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How COVID-19 (2019-nCoV) is Currently Treated in China with TCM

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: 预防期

Formula: Pneumonia Prevention #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 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 风寒袭表证

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: 葛根汤或柴葛解肌汤 (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号

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 热毒袭肺证

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:银翘散加清瘟败毒散加减 (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 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

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

Ma Huang 生麻黃 (Herba Ephedrae) 6g

Qiang Huo 羌活 (Rhizoma et 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 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 少阳夹湿证

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: 小柴胡汤合三仁汤或甘露消毒丹 (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 et Rhizoma Glycyrrhizae) 10g

Diagnosis: Damp Heat Afflicting the Lung 湿热郁肺证

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: 麻杏薏甘汤、小陷胸汤、草果知母汤 (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号

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 毒瘀壅肺证

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: 白虎汤加人参汤合四土汤 (Bai Hu Jia Ren Shen Tang (White Tiger plus Ginseng Decoction) with Si Tu Tang (Four Wild Decoction)

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

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 内闭外脱证

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: 四逆加人参汤、送服 安宫牛黄丸、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号

Ren Shen 人参 (Radix et Rhizoma Ginseng) 10g

Fu Zi 制附子 (Radix Aconiti Lateralis Praeparata) 10g

Serve with An Gong 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: 沙参麦门冬汤(Sha Shen Mai Dong Tang (Glehnia and Ophiopogonis Decoction))

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 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!

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?