Treatment of Covid-19 (2019-nCoV) in TCM – smart health with Traditional Chinese Medicine

Compiled and edited by John K. Chen, Pharm.D., PhD., OMD, LAc and Lori Hsu, MTOM, MS Editors: Michael Norris, L.Ac., CH, Debra Nash-Galpern, LAc, Donna Chow, L .Ac., DiplOM

Disclaimer: this article is compiled, translated and edited by John K. Chen and Lori Hsu from three references to inform readers of how COVID-19, the 2019 novel coronavirus, is currently treated in China. For more information, please contact the World Health Organization (WHO), the Center of Disease Control (CDC) and the Food and Drug Administration (FDA).

With the complete foreclosure of Wuhan, the Chinese government announces a major change in its strategy to fight the epidemic: all affected patients are invited to use Chinese medicine.

02/10/2020 Wuhan New Coronavirus Medical Treatment Unit (2019-Sxy) Currently named COVID-19, Prevention and Control Headquarters, has issued a "Notice regarding the agreement to recommend the use of Chinese medicine in the treatment of pneumonia caused by infection with the new coronavirus".

The notice emphasizes that all designated medical facilities in Wuhan will ensure that all infected patients take Chinese medicines (decoction or Chinese medicine granules) before midnight (midnight) on February 3, 2020. Collaboration between Western and Chinese medicine is undoubtedly good news, especially since the results of the front lines in Wuhan have been very promising. See below for more details.

1/29/20 The seconddistribution of central government support to the treatment teamHubei Chinese Medicine Supported Newly Isolated Isolation Servicecreated for 2019-nCoV-infected pneumonia patients at Hubei Provincial Hospital inintegrated traditional Chinese and Western medicine. It's the only onemedical institution in Hubei province which is fully managed and undersupervision of the Chinese system of traditional Chinese medicine (TCM),providing a reference to determining diagnosis and treatment.

What followsis reported in the departments under the responsibility of the Provincial Hospital ofMTC of Guandong:

Patient overview: The severity of the patient's conditions was unexpected and the entire ward was more or less calm because some of these patients were so weak that they did not even have the energy to moan. Most of the patients treated were treated as a matter of urgency because they were critically ill or seriously ill. Many of them had a high fever, a thick tongue, a Slippery, Rope pulse, fecal incontinence, and little to no expression on their faces (maybe extreme fatigue?).

1/30/20 Formulas based on Plants were administered to patients according to the modalities of individualized diagnosis of TCM and as prescribed by experts from Guandong.

01/02/20 Presentation of patients: fever in some patients has been reduced. There were more patients with lower fever. On the whole, the tongue coatings have changed from thick and fatty to thin and the stools are more formed. In addition, these patients now have enough energy to speak up to five sentences before moderate wheezing occurs. In addition, the cough was generally significantly less. Patient reports on their conditions have improved somewhat. Patients can now sit and practice qigong exercises such as the Eight Brocade Pieces in bed and / or meditate.

From 2/4/20: Nearly fifty patients in the department have improved significantly. The effectiveness of Chinese herbal treatments is actively observed in this clinical context.

NB: For the first time, eight patients treated with traditional Chinese medicine or a combination of traditional Chinese and Western medicine were allowed to leave the hospital.

1/28/20, Dr. Huang Luqi, president of the Chinese Academy of Chinese Medical Sciences, led the medical team at Guang’anmen Hospital and Xiyuan Hospital in Beijing to support Wuhan Jinyintan Hospital. Chinese medicine combined with Western medicine, treatment by differentiation of syndromes, has significantly improved patients' respiratory problems, fatigue, dry mouth and bitterness, chest tightness, diarrhea and others symptoms.

2/3/20, Eight confirmed patients have left the first ward of the southern building of Wuhan Jinyintan Hospital. This represents the first group of patients who have been discharged after being treated in a hospital using traditional Chinese medicine or a combination of traditional Chinese medicine and western medicine. Among them, six were women, two were men. Among them, six cases were serious and two cases were mild. The age range of the patients was twenty-six to sixty-eight. After treatment with traditional Chinese medicine and herbs, most of the patients showed improvement in symptoms and their overall mental state. Each patient was discharged health home with a two-week prescription of Chinese herbs and instructions on proper exercise and proper nutrition in order to achieve full recovery.

Please share this article and herbal prescriptions with everyone.

In the fight against the pandemic of pneumonia due to infection with 2019-nCoV Novel Coronavirus, the provincial hospital of Traditional Chinese Medicine of Hubei in cooperation with the relevant departments to study and formulate prevention and treatment programs for pneumonia, reveals that Chinese herbs played a definitive role in the positive results of the treatment. Chinese herbal formulas harbor the unique potential to reduce fever and cough symptoms, limit disease progression and improve overall immunity and therefore a person's ability to build an immune response adapted to the virus.

Here are the recommended formulas, acupuncture and moxibustion protocols for the prevention and treatment of coronavirus according to MTC experts.

Please note that the following formulas should not be used in place of Western medicine but rather integrated into a comprehensive treatment plan that uses both Western and Chinese medicine to ensure optimal results for patients.

In addition, patients are advised not to self-treat or use formulas blindly, but rather to consult licensed physicians to ensure optimal treatment on a case-by-case basis.

Prevention phase: 预防 期 

Formula: Prevention of pneumonia # 1肺炎 预防 1 号

• 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 influenza.

Acupuncture treatment for suspect cases: the goal is to strengthen the immune system, help relieve early symptoms, and shorten the lifespan of the virus.

Points: Zusanli (E 36) bilaterally, Qihai (RM 6), Zhongwan (RM 12)

Method and frequency: 

• Moxa on Zusanli (E 36) on both sides for 15 minutes.

• Moxa on Qihai (RM6) or zhongwan (RM 12) for 10 minutes (alternating from one treatment to another)

• Twice a day, once in the afternoon and once at night.

Diagnostic : The cold wind is invading outdoors 风寒 袭 表 证 

Clinical manifestations: bouts of fever (mostly low fever), aversion and fear of the cold, chills, headache, ticklish throat, muscle pain in all 4 limbs, no sweating or night sweats.

Exam : Negative pulmonary CT. The tongue is pale, the coating is white and thin. Floating pulse.

Principle of treatment: Expel the wind, free the outside; clarify the Heat, detoxify.

Herbal formula : Ge Gen Tang (Kudzu Decoction) or Chai Ge Jie Ji Tang   (Decoction of Bupleurum and Kudzu to release the muscle layer)

Flu formula # 1 流感1号

• Ge Gen 葛根 (Radix Puerariae Lobatae) 15g

• My huang 麻黄 (Herba Ephedrae) 10g

• Mistletoe 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 and Rhizoma Glycyrrhizae) 10g

• Da Zao 大枣 (Fructus Jujubae) 10g

• Jin Yin Hua 金银花 (Flos Lonicerae Japonicae) 20g

• In case of headache, add baizhi 白芷 (Radix Angelicae Dahuricae) 15g

• In case of dry or ticklish throat, add She gan 射干 (Rhizoma Belamcandae) 15g

Other possible formulas to consider: HuoXiangZhengQiSan

Diagnostic : Toxic heat attacking the lung热 毒 袭 肺 证 

Clinical manifestations: fever, aversion to cold, sore and dry throat, dry cough, little sputum, sore muscles and pain in limbs, weakness, headache.

Exam : The CT scan reveals that both lungs have a frosted glass infiltrate (pathological image that can be seen on a radiography pulmonary. This image corresponds to an enlarged inflammatory interstitial tissue (alveolar walls and interstitium interlobular) which becomes radiologically individualizable. It can also correspond to the partial filling of the light of certain alveoli by debris cell or by hyaline membranes. This aspect is frequently encountered in all acute or subacute pulmonary affections: viral affections, eosinophilic lung, extrinsic allergic alveolitis, pneumocystis pulmonary, alveolar proteinosis etc.)

The tip and sides of the tongue are red; the coating is thin, white or yellow. The pulse is floating and rapid.

Treatment strategy: Expel the wind, free the outside; clarify the Heat, detoxify.

Herbal formula:  银 翘 散 加 清 瘟 败毒 散 加减YinQiaoSan and QingWenBaiDuSan amended

Flu formula # 2 流感2号

• 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 and 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

Diagnostic : Cold humidity in the lung 濕 寒 鬱 肺 

Clinical manifestations: Aversion to cold, fever or no fever, dry cough, dry throat, fatigue, weakness, chest congestion, epigastric distension, nausea, diarrhea. Pale tongue, fat and white coating, slippery pulse.

Treatment strategy: Kick out the wind, free the outside; Disperse cold and humidity

Formula against Cold-Humidity:

• Cang Zhu 蒼朮 (Rhizoma Atractylodis) 15g

• Chen Pi 陳皮 (Pericarpium Citri Reticulatae) 10g

• Hou Po 厚樸 (Cortex Magnoliae Officinalis) 10g

• Huo Xiang 藿香 (Herba Pogostemonis seu Agastaches) 10g

• Cao Guo 草 果 (Fructus Tsaoko) 6g

• My huang 生 麻黃 (Herba Ephedrae) 6g

• Qiang Huo 羌活 (Rhizoma and Radix Notopterygii) 10g

• Sheng Jiang 生薑 (Rhizoma Zingiberis Recens) 10g

• Bing Lang 檳榔 (Semen Arecae) ​​10g

Acupuncture treatment for mild and moderate cases: The goal is to reduce the severity of the symptoms, shorten their duration and alleviate emotional stress.

Points: Hegu (GI 4), Taichong (F 3), Zusanli (E 36), Shenque (RM 8) bilaterally

Method and frequency:

• Moxa Hegu (GI 4) and Taichong (F 3) bilaterally for 15 minutes.

• Moxa on Zusanli (E36) bilaterally for 10 minutes.

• Moxa on Shenque (RM 8) with moxa box for 15 minutes.

• Twice a day, once in the morning and once in the afternoon.

Diagnostic : Shaoyang syndrome with presence ofhumidity 少阳 夹 湿 证 

Clinical manifestations: Fever, more pronounced in the afternoon, alternating chills and fever, cough, no wheezing, bitter taste in the mouth, dry mouth, chest congestion, feeling of suffocation, chest fullness and distension, irritability, nausea or vomiting, lack of appetite, weakness. Similar to the early stage of pneumonia.

Exam : the CT scan reveals that both lungs have multiple or large pieces of infiltrate frosted glass (GGO). Slightly red, thick and oily tongue, white or yellow coating, slippery and rapid pulse.

Treatment strategy: Harmonize Shaoyang syndrome, clarify heat-humidity

Herbal formula:  小 柴胡 汤 合 三 仁 汤 或 甘露 消毒 丹 XiaoChaiHutang  with SanRenTang  or GanLuXiaoDuDan

Formula 1 pneumonia 肺炎1号

• 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 and Rhizoma Glycyrrhizae) 10g

Diagnostic : Heat-humidity affects the lung 湿热 郁 肺 证 

Clinical manifestations: Low intensity fever or no fever, dry cough, little sputum, dryness and pain in the throat, fatigue, weakness, lack of appetite, chest congestion, epigastric distension, nausea or vomiting, loose stools.

Exam : The CT scan reveals that both lungs have multiple or large pieces of infiltrate frosted glass (GGO). Pale or pink tongue, swollen with teeth marks. White or white and fatty coating. Normal or slippery pulse.

Treatment strategy: Transform moisture, detoxify; Disperse lungs and expel pathogens

Herbal formula:  麻 杏 薏 甘 汤, 小 陷 胸 汤, 草 果 知母 汤 MaXingYiGanTang, XiaoXianXiongTang and CaoGuoZhiMuTang 

pneumoniaFormula # 2 肺炎2号

• My 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 and Rhizoma Glycyrrhizae) 10g

• Bai Dou Kou 白 豆蔻 (Fructus Amomi Rotundus) 9g

Diagnostic : Toxic stagnation obstructing the lung 毒 瘀 壅 肺 证 

Clinical manifestations: Cough, feeling of suffocation, congestion and distension in the chest, asthma and wheezing which worsens with exertion, accelerated breathing, thirst, irritability, reddish yellow urine.

Exam : The CT scan reveals that both lungs have multiple or large pieces of infiltrate frosted glass (GGO). The fibrotic changes in the lung are also visible. Dark purplish tongue, yellow and dry or thick and oily yellow coating, rapid and slippery pulse.

Treatment strategy: Detoxify, stop wheezing; Transform the blood stasis and open the collaterals

Herbal formula: 白虎 汤加 人 参汤 合 四 土 汤 BaiHuJiaRenShenTang with SiTuTang 

Pneumonia Formula # 3 肺炎3号

• 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

• You 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

• If Gua Luo 丝瓜络 (Retinervus Luffae Fructus) 30g

Diagnostic : wind-heat with internal blockage syndrome and external collapse内 闭 外 脱 证 

Clinical manifestations: Mental inconsistency, irritability, burning or hot feeling in the chest and abdomen, cold extremities, rapid breathing and need for assisted breathing, scarlet purple tongue, dry yellow or yellowish brown coating, strong and floating pulse which is empty at the level deep or rootless.

Treatment strategy: Open what is closed, consolidate collapse, detoxify, save from overthrow

Herbal formula:   四逆 加 人 参汤 、 送 服 安宫牛黄丸 、 紫雪 散 SiniJiaRenShenTangtaken with AnGongNiuHuangWan andZiXueSan

Pneumonia Formula # 4 肺炎4号

• Ren shen 人参 (Radix and Rhizoma Ginseng) 10g

• Fu Zi 制 附子 (Radix Aconiti Lateralis Praeparata) 10g

• served with An Gong Niu Huang Wan and Zi Xue San.

Clinical manifestations: No fever, dry cough, chest congestion, shortness of breath, shortness of breath on exertion, dry mouth, weakness.

Exam : a CT scan reveals that the inflammation is starting to go away as well as the interstitial lung changes. Pale red tongue, thick or oily coating, fine, rapid pulse.

Treatment strategy: tone Qi, nourish Yin, tone lung and open collaterals

Herbal formula : 沙 参麦 门冬 汤 ShaShenMaiDongTang 

Pneumonia formula # 5 肺炎5号

• 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 and Rhizoma Ginseng) 12g

• Lai Fu Zi 莱菔子 (Semen Raphani) 15g

• If 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 and Rhizoma Glycyrrhizae) 10g

Acupuncture treatment for the recovery phase: The goal is to restore the functions of the lung and spleen and the zheng qi of the body.

Points: Dazhui (DM 14), Geshu (V 17), Feishu (V 13), Zusanli (E 36) or Kongzui (P 6) bilaterally.

Method and frequency:

• Moxaon all points for 15 minutes.

• Atimes a day.

History and experience have shown 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 constantly been used over time to fight battles against various plagues and has succeeded in containing the spread of epidemics. In the history of China there has never been a tragedy comparable to the Spanish flu or the black plague which occurred in Europe. These are examples of global scourges that have killed tens of millions of people.

In Chinese history, whenever a plague is endemic, practitioners of Chinese medicine are always at the forefront of combating the disease. Many have survived with the help of Chinese medicine. In this fight against the coronavirus, Chinese medicine should once again play a key role and should not be dismissed.

• 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

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