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How COVID-19 is Currently Treated in China with TCM

By March 2, 2020 March 6th, 2020 No Comments

Compiled, Translated by John Chen, Pharm.D., Ph.D., OMD., L.Ac., Lori Hsu, MTOM, MS

Edited by Michael Norris, L.Ac., C.H., Debra Nash-Galpern, Donna Chow, L.Ac., DiplOM

Published on February 19, 2020

Disclaimer: This article is compiled, translated and edited by John K. Chen and Lori Hsu from three references to inform the readers how COVID-19, the 2019 novel coronavirus, is currently treated in China. For readers who may have such an infection, contact and consult your primary physician, go to the hospital or the CDC immediately. For additional information, please contact the World Health Organization (WHO), the Center of Disease Control (CDC) and the Food and Drug Administration (FDA).

With Wuhan on Lockdown for More Than 10 days, the Chinese Government Announces a Major Change in Strategy: All Patients with Confirmed Infections are to Use Chinese medicine.  2/10/2020

The Medical Treatment Unit of Wuhan’s Novel Coronavirus (2019-nCoV), currently named COVID-19, Prevention and Control Headquarters issued a “Notice Regarding the Agreement to Recommend the Use of Chinese Medicine in the Treatment of Pneumonia due to Infection from the Novel Coronavirus”. The “Notice” emphasizes that all designated medical institutions in Wuhan will ensure that all infected patients take Chinese medicine (Chinese medicine decoction or granules) before midnight (24:00) on February 3, 2020.

A collaboration between Western and Chinese medicine is undoubtedly welcoming news, especially now as the results from the front lines in Wuhan have been very promising. See below for more.

1/29/20 The second dispatch of support from the central government to the Hubei Chinese Medicine Treatment team took over the newly created isolation ward for pneumonia patients infected by the 2019-nCoV in the Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine. It is the only medical facility in the Hubei Province that is managed entirely under the supervision of the China’s Traditional Chinese Medicine (TCM), TCM system, providing a central point responsible for determining diagnosis and treatment.

The following is reported in the patient wards under the responsibility of Guandong Provincial TCM Hospital:

Patient Rounds: The severity of patient conditions was unexpected, and the entire ward was more or less quiet as these patients were so weak, that it seemed that they did not even have the energy to moan. Most of the patients treated were urgently, critically, or severely ill. Many of them had a high fever, a thick tongue coating, slippery and wiry pulses, bowel incontinence, and little to no expression on their faces (perhaps from extreme fatigue?).

1/30/20 Herbal formulas were  administered to patients according to the individual’s TCM pattern diagnoses, as prescribed by Guandong’s experts.

2/1/20 Patient Rounds: Some patients’ fever have been reduced. There were more patients with low-grade fever.  By and large,tongue coatings changed from thick and greasy to thin, and patient stools were more formed. Furthermore, these patients now had the energy to speak for up to five sentences before the onset of mild wheezing. Also, in general, coughing was significantly less compared to before. Patients’ self-reports of conditions have improved quite a bit. Patients can now  sit up and practice the qigong exercise, Eight Brocade in bed and/or meditate.

As of 2/4/20: Nearly fifty patients in the ward have clearly improved. The effectiveness of Chinese herbal treatments are being actively observed and witnessed in this clinical setting.

Caption: For the first time, eight patients treated with traditional Chinese medicine or a combination of traditional Chinese and western medicine were discharged from hospital.

1/28/20, Dr. Huang Luqi, the chair of the Chinese Academy of Chinese Medical Sciences, led the medical team of Guang’anmenHospital and Beijing Xiyuan Hospital of the Chinese Academy of Chinese Medical Sciences to support Wuhan Jinyintan Hospital. Chinese medicine combined with Western medicine, treatment by syndrome differentiation, greatly improved the  patients’breathing issues, fatigue, dry mouth, bitterness, chest tightness, diarrhea and other symptoms.

2/3/20, Eight confirmed patients were discharged from the first ward of the South Building of Wuhan Jinyintan Hospital. This represents the first group of patients who were discharged from a hospital using traditional Chinese medicine or a combination of traditional Chinese medicine and Western medicine. Amongst them, six were female, two were male.  Of these, six were severe and two were mild cases.   The age range of the patients was from twenty-six to sixty-eight. After treatment with traditional Chinese medicine and herbs, most patients had obviously improved symptoms and an overall improved mental state. At the time of discharge, each patient was sent home with a two-week dose of Chinese herbs along with instructions on appropriate exercise and proper diet in order to gain full recovery.

Please share this article and the herbal prescriptions with everyone.

In the fight against the pandemic of pneumonia from 2019-nCoV Novel Coronavirus infection, Hubei Provincial Hospital of Traditional Chinese Medicine diligently used the specialties of TCM, in cooperation with relevant departments to study and formulate pneumonia prevention and treatment programs revealing that Chinese herbs played a definitive role in positive treatment outcomes. Chinese herbal formulas harbor the unique potential to reduce fever and cough symptoms, limit disease progression, and improve overall immunity, and thus a person’s ability to mount an essential immune response to the virus.

The following are the recommended formulas, acupuncture and moxibustion protocols for prevention and treatment of Coronavirus according to TCM experts. Please note, the following formulas are not to be used in place of Western medicine rather they are to be integrated into a comprehensive treatment plan utilizing both Western and Chinese medicine to ensure optimal patient outcomes. Furthermore, patients are advised not to self treat or use the formulas blindly, but rather to consult with licensed medical practitioners to ensure optimal treatment on a case by case basis. 

Prevention Phase: 防期 

Formula:  Pneumonia Prevention #1肺炎1 

  • Huang Qi黄芪 (Radix Astragali) 15g,
  • Bai Zhu 炒白术(Rhizoma Atractylodis Macrocephalae), dry fried 10g
  • Fang Feng防风 (Radix Saposhnikoviae) 10g
  • Mian Ma Guan Zhong贯众 (Rhizoma Dryopteridis Crassirhizomatis) 10g
  • Jin Yin Hua金银花 (Flos Lonicerae Japonicae) 10g
  • Chen Pi 陈皮(Pericarpium Citri Reticulatae) 6g
  • Pei Lan佩兰(Herba Eupatorii) 10g

Suitable for: Prevention of pneumonia due to viral infections, and the flu.

Acupuncture Treatment for Suspected Cases:

The purpose is to strengthen the immune system,  to help alleviate early symptoms, and to shorten the duration of the virus.

Points: Bilateral Zusanli (ST 36), Qihai (CV 6), Zhongwan (CV 12)

Method and Frequency:

  • Moxa Zusanli(ST 36) on both sides for 15 minutes. Moxa Qihai (CV 6) or Zhongwan (CV 12) for 10 minutes. (alternating from treatment to treatment).
  • Twice a day, once in the afternoon and once at night.

 

Influenza Phase: 流感期

Diagnosis: Wind-Cold Invading the Exterior  

Clinical Manifestations: Onset of fever (mostly low-grade fever), aversion to cold and fear of cold, chills, headache, ticklish throat, soreness of muscles of limbs, no sweat or night sweats.

Examination: Lung CT negative. Tongue is pale, coating is white and thin. Floating pulse

Treatment Strategy: Expel Wind, Release the Exterior; Clear Heat, Detoxify

Herbal Formula:  葛根或柴葛解肌 (Ge Gen Tang (Kudzu Decoction) or Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Release the Muscle Layer))

Flu Formula #1流感1

  • Ge Gen 葛根(Radix Puerariae Lobatae) 15g
  • Ma Huang 麻黄(Herba Ephedrae) 10g
  • Gui Zhi 桂枝(Ramulus Cinnamomi) 6g
  • Bai Shao白芍 (Radix Paeoniae Alba) 15g
  • Sheng Jiang生姜 (Rhizoma Zingiberis Recens) 10g
  • Gan Cao生甘草 (Radix et Rhizoma Glycyrrhizae) 10g
  • Da Zao大枣 (Fructus Jujubae) 10g
  • Jin Yin Hua金银花 (Flos Lonicerae Japonicae) 20g
    • with headache, add Bai Zhi 白芷(Radix Angelicae Dahuricae) 15g
    • with dry or ticklish throat, add She Gan射干 (Rhizoma Belamcandae) 15g

Other possible formulas to consider: Huo Xiang Zheng Qi San

 Diagnosis: Toxic Heat Attacking the Lung 

 Clinical Manifestations: Fever, aversion to cold, sore and dry throat, dry cough, scanty sputum, sore and painful muscles in the limbs, weakness, headache

Examination: CT scan reveals both lungs to have scattered ground-glass opacity (GGO). Tip and sides of the tongue are red; thin white or yellow tongue coating. Floating and rapid pulse.

Treatment Strategy: Expel Wind, Release the Exterior; Clear Heat, Detoxify

Herbal Formula:银翘散加清瘟毒散加减 (Yin Qiao San (Honeysuckle and Forsythia Powder) and Qing Wen Bai Du San(Clear Epidemics and Overcome Pathogenic Influences Powder), modified) 

Flu Formula #2流感2 

  • Jin Yin Hua 金银花(Flos Lonicerae Japonicae) 10g
  • Lian Qiao连翘 (Fructus Forsythiae) 10g
  • Jing Jie荆芥 (Herba Schizonepetae) 10g
  • Niu Bang Zi 牛蒡子(Fructus Arctii) 10g
  • Bo He薄荷 (Herba Menthae) 10g
  • Gan Cao生甘草 (Radix et Rhizoma Glycyrrhizae) 10g
  • Dan Zhu Ye 淡竹叶(Herba Lophatheri) 10g
  • Lu Gen芦根 (Rhizoma Phragmitis) 15g
  • Huang Lian黄连 (Rhizoma Coptidis) 6g

Diagnosis: Damp Cold in the Lung 濕寒鬱肺 

Clinical Manifestations: Aversion to cold, fever or absence of fever, dry cough, dry throat, fatigue, weakness, chest stuffiness, epigastric distention, nausea, diarrhea. Pale tongue, white greasy coating, slippery pulse. 

Treatment Strategy: Expel Wind, Release the Exterior; Dispel Damp Cold

Herbal Formula: 

Damp Cold Formula #1

  • CangZhu 蒼朮 (Rhizoma Atractylodis) 15g 
  • ChenPi 陳皮 (Pericarpium Citri Reticulatae) 10g 
  • HouPo 厚樸 (Cortex Magnoliae Officinalis) 10g 
  • HuoXiang 藿香(Herba Pogostemonis seu Agastaches) 10g 
  • CaoGuo 草果 (Fructus Tsaoko) 6g
  • MaHuang 生麻黃 (Herba Ephedrae) 6g
  • Qiang Huo 羌活(Rhizoma et Radix Notopterygii) 10g
  • ShengJiang 生薑 (Rhizoma Zingiberis Recens) 10g
  • BingLang 檳榔 (Semen Arecae) 10g

Acupuncture Treatment for Mild and Moderate Cases:

The purpose is to reduce the severity of symptoms, shorten the duration, and alleviate emotional burden.

Points: Bilateral Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Shenque (CV 8)

Method and Frequency:

  • Moxa Hegu(LI 4) and Taichong (LR 3) bilaterally for 15 minutes. Moxa Zusanli (ST 36) bilaterally for 10 minutes. Moxa Shenque (CV 8) with a moxa box for 15 minutes.
  • Twice a day, once in the morning and once in the afternoon.

 

Pneumonia Phase: 肺炎期 

Diagnosis: Shaoyang Syndrome with Damp 少阳湿 

Clinical Manifestations: Fever, which is more pronounced in the afternoon, alternating chills with fever, cough, absence of wheezing, bitter taste in the mouth, dry mouth, chest stuffiness, stifling sensation, chest and hypochondriac fullness and distention, irritability, nausea or vomiting, no appetite, weakness. Similar to the beginning stage of pneumonia.

Examination: CT scan reveals both lungs to have multiple scattered or large pieces of ground-glass opacity (GGO). Slightly red tongue, thick and greasy, white or yellow coating, slippery, rapid pulse.

Treatment Strategy: Harmonize Shaoyang Syndrome, Clear Damp-Heat

Herbal Formula: 小柴胡合三仁或甘露消毒丹 (Xiao Chai Hu Tang (Minor Bupleurum Decoction) with San Ren Tang(Three-Nut Decoction) or Gan Lu Xiao Du Dan (Sweet Dew Special Pill to Eliminate Toxins))

Pneumonia Formula #1 肺炎1

  • Chai Hu 柴胡(Radix Bupleuri) 24g
  • Huang Qin 黄芩(Radix Scutellariae) 9g
  • Sheng Jiang生姜 (Rhizoma Zingiberis Recens) 10g
  • Fa Ban Xia法夏 (Rhizoma Pinelliae) 12g
  • Ku Xing Ren杏仁 (Semen Armeniacae Amarum) 15g
  • Bai Dou Kou白豆蔻 (Fructus Amomi Rotundus) 10g
  • Yi Yi Ren 薏苡仁(Semen Coicis) 30g
  • Dan Zhu Ye竹叶 (Herba Lophatheri) 15g
  • Hua Shi 滑石(Talcum) 15g
  • Tu Fu Ling 土茯苓(Rhizoma Smilacis Glabrae) 30g
  • Gan Cao生甘草 (Radix et Rhizoma Glycyrrhizae) 10g

Diagnosis: Damp Heat Afflicting the Lung 湿郁肺 

 Clinical Manifestations: Low-grade fever or absence of fever, dry cough, scanty sputum, dry and sore throat, fatigue, weakness, poor appetite, chest stuffiness, epigastric distention, nausea or vomiting, loose stool.

Examination: CT scan reveals both lungs to have multiple scattered or large pieces of ground-glass opacity (GGO). Pale or pink, puffy tongue with teeth marks. White or greasy white coating. Soft or slippery pulse.

Treatment Strategy: Transform Dampness, Detoxify; Disperse the Lungs and Expel Pathogens

Herbal Formula: 麻杏薏甘、小陷胸、草果知母 (Ma Xing Yi Gan Tang (Ephedra, Apricot Kernel, Coicis, and Licorice Decoction), Xiao Xian Xiong Tang (Minor Sinking into the Chest Decoction) and Cao Guo Zhi Mu Tang (Tsaoko and Anemarrhena Decoction) 

Pneumonia Formula #2  肺炎2

  • Ma Huang 麻黄(Herba Ephedrae) 10g
  • Ku Xing Ren杏仁 (Semen Armeniacae Amarum) 10g
  • Yi Yi Ren薏苡仁 (Semen Coicis) 30g
  • Huang Lian黄连 (Rhizoma Coptidis) 6g
  • Fa Ban Xia法夏 (Rhizoma Pinelliae) 10g
  • Gua Lou Pi瓜蒌皮 (Pericarpium Trichosanthis) 10g
  • Cao Guo草果 (Fructus Tsaoko) 10g
  • Zhi Mu知母 (Rhizoma Anemarrhenae) 10g
  • Yu Xing Cao鱼腥草 (Herba Houttuyniae) 15g
  • Gan Cao生甘草 (Radix et Rhizoma Glycyrrhizae) 10g
  • Bai Dou Kou白豆蔻 (Fructus Amomi Rotundus) 9g

 Diagnosis: Toxic Stagnation Obstructing the Lung 毒瘀壅肺

Clinical Manifestations: Cough, stifling sensation, stuffiness and distention in the chest, asthma and wheezing that worsens with exertion, accelerated respiration, thirst, irritability, reddish yellow urine.

Examination: CT scan reveals both lungs to have multiple scattered or large pieces of ground-glass opacity (GGO). Fibrotic changes of the lung are also visible. Dark purplish tongue, yellow dry tongue coating or thick and greasy yellow coating, rapid, slippery pulse.

Treatment Strategy: Detoxify, Arrest Wheezing; Transform Blood Stasis and Open Collaterals

Herbal Formula: 白虎加人参合四土 (Bai Hu Jia Ren Shen Tang (White Tiger plus Ginseng Decoction) with Si Tu Tang (Four Wild Decoction)

Pneumonia Formula #3 肺炎3

  • Shi Gao石膏 (Gypsum Fibrosum) 30g
  • Zhi Mu知母 (Rhizoma Anemarrhenae) 10g
  • Shan Yao山药 (Rhizoma Dioscoreae) 15g
  • Xi Yang Shen西洋参 (Radix Panacis Quinquefolii) 5g
  • Tu Fu Ling 土茯苓(Rhizoma Smilacis Glabrae) 30g
  • Tu Da Huang土大黄(Radix Rumicis Obtusifolii) 10g
  • Tu Bei Mu 土贝母(Rhizoma Bolbostemmatis) 10g
  • Tu Niu Xi 土牛膝(Rhizoma Achyranthes Sylvestris) 10g
  • Su Mu苏木 (Lignum Sappan) 10g
  • Tu Bie Chong土鳖 (Eupolyphaga seu Steleophaga) 10g
  • Ju Luo橘络 (Vascular Citri Reticulatae) 15g
  • Lai Fu Zi莱菔子 (Semen Raphani) 20g
  • Ting Li Zi 葶苈子(Semen Descurainiae seu Lepidii) 15g
  • Si Gua Luo丝瓜络 (Retinervus Luffae Fructus) 30g

 Diagnosis: Closed Interior and Abandoned Exterior Syndrome 外脱

 Clinical Manifestations: Mental incoherence, irritability, burning or heat sensation in the chest and abdomen, cold extremities, accelerated respiration and need for assisted breathing, scarlet purple tongue, dry yellow or yellowish brown coating, floating, forceful pulse that is empty in the deep level, or rootless.

Treatment Strategy: Open the Closed, Consolidate the Abandoned, Detoxify, Rescue Reversal

Herbal Formula: 四逆加人参、送服 牛黄丸、紫雪散 (Si Ni Jia Ren Shen Tang (Frigid Extremities Decoction plus Ginseng), taken with An Gong Niu Huang Wan (Calm the Palace Pill with Cattle Gallstone) and Zi Xue San (Purple Snow Powder))

Pneumonia Formula #4肺炎4

  • Ren Shen 人参(Radix et Rhizoma Ginseng) 10g
  • Fu Zi制附子(Radix Aconiti Lateralis Praeparata) 10g
  • Serve with AnGong Niu Huang Wan (Calm the Palace Pill with Cattle Gallstone) and Zi Xue San (Purple Snow Powder).

 

Recovery Phase: 恢复期

Clinical Manifestations: Absence of fever, dry cough, chest stuffiness, shortness of breath, shortness of breath upon exertion, dry mouth, weakness.

Examination: CT reveals inflammation begins to subside as well as pulmonary interstitial changes. Pale red tongue, thick or greasy coating, thread, rapid pulse.

Treatment Strategy: Tonify Qi, Nourish Yin, Tonify Lung and Open the Collaterals

Herbal Formula: 沙参麦(Sha Shen Mai Dong Tang (Glehnia and Ophiopogonis Decoction))

Pneumonia Formula #5肺炎5

  • Sha Shen 沙参(Radix Glehniae seu Adenophorae) 15g
  • Mai Dong麦冬 (Radix Ophiopogonis) 15g
  • Wu Wei Zi五味子(Fructus Schisandrae Chinensis) 15g
  • Ren Shen人参 (Radix et Rhizoma Ginseng) 12g
  • Lai Fu Zi莱菔子 (Semen Raphani) 15g
  • Si Gua Luo丝瓜络 (Retinervus Luffae Fructus) 15g
  • Ju Luo 橘络(Vascular Citri Reticulatae) 15g
  • Zi Su Zi 苏子(Fructus Perillae) 12g
  • Zhe Bei Mu浙贝 (Bulbus Fritillariae Thunbergii) 12g
  • Ku Xing Ren杏仁 (Semen Armeniacae Amarum) 12g
  • Huang Qin黄芩 (Radix Scutellariae) 15g
  • Gan Cao生甘草 (Radix et Rhizoma Glycyrrhizae) 10g

 Acupuncture Treatment for The Recovery Phase:

The Purpose is restore Lung and Spleen functions and the body’s zheng (upright) qi.

Points: Bilateral Dazhui (GV 14), Geshu (BL 17), Feishu (BL 13), Zusanli (ST 36) or Kongzui (LU 6).

Method and Frequency:

  • Moxa all points for 15 minutes.
  • Once a day.

History and experience prove that Traditional Chinese Medicine is effective against epidemic diseases. 

From the Western Han Dynasty to the end of the Qing Dynasty, at least 321 large-scale plagues occurred in China. Chinese medicine has served to wage life-and-death battles against various plague consistently through time and has successfully contained the spread of epidemics in a limited area and time.  There has never been a similar tragedy in China’s history, such as the Spanish flu or the Black Death in Europe.  These are examples of global plagues that killed tens of millions of people.

In the Chinese history, whenever a plague is rampant, Chinese medicine practitioners are always on the front lines to battle the disease. Many survived with the help of Chinese Medicine; so in this fight with the insidious and novel Coronavirus, Chinese Medicine once again should take a primary role in effective treatment and must not be absent in action!

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Reference 1: https://mp.weixin.qq.com/s/qzSecLwVXQIfFBTQyHQxHQ

Reference 2: https://mp.weixin.qq.com/s/YajZ_fycSKEoTBvzhOv5Wg

Reference 3: https://mp.weixin.qq.com/s/qSUM5kYJIPJTvKkf_HfuaA?