Jiangxi Province Coronavirus Pneumonia Prevention And Control Plan With Traditional Chinese Medicine (Trial Version 3)
Mar 21, 2022
For more information:ali.ma@wecistanche.com
In order to give full play to the role of traditional Chinese medicine in the prevention and control of the new coronavirus pneumonia epidemic, and to further improve the prevention and syndrome differentiation of traditional Chinese medicine for the new coronavirus pneumonia in combination with the participation of traditional Chinese medicine in the treatment of confirmed cases in our province and the characteristics of the region and climate, this program.
The characteristics of the disease
(1) Clinical manifestations
Based on the current epidemiological investigation, the incubation period is 1-14 days, mostly 3-7 days. The main symptoms are fever, dry cough, and fatigue. A small number of patients have symptoms such as nasal congestion, runny nose, sore throat, myalgia, and diarrhea. Severely ill patients often develop dyspnea and/or hypoxemia one week after the onset of symptoms, and severe cases can rapidly progress to acute respiratory distress syndrome, septic shock, metabolic acidosis that is difficult to correct, coagulation dysfunction and multi-organ functional failure, etc. It is worth noting that severe and critically ill patients may have moderate to low fever or even no obvious fever during the course of the disease. Mild patients only showed low fever, mild fatigue, etc., without pneumonia. According to the current case conditions, most patients have a good prognosis, and a few patients are in critical condition. The elderly and those with chronic underlying diseases have a poor prognosis. Children's cases are relatively mild.
(2) Laboratory examination
In the early stage of the disease, the total number of white blood cells in the peripheral blood was normal or decreased, and the lymphocyte count decreased. Some patients may have increased liver enzymes, lactate dehydrogenase (LDH), muscle enzymes, and myoglobin; some critically ill patients showed increased troponin. Most patients had elevated C-reactive protein (CRP) and erythrocyte sedimentation rate, and normal procalcitonin. In severe cases, D-dimer increased and peripheral blood lymphocytes decreased progressively. Severe and critically ill patients often have elevated inflammatory factors. Novel coronavirus nucleic acid can be detected in nasopharyngeal swabs, sputum, and other lower respiratory tract secretions, blood, feces, and other specimens. In order to improve the positive rate of nucleic acid detection, it is recommended to collect sputum as much as possible, collect lower respiratory tract secretions from patients undergoing tracheal intubation, and send the specimens for inspection as soon as possible after collection.
(3) Chest imaging
In the early stage, there are multiple small patchy shadows and interstitial changes, especially in the extrapulmonary zone. It then develops into multiple ground-glass opacities and infiltration shadows in both lungs. In severe cases, pulmonary consolidation may occur, and pleural effusion is rare.
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Traditional Chinese Medicine Prevention
(1) Drug prevention
1. Substitute tea recipe: 3g of Radix Radix Ginseng, 3g of Honeysuckle, 3g of Huoxiang, 3g of Platycodon grandiflorum, and 3g of Licorice.
2. Basic prescription: Yupingfeng Powder with added flavor, the composition is as follows: 12g of raw astragalus, 10g of Fangfeng, 10g of Atractylodes, 10g of Yinhua, 10g of Forsythia, 6g of Guanzhong, 10g of Peilan, 10g of dried tangerine peel, 10g of Atractylodes, and 10g of Campanulaceae.
(2) Prevention of heat-sensitive moxibustion (one moxa and three prescriptions)
(1) Smell the mugwort
Smell the mugwort produced by the heat-sensitive moxibustion sticks several times a day for 30 seconds each time. The aromatic components of pure moxa in heat-sensitive moxibustion sticks and the aromatic medicinal properties of Qianghuo, Duhuo, Asarum, and Chuanxiong have a good aroma and refreshment, sensitize the sense of smell, purify the internal environment of the nasopharynx, and improve the immunity of the nasopharynx. , Smell the incense to dispel the dampness evil of Shangjiao, and prevent the dampness evil from attacking.
(2) Apply moxibustion
Acupoint selection: Zhongwan, Shenque, Guanyuan.
Operation method: Suspend moxibustion along the meridian back and forth. During moxibustion, moxa heat moves slowly around the moxibustion acupoint area, finds the location where the heat sensation has special sensations such as penetration, remote transmission, diffusion, and comfort, and performs moxibustion along the meridian.
Dosage of moxibustion: once a day, moxibustion on each point for about 45 minutes each time. On the basis of the above, for those who can accept wheat grain moxibustion, the effect of adding wheat grain moxibustion to the Zusanli point is better.
Matters needing attention: During the moxibustion process, the moxibustion person should pay attention to keeping warm and cold, and the room temperature should be kept at about 25 degrees; it is not advisable to take a bath within 4 hours after the moxibustion.
(3) Ai Foot Therapy
Put half a stick of heat-sensitive moxibustion moxa stick in 1000ml hot water for 30 minutes every day, until the skin on the forehead or the back of the neck is moist or slightly sweaty. This program is used for three uses. The application of dynamic moxibustion can effectively stimulate the operation of meridians and qi, mobilize the body's self-regulating function, dispel dampness and transport the spleen; cooperate with wheat grain moxibustion to improve human immunity, strengthen the body; Hot mugwort leaf water, warms the meridians of the lower limbs, and helps coking dampness and turbidity. Sanjiao Tongzhi, taking into account both the symptoms and symptoms, has obvious aroma and dampness, and promotes the effect of Sanjiao.
TCM treatment
This disease belongs to the category of "epidemic" diseases in traditional Chinese medicine. The cause of the disease is the feeling of "epidemic violence". According to the conditions of the disease, local climate characteristics and different physical conditions, the following schemes can be used for syndrome differentiation and treatment. When it comes to exceeding the pharmacopoeial dose, it should be used under the guidance of a physician.
1. Medical observation period
Clinical manifestation 1: Fatigue with gastrointestinal discomfort
Recommended Chinese patent medicine: Huoxiangzhengqi capsule (pills, water, oral liquid)
Clinical manifestation 2: Fatigue with fever
Recommended Chinese patent medicines: Jinhua Qinggan Granules, Lianhua Qingwen Capsules (granules), Shufeng Jiedu Capsules (granules), Plum Leaf Granules
2. Clinical treatment period (confirmed cases)
2.1 Qingfei Paidu Decoction
Scope of application: It is suitable for light, ordinary and severe patients, and can be reasonably used in combination with the actual situation of patients in the treatment of critically ill patients.
Basic formula: ephedra 9g, licorice root 6g, almond 9g, gypsum 15-30g (fried first), cassia twig 9g, Alisma 9g, Polyporus 9g, Atractylodes 9g, Poria 15g, Bupleurum 16g, Scutellaria 6g, Ginger Pinellia 9g, ginger 9g, aster 9g, winter flower 9g, shegan 9g, Asarum 6g, yam 12g, citrus Aurantium 6g, tangerine peel 6g, Huoxiang 9g.
Dosage: Decoction of traditional Chinese medicine, decocted in water. 1 dose per day, twice in the morning and evening (forty minutes after meals), warm, 3 doses for a course of treatment.
If conditions are met, half a bowl of rice soup can be added after taking the medicine each time, and those with a dry tongue and body fluid deficiency can take up to one bowl. (Note: If the patient does not have a fever, the dosage of gypsum should be small, and the dosage of gypsum can be increased if the patient has a fever or strong fever). If the symptoms improve but are not cured, take the second course of treatment. If the patient has special conditions or other underlying diseases, the second course of treatment can modify the prescription according to the actual situation, and stop the drug if the symptoms disappear.
Source of prescription: "Notice on recommending the use of "Qingfei Paidu Decoction" in the treatment of novel coronavirus-infected pneumonia with integrated traditional Chinese and Western medicine" by the General Office of the National Health Commission and the Office of the State Administration of Traditional Chinese Medicine (Medical Policy Letter from the State Administration of Traditional Chinese Medicine) [2020] No. 22).
2.2 Heat-sensitive moxibustion treatment
Scope of application: It is suitable for a mild, common, clinical observation period and recovery period of lung and spleen deficiency syndrome.
Therapeutic effect: invigorating the spleen, aromatizing dampness.
2.2.1 Moxibustion positions: Shenque, Tianshu (double), Daheng (double).
2.2.2 Posture: take a comfortable supine position and relax the whole body.
2.2.3 Operation:
The moxibustion subject lies on his back, ignites two moxa columns with a diameter of 2.5 cm and a length of 4 cm, respectively, and inserts them into a special moxibustion tool with a moxa heat reflection cavity that can adjust the heat of the unit. The moxibustion tool is 22 cm long and 16 cm wide. The smoke outlet is connected with the portable smoke suppressor, and the moxibustion tool is placed horizontally with the navel as the center. During the process of moxibustion, the intensity of moxa heat can be adjusted by adjusting the handle of each moxibustion unit, so that the abdominal acupoint area of moxibustion can feel hot and even, comfortable and not burning; Place moxibustion at the location where the qi and heat are felt by moxibustion, such as penetration, remote transmission, diffusion, and comfort. During the whole process of moxibustion, it is necessary to ensure that the heat is uniform, comfortable, and not burning, and the moxibustion should be until the thermal induction such as deep heat, distant heat, body heat, and forehead sweat subsides.
2.2.4 Dosage of moxibustion: once a day, about 40 to 60 minutes, each moxibustion should not exceed 60 minutes.
2.3 Lightweight
(1) Syndrome of cold dampness and stagnation of the lung
Clinical manifestations: fever, fatigue, body aches, cough, expectoration, chest tightness and suffocation, anorexia, nausea, vomiting, and sticky stool. The tongue is pale with tooth marks or reddishness, the coating is white and thick, rotten or greasy, and the pulse is moist or slippery.
Recommended prescription: Dispelling cold, dehumidifying, and anti-drug prescription
Raw Ephedra 6g, Almond 9g, Guizhi 9g, Zhigancao 6g, Fried Atractylodes 9g, Perilla 6g, Pinellia 9g, Chenpi 9g, Qianhu 9g, Platycodon 9g, Citrus Citrus 9g, Poria 9g, Ginger 9g, Jujube 9g. For those who have exchanges of cold and heat, add Bupleurum 9g and Scutellaria 9g; for those with obvious vomiting and diarrhea, add Hehuoxiang Zhengqi San.
Dosage: 1 dose per day, decoct 400ml in water, take in 2 times, once in the morning and once in the evening, before meals.
(2) Damp-heat Accumulating Lung Syndrome
Clinical manifestations: low or no fever, slight aversion to cold, fatigue, heavy head and body, muscle aches, dry expectoration with little phlegm, sore throat, dry mouth and no desire to drink more, or accompanied by chest tightness and epigastric pain, no sweat or poor sweating, or nausea, nausea, loose stools or sticky stools. Pale red tongue, white thick greasy or thin yellow coating, slippery or moist pulse.
Recommended prescription: clearing heat, removing dampness and anti-drug
Almond 9g, Scutellaria 9g, Forsythia 9g, Poria 9g, Cardamom 6g (after the bottom), Talc 9g (fried), Mulberry Leaf 9g, Ephedra 6g, Raw Coix Seed 15g, Raw Licorice 6g. Bitter mouth, nausea and vomiting, combined with Xiao Chaihu Decoction; nausea and vomiting with joint pain, combined with Chaihu Guizhi Tang; asthma, chest tightness, combined with Xuanbi Decoction in Shangjiao chapter of "Warm Disease Diagnosis".
Dosage: 1 dose per day, decoct 400ml in water, take in 2 doses, once in the morning and once in the evening.
2.4 Ordinary type
(1) Syndrome of damp toxin and stagnant lung
Clinical manifestations: fever, cough with little phlegm, yellow phlegm, suffocation, shortness of breath, abdominal distension, and constipation. Dark red tongue, fat tongue, yellow greasy or yellow dry coating, slippery pulse or string slippery.
Recommended prescription: addition and subtraction of heat-clearing, dampness-and-drug formula
Almonds 9g, Scutellaria 9g, Forsythia 9g, Poria 9g, White Cardamom 6g (below), Talc 9g (fried), Mulberry Leaf 9g, Reed Root 9g, Winter Melon Seed 9g, Peach Kernel 6g, Coix Seed 15g. For mild diarrhea, add kudzu root 9g; cough with yellow phlegm, add golden buckwheat 9g, houttuynia cordata 9g; cough with restlessness and cannot lie down, combined with Tingli Dazao Xiefei Decoction; throat obstruction and sore throat, combined with Yinqiao puffball scattered.
Dosage: 1 dose per day, decoct 400ml in water, take in 2 doses, once in the morning and once in the evening.
(2) Lung syndrome due to cold and dampness
Clinical manifestations: low-grade fever, low body heat, or no fever, dry cough, less phlegm, fatigue, chest tightness, epistaxis, or nausea, loose stools. Pale or reddish tongue, white or greasy coating, moist pulse.
Recommended prescription: addition and subtraction of cold-dispelling, dehumidifying and anti-drug prescriptions
Raw ephedra 6g, almond 9g, cinnamon twig 9g, licorice 6g, stir-fried Atractylodes 9g, Huoxiang 9g, Magnolia 9g, Poria 9g, tangerine peel 9g, Divine Comedy 9g, fried malt 9g, Dabupi 6g, Yin Chen 6g, Chai Hu 9g. If the thirst is severe and the phlegm is not easy to come out, add 9-15g of raw gypsum; if cough induces chest pain, combine with Qianjinweijing Decoction.
Dosage: 1 dose per day, decoct 400ml in water, take in 2 doses, once in the morning and once in the evening.
2.5 heavy
(1) Epidemic virus closed lung syndrome
Clinical manifestations: fever, flushing, cough, yellow and sticky sputum, or blood in the sputum, shortness of breath, fatigue, dry mouth, bitter and sticky mouth, nausea, inedible, poor stool, short and red urination. Red tongue, yellow and greasy coating, slippery pulse.
Recommended prescription: raw ephedra 6g, almond 9g, raw gypsum 15g, licorice 3g, Huoxiang 10g (below), Magnolia 10g, Atractylodes 15g, Caoguo 10g, Pinellia 9g, Poria 15g, raw rhubarb 5g (below) , Raw Astragalus 10g, Tinglizi 10g, Red Peony 10g. For those with obvious blood in the sputum, add Rhizoma Imperatae 9g.
Dosage: 1-2 doses per day, decocted in water, 100ml-200ml each time, 2-4 times a day, orally or nasally.
(2) Two burnt certificates for gas camp
Clinical manifestations: high fever and polydipsia, shortness of breath, delirium, dizziness, vision errors, rash, vomiting blood, epistaxis, or limb convulsions. Dark tongue with little or no moss, and pulse is fine and few or floating and large.
Recommended prescription: gypsum 30-60g (fried first), Anemarrhena 30g, raw land 30-60g, buffalo horn 30g (fried first), red peony 30g, Scrophularia 30g, forsythia 15g, paeonol 15g, Coptis 6g, bamboo leaf 12g, Tinglizi 15g, raw licorice 6g.
Dosage: 1 dose a day, decoct in water, first decoct gypsum and buffalo horn, 100ml-200ml each time, 2-4 times a day, orally or nasally.
Recommended Chinese patent medicines: Xiyanping injection, Xuebijing injection, Reducing injection, Tanreqing injection, Xingnaojing injection. Drugs with similar efficacy can be selected according to individual conditions, or a combination of two can be used according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.
2.6 Critical type (internal closure and external decertification)
Clinical manifestations: dyspnea, frequent wheezing or need for mechanical ventilation, accompanied by dizziness, irritability, sweating, cold limbs, dark purple tongue, thick greasy or dry coating, floating and rootless pulse.
Recommended prescription: 15g of ginseng, 10g of Heishun tablets (fried first), 15g of dogwood, take Suhexiang Pills or Angong Niuhuang Pills.
Recommended Chinese patent medicines: Xuebijing injection, Reducing injection, Tanreqing injection, Xingnaojing injection, Shenfu injection, Shengmai injection, Shenmai injection. Drugs with similar efficacy can be selected according to individual conditions, or a combination of two can be used according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.
Note: Recommended usage of heavy and critical Chinese medicine injections
The use of traditional Chinese medicine injections follows the principle of starting with a small dose and gradually adjusting according to the drug instructions. The recommended usage is as follows:
Viral infection or mild bacterial infection: 0.9% sodium chloride injection 250ml plus Xiyanping injection 100mg bid, or 0.9% sodium chloride injection 250ml Heduning injection 20ml, or 0.9% sodium chloride injection 250ml Jiatanreqing injection 40ml bid.
Hyperthermia with disturbance of consciousness: 0.9% sodium chloride injection 250ml plus Xingnaojing injection 20ml bid.
Systemic inflammatory response syndrome or/and multiple organ failure: 0.9% sodium chloride injection 250ml plus Xuebijing injection 100ml bid.
Immunosuppression: 0.9% sodium chloride injection 250ml plus Shenmai injection 100ml bid.
Shock: 0.9% sodium chloride injection 250ml plus Shenfu injection 100ml bid.
2.7 Recovery period
(1) Lung spleen deficiency syndrome
Clinical manifestations: shortness of breath, fatigue, anorexia, nausea, fullness, weak stool, loose stools. Tongue pale, greasy coating.
Recommended prescription: Pinellia 9g, tangerine peel 10g, Codonopsis 15g, Sunburn Astragalus 30g, Fried Atractylodes 10g, Poria 15g, Huoxiang 10g, Amomum Vulgaris 6g (later), Licorice 6g.
Dosage: 1 dose per day, decoct 400ml in water, take in 2 doses, once in the morning and once in the evening.
Recommended Chinese patent medicine: Shenling Baizhu Powder, Xiangsha Liujun Pill
Auxiliary food therapy product: Jiangzhong Hougu Rice Diluted
(2) Qi and Yin deficiency syndrome
Clinical manifestations: fatigue, shortness of breath, dry mouth, thirst, palpitations, sweating, anorexia, low or no fever, dry cough, and less phlegm. Dry tongue with little fluid, thin or weak pulse.
Recommended prescription: 10g each of northern and southern ginseng, 15g of Ophiopogon japonicus, 6g of American ginseng, 6g of Schisandra, 15g of raw gypsum, 10g of pale bamboo leaves, 10g of mulberry leaves, 15g of reed roots, 15g of Salvia miltiorrhiza, and 6g of raw licorice.
Dosage: 1 dose per day, decoct 400ml in water, take in 2 doses, once in the morning and once in the evening.
(3) Syndrome of yang deficiency and phlegm coagulation and blood stasis
Clinical manifestations: chest tightness and suffocation, shortness of breath when moving, paroxysmal dry cough, mainly choking, or coughing up a small amount of white phlegm, with a pale face and coldness. Pale tongue, thin white or greasy fur, and deep stringy or astringent pulse. Chest CT showed obvious signs of interstitial lung disease.
Recommended prescription: Wenfei Huaxian Decoction
Deer Antler Cream 15g, Cinnamon 4g, Pao Jiang 10g, Raw Ephedra 10g, Rehmannia glutinosa 20g, White Mustard Seed 10g, Zhigancao 6g, Dilong 10g, Turmeric 10g, Chuanxiong 10g, Peach Kernel 10g, Safflower 10g. For those with anorexia, add 15g of fried malt and 15g of fried grain; for those with prominent qi deficiency, such as shortness of breath, Shenpi, and lazy speech, combine with Buzhong Yiqi Decoction; for those with yin deficiency such as dry mouth, dry throat, and less moss, combine with Pulse drink; for those with obvious cough, add 10g of Aster, 10g of Coltsfoot, 10g of Baibu, and 10g of Suzi.
Dosage: 1 dose per day, decoct 400ml in water, take in 2 doses, once in the morning and once in the evening.
Recommended Chinese patent medicine: Jinshuibao capsules (tablets)
