Trial Version 2 Prevention And Treatment Plan Of Traditional Chinese Medicine For Pneumonia Caused By Novel Coronavirus in Jiangxi Province

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The characteristics of the disease

(1) Epidemiology.

The disease is mainly transmitted through respiratory droplets, but also through contact transmission and aerosol transmission. The incubation period is 1-14 days, mostly 3-7 days, and the longest is about 14 days. The incubation period is contagious, which is very different from SARS. The source of infection seen so far is mainly pneumonia patients infected with the new coronavirus, and most of the cases have a history of direct or indirect contact with Wuhan. The population is generally susceptible, and there have been clusters of cases. The elderly and those with underlying diseases are more seriously ill after infection, and children and infants also have the disease.

(2) Clinical manifestations.

Fever and cough are not the only initial symptoms of pneumonia caused by a new coronavirus infection. Digestive system symptoms, nervous system symptoms, cardiovascular system symptoms, ophthalmological symptoms, or only mild limb or lower back muscle pain can be the initial symptoms of the disease. . Some epidemiological patients have no obvious symptoms, but are highly contagious, only showing low fever, mild fatigue, etc., without pneumonia, and most of them recover after 1 week. Severe cases mostly develop dyspnea after 1 week, and severe cases rapidly progress to acute respiratory distress syndrome, septic shock, metabolic acidosis that is difficult to correct, and coagulation dysfunction. The prognosis of most patients is good, the symptoms of children are relatively mild, and a few patients are critically ill or even die. The deaths are more common in the elderly and those with chronic underlying diseases.

(3) Laboratory examination.

In the early stage of the disease, the total number of white blood cells in peripheral blood was normal or decreased, and the lymphocyte count decreased. Liver enzymes, muscle enzymes, and myoglobin were elevated in some patients. Most patients had elevated C-reactive protein and erythrocyte sedimentation rate, and normal procalcitonin. In severe cases, D-dimer is elevated. Novel coronavirus nucleic acid can be detected in sputum, throat swabs, lower respiratory tract secretions, blood, and other specimens.

(4) Chest imaging.

In the early stage, there were 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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The protection of medical staff

When an observed case or a confirmed case is found, medical staff should follow the principles of standard prevention and additional prevention, and adopt a combination of droplet prevention and contact prevention. Isolation measures, testing at the first time, adhere to the responsibility system of the first doctor, standardize the detection, reporting, and disposal of cases, and the use of protective equipment can refer to the "General Office of the National Health and Health Commission on Printing and Distributing the Common Medicines in the Prevention and Control of Pneumonia Infected by Novel Coronavirus" Notice on the Guidelines for the Scope of Use of Protective Equipment (Trial Implementation) (Guoweiban Medical Letter [2020] No. 75).

Three, traditional Chinese medicine prevention

(1) Drug prevention

1. Substitute tea recipe: 3g of Radix ginseng, 3g of honeysuckle, 3g of Huoxiang, 3g of Platycodon grandiflorum, 3g of licorice.

2. Basic prescription: Yupingfeng Powder with added flavor, the composition is as follows: 12g of Astragalus, 10g of Fangfeng, 10g of Atractylodes, 10g of Yinhua, 10g of Forsythia, 6g of Guanzhong, 10g of Peilan, 10g of tangerine peel, 10g of Atractylodes, and 10g of Platycodon grandiflorum.

(2) Prevention of heat-sensitive moxibustion (one moxa and three prescriptions)

method one:

Smell the mugwort fragrance produced by the heat-sensitive moxibustion sticks once an hour 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. , especially suitable for Xuanhua Shangjiao dampness evil.

Method Two:

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 process of moxibustion, the person being moxibustion should be protected from cold and keep warm.

Method three:

Put half a stick of heat-sensitive moxibustion moxa stick in 1000ml hot water to soak your feet for 30 minutes every day, until the forehead sweats.

Through moxa smoking, moxibustion, foot bath, one moxa, and three uses, once a day, there is obvious aroma and dampness, and the effect of Sanjiao is announced.

TCM treatment

This disease belongs to the category of epidemic diseases in traditional Chinese medicine. Because of the viciousness of the epidemic, all parts of the province can refer to the following schemes for syndrome differentiation and treatment according to the condition, climate characteristics, and different physical conditions.

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), Mountain Wax Plum Leaf Granules, Shufeng Jiedu Capsules (granules), Fangfengtongsheng Pills (granules)

2. Clinical treatment period

(1) Early-stage: cold dampness and stagnation of the lungs

Clinical manifestations: aversion to cold, fever or no fever, dry cough, dry throat, fatigue, chest tightness, epigastric distention, or nausea, loose stools, pale or reddish tongue, greasy white coating, and wet pulse.

Recommended prescription: Atractylodes 15g, tangerine peel 10g, Magnolia officinalis 10g, Huoxiang 10g, Caoguo 6g, Ephedra 6g, Qiang Huo 10g, Ginger 10g, Betel lang 10g

Addition and subtraction: add talc for severe fever; add dwarf tea for obvious cough

(2) Mid-term: Epidemic virus closes the lungs

Clinical manifestations: persistent fever or alternating cold and heat, cough with less phlegm, yellow phlegm, abdominal distension, and constipation. Chest tightness, shortness of breath, coughing and wheezing, and wheezing when moving. Red tongue, yellow greasy coating or yellow dryness, slippery pulse.

Recommended prescription: 10g almond, 30g raw gypsum, 30g melon wilt, 6g raw rhubarb (after the next), 6g raw ephedra each, 10g Tinglizi, 10g peach kernel, 6g grass fruit, 10g betel lang, 10g atractylodes

Addition and subtraction: add An Gong Niuhuang Pill or Antelope Horn Powder (Chong) for those with persistent high fever, and add Citrus aurantium and Magnolia officinalis for those with severe abdominal distension and constipation

Recommended Chinese patent medicines: Xiyanping injection, Xuebijing injection, Tanreqing injection

(3) Severe stage: internal closure and external disengagement

Clinical manifestations: dyspnea, frequent wheezing or need for assisted ventilation, accompanied by dizziness, irritability, sweating, cold limbs, dark purple tongue, thick greasy or dry fur, large floating, and rootless pulse.

Recommended prescription: 15g ginseng, 10g Heishun tablet (fried first), 15g dogwood, take Suhexiang Pill or Angong Niuhuang Pill

Recommended Chinese patent medicines: Xuebijing injection, Shenfu injection, Shengmai injection

(4) Recovery period: Lung and spleen deficiency

Clinical manifestations: shortness of breath, fatigue, anorexia, nausea, fullness, weak stools, loose stools, pale and fat tongue, and white greasy coating.

Recommended prescription: Pinellia 9g, tangerine peel 10g, Codonopsis 15g, Astragalus 30g, Poria 15g, Huoxiang 10g, Amomum Vulgaris 6g (below)

Recommended Chinese patent medicine: Shenling Baizhu Powder, Xiangsha Liujun Pill

Heat-sensitive moxibustion treatment: refer to the method of "heat-sensitive moxibustion prevention (one moxa and three prescriptions)"