daily, 400ml in water, divided into 2 doses, one in the morning and one in the evening.
(Ⅲ) General type
1、Dampness and toxicity in the lung
Clinical manifestations: fever, cough with little phlegm, or yellow phlegm, suffocating shortness of breath, abdominal distension, constipation. Dark red tongue, fat tongue, yellow greasy or yellow dry coating, slippery or smooth pulse.
Suggested prescription: Xuanlung Defeat Poison Formula
Basic formula: 6g Raw Ephedra, 15g Bitter Almond, 30g Raw Gypsum, 30g Raw Coix Seed, 10g Atractylodes Macrocephalae, 15g Patchouli, 12g Artemisia Annua, 20g Tiger Balm, 30g Verbascum, 30g Dried Rehmanniae, 15g Dried Scapulariae, 15g Mandarin Red, 10g Raw Licorice.
Dosage: 1 dose daily, 400ml in water, divided into 2 doses, 1 in the morning and 1 in the evening.
2、Cold and dampness blocking the lung
Clinical manifestations: low fever, body heat, or no fever, dry cough, little phlegm, tiredness, chest tightness, abdominal froth, vomiting, loose stools. The tongue is light or light red, with white or white greasy coating and moist pulse.
Suggested prescription: Atractylodes Macrocephala 15g, Pericarpium Citri Reticulate 10g, Phellodendron Houpo 10g, Patchouli 10g, Cao Guo 6g, Ephedra 6g, Qiang Wu 10g, Ginger 10g, Betel nut 10g.
Dosage: 1 dose daily, 400ml in water, divided into 2 doses, 1 in the morning and 1 in the evening.
(Ⅳ) Heavy type
1、Epidemic poison closed lung evidence
Clinical manifestations: fever with a red face, cough, yellow sputum with little stickiness, or blood in the sputum, shortness of breath, fatigue, and lassitude, dry mouth with bitter stickiness, nausea, and inappetence, poor bowel movement, short red urine. The tongue is red, the coating is yellow and greasy, and the pulse is slippery.
Recommended prescription: Dampness and Detoxification Formula
Basic formula: 6g raw ephedra, 9g almonds, 15g raw gypsum, 3g licorice, 10g patchouli (later), 10g thick park, 15g atractylodes, 10g Cao Guo, 9g Fructus Fargesia, 15g poria, 5g raw rhubarb (later), 10g raw astragalus, 10g scape seed, 10g red peony.
Dosage: 1~2 doses daily, 100 ml~200 ml in water, 2~4 times a day, orally or intranasally. 2、Burnt Qi and Ying evidence
Clinical manifestations: great heat and thirst, shortness of breath, delirium, dizziness, misalignment of vision, rash, vomiting blood, epistaxis, or convulsions of the limbs. The tongue is vivid with little or no moss, and the pulse is sunken and fine, or floating and large.
Suggested prescription: 30-60g of gypsum (decoction first), 30g of Zhi Mu, 30-60g of Radix Rehmanniae, 30g of water hyacinth (decoction first), 30g of red peony, 30g of Radix et Rhizoma Ginseng, 15g of forsythia, 15g of dandanbark, 6g of Huang Lian, 12g of bamboo leaf, 15g of scape bark, 6g of raw licorice.
Dosage: 1 dose per day, decoction in water, the first decoction of gypsum and water hyacinth, then the drugs, each time 100ml-200ml, 2-4 times a day, orally or nasally.
Recommended traditional Chinese medicine: Xiyamping injection, Xibijing injection, Hot poisoning injection, Phlegm fever clear injection, Awakening brain Jing injection. Drugs with similar efficacy can be selected according to individual conditions, or two can be combined according to clinical symptoms. Chinese medicine injections can be used in combination with Chinese medicine tonics.
(Ⅴ) Critical type
1、Internal closure and external decompensation
Clinical manifestations: dyspnea, shortness of breath or need for mechanical ventilation, dizziness, irritability, sweating and cold limbs, purple tongue, thick and greasy or dry coating, floating pulse without root.
Recommended prescription: Ginseng 15g, Black Shun Tablet 10g (decoction first), Cornus officinalis 15g, Suhe Xiang Pill or Angong Niuhuang Pill.
In case of mechanical ventilation with constipation or constipation, use 5-10g of raw rhubarb, and in case of human-machine dyssynchrony, use 5-10g of raw rhubarb and 5-10g of mannitol under sedation and inotropic agents.
Recommended traditional Chinese medicine: Haibijing Injection, Fever Nimble Injection, Phlegm Fever Clear Injection, Awakening Brain Quenching Injection, Ginseng Injection, Shengve Injection, Ginseng, and Mai Injection. Drugs with similar efficacy can be selected according to the individual situation, or two drugs can be used in combination according to clinical symptoms. Chinese medicine injections can be used in combination with Chinese medicine tonics.
Note: Recommended use of heavy and critical herbal injections
The use of Chinese medicine injections follows the principle of starting with small doses and gradually adjusting the dosage according to the drug instructions:
(1) Viral infection or combined with mild bacterial infection: 0.9 sodium chloride injection 250ml plus Xiyampin injection l00mg bid, or 0.9 sodium chloride injection 250ml plus Toxinin injection 20ml, or 0.9 sodium chloride injection 250ml plus Phlegm Fever Qing injection 40ml bid.
(2) Hyperthermia with impaired consciousness: 0.9 sodium chloride injection 250ml plus 20ml bid of wake-up call injection.
(3) Systemic inflammatory response syndrome or/and multiple organ failure: 0.9 sodium chloride injection 250ml plus hemopressin injection 100ml bid.
(4) Immunosuppression: glucose injection 250ml plus ginseng and wheat injection 100ml or raw vein injection 20-60ml bid.
(Ⅵ) Recovery period
1、Lung and spleen qi deficiency evidence
Clinical manifestations: shortness of breath, tiredness, and fatigue, poor appetite and vomiting, fullness, weakness of stool, loose stools. Pale fat tongue, white greasy coating.
Recommended prescription: Radix Panax Notoginseng 9g, Pericarpium Citri Reticulate 10g, Radix Codonopsis Pilosulae 15g, Radix Astragali 30g, Rhizoma Atractylodis Macrocephalae 10g, Poria 15g, Hordeum Vulgare 10g, Radix et Rhizoma Saxifraga 6g (later), Glycyrrhiza uralensis 6g.
Dosage: 1 dose daily, 400ml in water, divided into 2 doses, 1 in the morning and 1 in the evening.
2、Qi and Yin deficiency
Clinical manifestations: weakness, shortness of breath, dry mouth, thirst, palpitation, sweating, poor appetite, low or no fever, dry cough with little phlegm. Dry tongue with little fluid, thin pulse or weakness.
Suggested prescription: 10g of Radix Salviae Miltiorrhiza, 15g of Radix Salviae Miltiorrhiza, 6g of Radix Panax Ginseng, 6g of Fructus Schisandrae, 15g of Radix et Rhizoma Gastrodiae, 10g of Rhizoma Polygonati, 10g of Radix Mulberry Leaf, 15g of Radix Rehmanniae, 15g of Radix Salviae Miltiorrhizae, 6g of Radix Glycyrrhizae.
Dosage: 1 dose daily, 400ml in water, divided into 2 doses, 1 in the morning and 1 in the evening.
