Revised Version Of COVID-19 Chinese Medicine Treatment Protocol (Trial 8th Edition) - China National Health Commission

(Revised version of COVID-19 Chinese Medicine Treatment Protocol (Trial 8th Edition)) - China National Health Commission

Published: April 14, 2021

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This disease belongs to the category of "epidemic disease" in traditional Chinese medicine. Because the disease feels the Qi of "epidemic hostility", all localities can treat it according to the following schemes according to the condition, local climate characteristics, and different physique. If the dose exceeds the Pharmacopoeia, it should be used under the guidance of doctors.

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Ⅰ、 Medical observation period

Clinical manifestation 1: fatigue with gastrointestinal discomfort

Recommended Chinese patent medicine: Huoxiang Zhengqi Capsule (pill, water, oral liquid)

Clinical manifestation 2: fatigue with fever

Recommended Chinese patent medicines: Jinhua qing gan granule, Lianhua Qingwen capsule (granule), Shufeng Jiedu Capsule (granule)

Ⅱ、 Clinical treatment period (confirmed cases)

1、Qingfei Paidu Decoction

Scope of application: combined with the clinical observation of doctors in many places, it is suitable for light, ordinary and severe patients. It can be used reasonably in combination with the actual situation of patients in the treatment of critical and severe patients.

Basic prescriptions: ephedra 9g, roasted licorice 6G, almond 9g, raw gypsum 15-30g (decocted first), cinnamon 9g, Alisma Orientalis 9g, Polyporus 9g, Atractylodes macrocephala 9g, Poria 15g, bupleurum 16g, Huangling 6G, ginger Pinellia 9g, ginger 9g, aster 9g, winter flower 9g, Shegan 9g, Asarum 6G, yam 12g, Fructus aurantii 6G, tangerine peel 6G and patchouli 9g.

Taking method: decoction pieces of traditional Chinese medicine, decocted in water. Once a day, once in the morning and once in the evening (40 minutes after dinner), warm clothes, three for a course of treatment.

If possible, you can take half a bowl of rice soup after taking the medicine every time. Those with dry tongues and deficiency of body fluid can take more than one bowl. (Note: if the patient does not have a fever, the amount of raw gypsum should be small, and the amount of raw gypsum can be increased for fever or strong fever). If the symptoms are improved but not cured, take the second course of treatment. If the patient has special conditions or other basic diseases, the prescription can be modified according to the actual situation in the second course of treatment, and the medicine can be stopped when the symptoms disappear.

Prescription source: the office of the national health and Health Committee and the office of the State Administration of traditional Chinese medicine "on the recommendation of the combination of Chinese and Western medicine in the treatment of New Coronavirus infected pneumonia," Qingfei detoxification soup "notice (Medicine Office of the State Medical Office [2020] 22).

2、Light

（1） Cold dampness stagnation of lung syndrome

Clinical manifestations: fever, fatigue, body pain, cough, expectoration, chest tightness, suffocation, stupidity, nausea, vomiting, sticky stool. The tongue is light fat, tooth marks or light red, the moss is white, thick, rotten or white, and the pulse is wet or slippery.

Recommended prescription: cold dampness Disease formula

Basic prescriptions: raw ephedra 6G, raw gypsum 15g, almond 9g, notopterygium 15g, Tinglizi 15g, Guanzhong 9g, earthworm 15g, Xu Changqing 15g, Huoxiang 15g, Peilan 9g, Atractylodes rhizome 15g, Yunling 45g, raw Atractylodes macrocephala 30g, Jiao Sanxian 9g, Magnolia officinalis 15g, jiaoareca 9g, simmered grass fruit 9g and ginger 15g.

Administration: 1 dose per day, water decoction 600ml, take it three times, one time in the morning, one time in the afternoon and one time in the evening, before meals.

（2）Damp heat-accumulating lung syndrome

Clinical manifestations: low fever or no fever, slight aversion to cold, fatigue, heavy head and body sleepiness, muscle soreness, dry cough, less phlegm, sore throat, dry mouth, do not want to drink more, or accompanied by chest tightness, wrist ruff, no sweat or poor perspiration, or nausea and stupidity, loose stool or sticky stool. The tongue is light red, the moss is white, thick and greasy or thin yellow, and the pulse is slippery or wet.

Recommended prescription: betel nut 10g, grass fruit 10g, Magnolia officinalis 10g, Anemarrhena 10g, Huangling 10g Radix Bupleuri 10g, Radix Paeoniae Rubra 10g, forsythia 15g, Artemisia annua 10g (lower back), Atractylodes rhizome 10g, Folium Isatidis 10g and raw licorice 5g.

Administration: 1 dose per day, 400ml in water, taken twice, once in the morning and once in the evening.

3、 Common type

（1）Syndrome of dampness toxin depressing lung

Clinical manifestations: fever, cough, less phlegm, or yellow phlegm, suffocation, shortness of breath, abdominal distention, poor constipation. The tongue is dark red, fat, yellow greasy or yellow dry, and the pulse is slippery or strings slippery.

Recommended prescription: Xuanfei Baidu recipe

Basic prescription: raw ephedra 6G, bitter almond 15g, raw gypsum 30g, raw coix seed 30g Atractylodes lanceolata 10g, patchouli 15g, Artemisia annua 12g, Polygonum cuspidatum 20g, Verbena 30g, dry reed root 30g, Tingli 15g, huaorange 15g and raw licorice 10go

Administration: 1 dose per day, decoction 400ml, take it twice, one time in the morning.

（2）Cold dampness blocking lung syndrome

Clinical manifestations: low fever, no body heat, or no heat, dry cough, less phlegm, fatigue, chest tightness, wrist ruff, or vomiting, loose stool. The tongue is light or reddish, the moss is white or greasy, and the pulse is moist.

Recommended prescriptions: Atractylodes rhizome 15g, tangerine peel 10g, Magnolia officinalis log, Huoxiang 10g, Cao Guo 6G, raw ephedra 6G, notopterygium 10g, ginger 10g, and areca 10go

Administration: 1 dose per day, decoction 400ml, take it twice, one time in the morning.

4、 Heavy

（1）Syndrome of closing lung with epidemic toxin

Clinical manifestations: fever, redness of the face, cough, yellow and less sticky phlegm, or blood in sputum, wheezing, shortness of breath, fatigue, dry mouth, bitter and sticky, nausea, no food, poor stool, short and red urine. The tongue is red, the moss is yellow and greasy, and the pulse is slippery.

Recommended prescription: Huashi Baidu recipe

Basic prescriptions: raw ephedra 6G, almond 9g, raw gypsum 15g, licorice 3G, Huoxiang 10g (lower back), Magnolia officinalis 10g, Atractylodes 15g, Cao Guo 10g, Pinellia ternata 9g, Poria cocos 15g, raw rhubarb 5g (lower back), raw rhubarb 10g, Tinglizi 10g and red peony 10g.

Administration method: Take 1 ~ 2 doses of water decoction every day, 100ml ~ 200ml each time, 2 ~ 4 times a day, oral or nasal feeding.

（2） Qi Ying two burnt syndrome

Clinical manifestations: fever, thirst, shortness of breath, delirium, dizziness, wrong vision, or rash, hematemesis, bleeding, or limb convulsions. The tongue is crimson, with little or no moss, and the pulse is heavy and thin, or floating and large.

Recommended prescriptions: raw gypsum 30 ~ 60g (decocted first), Anemarrhena 30g, raw land 30 ~ 60g, buffalo horn 30g (decocted first), red peony 30g, Scrophularia 30g, forsythia 15g, Danpi 15g, Coptis 6G, bamboo leaf 12g, Tinglizi 15g and raw licorice 6G.

Administration method: 1 dose per day, decoct in water, decoct gypsum and buffalo horn first, and then apply various drugs, 100ml ~ 200ml each time, 2 ~ 4 times a day, oral or nasal feeding.

Recommended Chinese patent medicines: Xiyanping injection, Xuebijing injection, Reduncing injection, Tanreqing injection, and Xingnaojing injection. One drug with similar efficacy can be selected according to individual conditions, or two drugs can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.

5、Dangerous heavy

（1）Syndrome of internal closure and external detachment

Clinical manifestations: dyspnea, frequent asthma or need mechanical ventilation, accompanied by dizziness, irritability, sweating, cold limbs, purple and dark tongue, thick greasy or dry fur, floating pulse and no root.

Recommended prescription: 15g ginseng, 10g heishun tablet (decocted first), 15g Cornus, and take Suhexiang pill or Angong Niuhuang Pill. In case of mechanical ventilation with abdominal distension, constipation or poor stool, raw rhubarb 5 ~ 10g can be used to cause man-machine synchronization. In case of sedation and muscle relaxant, raw rhubarb 5 ~ 10g and mirabilite 5 ~ 10g can be used.

Recommended Chinese patent medicines: Xuebijing injection, Reduning injection, Tanreqing injection, Xingnaojing injection, Shenfu injection, Shengmai injection and Shenmai injection. One drug with similar efficacy can be selected according to individual conditions, or two drugs can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.

Note recommended usage of heavy and dangerous traditional Chinese medicine injections.

The use of traditional Chinese medicine injection follows the principle of starting from a small dose and gradually adjusting according to syndrome differentiation in the drug manual. The recommended usage is as follows:

(1) Viral infection or combined with mild bacterial infection: 250ml of 9% sodium chloride injection plus 100mg bid of Xiyanping injection, or 250ml of 0.9% sodium chloride injection plus 20ml of during injection, or 250ml of 0.9% sodium chloride injection plus 40ml bid of Tanreqing injection.

(2) High fever with disturbance of consciousness: 250ml 0.9% sodium chloride injection plus 20ml Xingnaojing injection BIDO

(3) Systemic inflammatory response syndrome or/and multiple organ failures: 0.9% sodium chloride injection 250ml plus Xuebijing injection 100ml bid.

(4) Immunosuppression: 250ml glucose injection plus 100ml Shenmai injection or 20 ~ 60ml Shengmai injection bid.

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Ⅲ、Recovery period

1、Lung spleen qi deficiency syndrome

Clinical manifestations: shortness of breath, fatigue, anorexia, nausea, fullness, weak stool, loose stool. The tongue is light and fat, and the moss is white and greasy.

Recommended prescriptions: Pinellia ternata 9g, tangerine peel 10g, dangshen 15g, roasted Astragalus 30g, fried Atractylodes 10g, Poria cocos 15g, Huoxiang 10g, Amomum villosum 6G (lower back), licorice 6G.

Administration: 1 dose per day, 400ml in water, taken twice, once in the morning and once in the evening.

2、Qi Yin deficiency syndrome

Clinical manifestations: fatigue, shortness of breath, dry mouth, thirst, palpitation, sweating, poor appetite, low or no heat, dry cough and less phlegm. The tongue is dry with little fluid, and the pulse is thin or weak.

Recommended prescriptions: 10 g of North and south sea cucumber, 15 g of Ophiopogon japonicus, 6 g of American ginseng, 6 g of Schisandra chinensis, 15 g of raw gypsum, 10 g of light bamboo leaf, 10 g of mulberry leaf, 15 g of reed root, 15 g of Salvia miltiorrhiza and 6 g of raw licorice.

Administration: 1 dose per day, 400ml in water, taken twice, once in the morning and once in the evening.