The Prevention And Treatment Of COVID-19 With Qingfei Paidu Decoction in Shanxi, China
Mar 15, 2022
Contact: joanna.jia@wecistanche.com / WhatsApp: 008618081934791
Background
In December 2019, Corona Virus Disease 2019(COVID-19) burst in Wuhan, China, and wreaked havoc over the country. On January 27, 2020, the National Administration of Traditional Chinese Medicine urgently launched the special project, "research on screening effective prescriptions of traditional Chinese medicine (TCM) for prevention and treatment of COVID-19". As the first pilot areas, Shanxi Province, Hebei Province, Heilongjiang Province, and Shaanxi Province carried out clinical observation of Qingfei Paidu decoction in preventing and treating COVID-19. The basic formula of Qingfei Paidu decoction: Mahuang(Herba Ephedra)9g Zhigancao(Radix Glycyrrhizae)6g, Xingren(Semen Armeniacae Amarum)9gShengshigao (Gypsum Fibrosum)15g, Guizhi (Ramulus Cinnamomi)9g, Zexie(Rhizoma Alismatis)9g Zhuling(Polyporus Umbellatus) 9g, Baizhu (Rhizoma Atractylodis Macrocephalae) 9g, Fuling(Poria)15g, Chaihu (Radix Bupleuri)16g, Huangqin(Radix Scutellariae)6g, Jiangbanxia(Rhizome Pinelliae Preparata)9g, Shengjiang(Rhizoma Zingiberis Recens)9g, Ziyuan (Radix Asteris)9g, Kuandonghua(Flos Farfarae)9g, Shegan(Rhizoma Belamcandae)9g, Xixin(Herba Asari)6g, Shan Yao(Rhizoma Dioscoreae)12g, Zhishi (Fructus Auranti Immaturus) 6g, Chenpi (Pericarpium Citri Reticulate)6g, Huo Xiang(Herba Pogostemonis)9g [1].
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Ning Liu, Shuangquan Li, Kaili Fan, Tian Lu, Tingquan Li
1 The Affiliated Hospital of Shanxi University of Chinese Medicine, Taiyuan, Shanxi 030024, China.
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We made a statistical analysis on the data of TCM intervened cases up to 24: 00 on February 20, 2020. According to the COVID-19's diagnosis and treatment plan (the trial fifth, sixth Edition) (Abbreviated as “diagnosis and treatment plan” below) [2, 3], there were 132 confirmed cases (among which were 129 moderate cases, 2 severe cases, and 1 critical case), 11 suspected cases and 314 medical observation cases, totally 457 cases and 76 cured cases[4]. The data above come from the dynamic distribution of the epidemic cases on the official website of the Health Commission of Shanxi Province, combined with the data from prefecture-level cities of Shanxi Province.
General status of TCM in treating COVID-19
The main forms of TCM intervention in COVID-19 are TCM decoction, Chinese patent medicine, and the combined use of both. The TCM decoction is mainly Qingfei Paidu decoction modified by syndrome differentiation. Chinese patent medicines were also selected by syndrome differentiation, including Lianhua Qingwen Capsule, Shexiang Niuhuang Pill, Shenfu Injection, etc. Up to 24:00 on February 20, 2020, there were 347(75.93%) people, of the whole 457 people, were applied with TCM interventions intervention or treatment, which consists of 130(98.48%) of 132 confirmed cases, 8(72.73%) of 11 suspected cases and 209(66.56%) of 314 medical observation cases (Figure 1). From February 9 to February 20, in the confirmed cases, the number of patients receiving the treatment of integrated traditional Chinese and Western medicine gradually increased, and the utilization rate of traditional Chinese medicine also gradually increased (Figure 2). TCM treating status in 11 cities, including Taiyuan City, Datong City, Yangquan City, Changzhi City, Jincheng City, Shuozhou City, Xinzhou City, Luliang City, Jinzhong City, Linfen City, Yuncheng City, is shown in Table 1.
Figure 1 COVID-19's participation rate of TCM in confirmed, suspected, and medical observation cases (Integrative Medicine Group, the cases were treated with TCM and western medicine; non-Integrative Medicine Group
Figure 2 The trend of the combination of traditional Chinese and Western medicine in the treatment of confirmed cases (Integrative Medicine Group, the cases were treated with TCM and western medicine; non-Integrative Medicine Group, the cases were treated with western medicine or medical observation.)
Table 1 Statistics of different TCM participation forms in COVID-19 treating in Shanxi Province (up to
24:00 on February 20, 2020)
Note #, There were cases of regional transfer to provincial designated hospitals, including 1 case in Yangquan, 3 cases in Changzhi City, 3 cases in Jincheng City, 2 cases in Shuozhou City, 3 cases in Xinzhou City, 5 cases in Jinzhong City, and 2 cases in Yuncheng City. *, The medical observation cases only have a history of contact and have no specific clinical symptoms, there are no detailed statistics on the specific intervention form of TCM. The cases treated with TCM decoction only; B, the cases treated with Chinese patent medicine only; A&B, the cases treated with TCM decoction and Chinese patent medicine.
Utilization status and the effectiveness of Qingfei Paidu decoction
Utilization status of Qingfei Paidu decoction
Among the 138 confirmed or suspected cases, 103 (79.23% of 138) patients were applied with Qingfei Paidu decoction, including 102(99.02% of 103) confirmed cases and 1 (0.97% of 103) suspected cases (Table 2).
Table 2 Statistics of utilization status of Qingfei Paidu decoction in the prefecture-level cities of Shanxi Province
Note: a TCM only, merely use Qingfei Paidu decoction to treat COVID-19; b, Integrated medicine, use Qingfei Paidu decoction combined with western medicine treating, such as antiviral drugs, antibiotic drugs, atomization treating, etc.
Effectiveness of Qingfei Paidu decoction in COVID-19
Clinical symptoms of COVID-19 patients, such as fever, fatigue, cough, etc., were recorded by the Novel Coronavirus Pneumonia Symptom Collection and Evaluation Form, which was designed by the State Administration of Traditional Chinese Medicine, and every symptom was divided into four grades: None, Light, Medium, Heavy. The outcomes of the 102 confirmed cases, treated integrative medicine on the basis of Qingfei Paidu decoction, were assessed by 2 chief physicians, who majored in TCM and western medicine respectively. The symptoms were stable in 5 cases, partially relieved in 31 cases, completely relieved in 64 cases, aggravated in 2 cases, and the total symptom relief rate accounted for 93.14%
Efficacy of TCM interventions in critical COVID-19 cases.
In the hospital cases, there were 2 severe cases and 1 critical case. On the basis of western medicine therapy, TCM therapy mostly adopted Chinese patent medicine of restoring yang to save from collapse, such as Xuebijing injection, Shexiangniuhuang pill, Shenfu injection, etc., since the condition of the patients was critical. The utilization of TCM decoction was individually based on the change of the patient's condition.
Efficacy of Qingfei Paidu decoction in cured COVID-19 patients
Among the 76 discharged patients, 59 cases were treated with Qingfei Paidu decoction, and the mean hospitalization time was 11.3±4.2 days. The effect observation showed that the mean hospitalization time of moderate patients was 6±3.5days, and the meantime of symptom relief after taking TCM was 4±1.6 days, of which chest CT shows significant absorption of inflammatory lesions. In a few patients with positive nucleic acid, the nucleic acids could turn negative within a week, and the time of nucleic acid negative conversion was between 7 to 10 days for most patients. The time of severe and critical cases was longer than that of moderate cases.
Conclusion and Prospect
Qingfei Paidu decoction, as the official recommended emergency epidemic prevention prescription, has a high degree of participation in the prevention and treatment of patients with COVID-19 in Shanxi Province, and has better clinical efficacy in improving clinical symptoms and alleviating disease progression. According to the official report, the total effective rate of clinical treatment for 214 patients is more than 90% [5], Qingfei Paidu decoction has a definite curative effect in preventing and improving the clinical symptoms of patients [6]. For new diseases. when both TCM and Western medicine are lacking effective understanding, the syndrome differentiation and individualized treatment of TCM has certain advantages compared with the symptomatic support treatment of Western medicine. However, during the application of Qingfei Paidu decoction, when there are some uncomfortable symptoms such as diarrhea, it is difficult to distinguish whether it is due to the use of antiviral drugs or hormones or TCM, which often affects the confidence of attending physician and patient. It is an effective and convenient way of internet remote consultation, but it is difficult for remote consultation experts of TCM to reach a consensus and get the recognition of local experts in a short time, it may need more time to explore a feasible mode of remote consultation of TCM. Qingfei Paidu decoction can be regulated by multiple components and targets in a network pharmacological study of the mechanism of treating COVID-19 [7]. The clinical efficacy of Qingfei Paidu decoction needs to be further studied and verified in the future.
Executive Editor: Chaoyang Wu
Submitted: 18 February 2020,
Accepted: 23 February 2020,
Online:25 February 2020
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References
1 General Office of National Health Commission, Office of State Administration of Traditional Chinese Medicine. [Internet]. Notice on recommending the use of “Qingfei Paidu decoction” in the treatment of pneumonitis infected by COVID-19 with integrated Chinese and Western medicine [cited 2020 February 7]. (Chinese)
2. General Office of National Health Commission, Office of State Administration of Traditional Chinese Medicine. [Internet]. Notice on printing and distributing COVID-19's diagnosis and treatment plan (trial fifth edition) [cited 2020 February 9]. (Chinese) .
3. General Office of National Health Commission, Office of State Administration of Traditional Chinese Medicine. [Internet]. Notice on printing and distributing COVID-19's diagnosis and treatment plan (trial sixth edition) [cited 2020 February 19]. (Chinese)
4. Health Commission of Shanxi Province. [Internet]. Dynamic distribution of the epidemic cases on the official website of the Health Commission of Shanxi Province, combined with the data from cities of Shanxi Province.[cited 2020 February 14].
5. State Administration of Traditional Chinese Medicine. [Internet].Qingfei Paidu decoction has a good effect in treating COVID-19,[cited 2020 February 23]. (Chinese) .
6. Liu QQ, Xia WG, An HQ et al.Thoughts on the effect of integrated traditional and western medicine in the treatment of COVID-19.Journal of Traditional Chinese Medicine 2020, online. (Chinese)
7. Zhao J, Tian SS, Yang JS, et al. Network Pharmacology of Qingfei Paidu decoction in the Treatment of COVID-19. Chinese Traditional &Herbal Drugs 2020, online. (Chinese)
