Notice on recommending the use of traditional Chinese medicine to prevent COVID-19 in enterprises and institutions that have resumed work and production.
Prevention and control of pneumonia in novel coronavirus by cities and counties (districts) emergency headquarters;
In order to implement the provincial government’s Notice on Strengthening the Scientific Prevention and Control of Epidemic Situation and Promoting the Resumption of Production of Enterprises in the Province and the No.14 Order of emergency headquarters Province on Epidemic Prevention and Control, and give full play to the core role of traditional Chinese medicine in disease prevention, the Provincial Administration of Traditional Chinese Medicine organized experts from Jiangxi University of Traditional Chinese Medicine and other units to study and formulate a prescription of traditional Chinese medicine for preventing COVID-19 for employees of enterprises and institutions that have resumed work and resumed production on the basis of summarizing the preventive drugs used in our province in the early stage. Now, the prescriptions of traditional Chinese medicine for employees of enterprises and institutions who have resumed production to prevent COVID-19 are recommended for reference.
First, the general population prevention prescription
10g of atractylodes rhizome, 5g of dried tangerine peel, 5g of agastache rugosa, 5g of perilla, 5g of honeysuckle, 5g of cyrtomium rhizome and 10g of raw astragalus root.
Function: Aromatic turbidity, clearing away heat and toxic materials, and consolidating exterior.
Second, the prescription for the prevention of the weak population
15g of Radix Astragali, 10g of Radix Saposhnikoviae, 10g of Rhizoma Atractylodis Macrocephalae, 5g of Herba Agastaches, 5g of Perillae and 5g of Flos Lonicerae.
Function: invigorating qi, consolidating exterior, aromatic and turbid, and clearing away heat and toxic materials.
Prevention and Control of Pneumonia Infected in novel coronavirus Province
Emergency headquarters office
February 21, 2020
Notice on printing and distributing the prevention and control scheme of traditional Chinese medicine in novel coronavirus, Jiangxi Province (Trial Third Edition)
The health committees of counties (cities) directly under the jurisdiction of all districts and cities, and relevant medical institutions directly under the jurisdiction of the province:
In order to give full play to the unique role of traditional Chinese medicine in the prevention and treatment of novel coronavirus epidemic, according to the Notice of the General Office of the National Health and Wellness Committee and the Office of state administration of traditional chinese medicine on Printing and Distributing the Diagnosis and Treatment Plan of novel coronavirus (Trial Sixth Edition) (Guo Wei Ban Yi Han [2020] No.145), we organized experts to analyze and summarize the prevention and treatment of novel coronavirus by traditional Chinese medicine in our province, and combined with the geographical and climatic characteristics of Jiangxi, revised the prevention and treatment plan of traditional Chinese medicine, and formed the "Prevention and Treatment of Traditional Chinese Medicine in novel coronavirus, Jiangxi Province" Is issued to you, please refer to the implementation.
Attachment: Prevention and Treatment Plan of Traditional Chinese Medicine in novel coronavirus, Jiangxi Province (Trial Third Edition)
Jiangxi provincial administration of traditional Chinese medicine
February 21, 2020
Prevention and treatment scheme of traditional Chinese medicine in novel coronavirus, Jiangxi Province
(Trial Third Edition)
In order to give full play to the role of Chinese medicine in the prevention and control of epidemic situation in novel coronavirus, combined with the situation of Chinese medicine participating in the treatment of early confirmed cases in our province and the regional and climatic characteristics, and further improve the prevention and syndrome differentiation treatment of novel coronavirus by Chinese medicine, this scheme is formulated.
I. Characteristics of the disease
(1) Clinical manifestations
Based on the current epidemiological investigation, the incubation period is 1-14 days, mostly 3-7 days. The main manifestations are fever, dry cough and fatigue. A few patients have symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. Severe patients often have dyspnea and/or hypoxemia one week after onset, and severe patients can rapidly progress to acute respiratory distress syndrome, septic shock, metabolic acidosis that is difficult to correct, bleeding and coagulation dysfunction and multiple organ failure. It is worth noting that severe and critical patients may have moderate to low fever or even no obvious fever during the course of the disease.
Mild patients only showed low fever, slight fatigue, etc., and no pneumonia.
Judging from the current cases, most patients have a good prognosis and a few patients are in critical condition. The prognosis of the elderly and those with chronic basic diseases is poor. The symptoms of children cases are relatively mild.
(2) Laboratory inspection
At the early stage of onset, the total number of white blood cells in peripheral blood is normal or decreased, and the lymphocyte count is decreased. Some patients may have increased liver enzymes, lactate dehydrogenase (LDH), muscle enzymes and myoglobin. Increased troponin can be seen in some critically ill patients. C-reactive protein (CRP) and erythrocyte sedimentation rate increased in most patients, and procalcitonin was normal. In severe cases, D- dimer increased and peripheral blood lymphocytes decreased progressively. Severe and critical patients often have elevated inflammatory factors.
Novel coronavirus nucleic acid can be detected in nasopharyngeal swab, sputum and other lower respiratory secretions, blood, feces and other samples.
In order to improve the positive rate of nucleic acid detection, it is suggested that sputum should be collected as much as possible, and lower respiratory tract secretions should be collected by patients undergoing tracheal intubation, and the samples should be sent for inspection as soon as possible after collection.
(3) Chest imaging
In the early stage, there were many small patches and interstitial changes, especially in the outer lung. Then it develops into multiple ground glass shadows and infiltration shadows in both lungs. In severe cases, lung consolidation can occur, and pleural effusion is rare.
Second, prevention of traditional Chinese medicine
(1) Drug prevention
1. Tea substitute: Radix Pseudostellariae 3g, Flos Lonicerae 3g, Herba Agastaches 3g, Radix Platycodi 3g, and Radix Glycyrrhizae 3g.
2. Basic prescription: Yupingfeng Powder, which consists of raw astragalus root 12g, Saposhnikovia root 10g, Atractylodes macrocephala 10g, Lonicera japonica 10g, Forsythia suspensa 10g, Rhizoma Osmundae 6g, Eupatorium odoratum 10g, Pericarpium Citri Tangerinae 10g, Rhizoma Atractylodis 10g and Radix Platycodi 10g.
(2) Prevention of Heat-sensitive Moxibustion (One Ai and Three Uses)
(1) Smell mugwort
Smell the Ai Xiang produced by heat-sensitive moxibustion moxa sticks several times a day for 30 seconds each time. The aromatic components of pure moxa in heat-sensitive moxibustion moxa sticks and the aromatic medicinal properties of Notopterygium Rhizoma, Radix Angelicae Pubescentis, Herba Asari and Rhizoma Ligustici Chuanxiong have good functions of refreshing the brain, sensitizing the sense of smell, purifying the internal environment of the nasopharynx and improving the immunity of the nasopharynx. Smelling the fragrance can not only publicize the pathogenic factors of upper energizer and dampness, but also prevent the exogenous pathogenic factors.
(2) moxibustion
Selection of points: Zhongwan, Shenque and Guanyuan.
Operation method: hanging moxibustion back and forth along meridian. During moxibustion, the moxa heat moves slowly near the moxibustion point, finding the position where the heat has special feelings such as penetration, distant transmission, diffusion and comfort, and carrying out moxibustion back and forth along the meridian.
Moxibustion amount: once a day, each point is moxibustion for about 45 minutes.
On the basis of the above, those who can accept wheat grain moxibustion add wheat grain moxibustion to Zusanli point, and the effect is better.
Precautions: During moxibustion, the moxibustion recipient should pay attention to cold and warmth, and keep the room temperature at about 25 degrees; It is not advisable to take a bath within 4 hours after moxibustion.
(3) Ai pedicure
Soak your feet with half a stick of moxa stick with heat-sensitive moxibustion in 1000 ml of hot water for 30 minutes every day until the skin on your forehead or nape is moist or slightly sweaty.
This scheme has three uses. The application of dynamic moxibustion can effectively stimulate the movement of menstruation and qi, mobilize the body’s own regulatory function, eliminate dampness and transport the spleen; Cooperate with wheat grain moxibustion to improve human immunity and strengthen the body; Sensitize the sense of smell through the aromatic smell, and publicize the pathogenic factors of upper energizer and dampness; Using hot Folium Artemisiae Argyi water, the meridians of lower limbs are warmed, and the coking is wet and turbid. Treating the triple energizer with the same treatment, giving consideration to both the symptoms and the root causes, has obvious effects of aromatization and dampness elimination, and announces the triple energizer.
Third, Chinese medicine treatment
This disease belongs to the category of "epidemic" disease in traditional Chinese medicine. Because of the feeling of "epidemic", all localities can treat it according to the condition, local climate characteristics and different constitutions, with reference to the following schemes. Doses exceeding pharmacopoeia should be used under the guidance of doctors.
1. Medical observation period
Clinical manifestation 1: fatigue with gastrointestinal discomfort
Recommended Chinese patent medicine: Huoxiang Zhengqi Capsule (pill, water, oral liquid)
Clinical manifestation 2: fatigue with fever
Recommended Chinese patent medicines: Jinhua Qinggan granules, Lianhua Qingwen capsules (granules), Shufeng Jiedu capsules (granules) and Chimonanthus chinensis leaves granules.
2. Clinical treatment period (confirmed cases)
2.1 Qingfei Paidu Decoction
Scope of application: it is suitable for light, ordinary and severe patients, and can be used reasonably in combination with the actual situation of patients in the treatment of critical patients.
Basic prescription: Herba Ephedrae 9g, Radix Glycyrrhizae Preparata 6g, Semen Armeniacae Amarum 9g, Gypsum Fibrosum 15?30g (decocted first), Ramulus Cinnamomi 9g, Rhizoma Alismatis 9g, Polyporus 9g, Atractylodis Macrocephalae 9g, Poria 15g, Radix Bupleuri 16g, Scutellariae 6g, Jiang Banxia 9g, Rhizoma Zingiberis Recens 9g, Radix Asteris 9g, Flos Lonicerae 9g, Rhizoma Belamcandae 9g, Herba Asari 6g, Rhizoma Dioscoreae 12g, Fructus Aurantii Immatur
Administration method: traditional Chinese medicine decoction pieces, decocted in water. One dose a day, twice in the morning and evening (40 minutes after meals), and three doses for a course of treatment.
If conditions permit, you can take half a bowl of rice soup after taking the medicine every time, and you can take an extra bowl for those with dry tongue and body fluid deficiency. (Note: If the patient has no fever, the dosage of gypsum should be small, and the dosage of gypsum can be increased if the patient has fever or strong heat). If the symptoms improve but are not cured, take the second course of treatment. If the patient has special circumstances or other basic diseases, the prescription can be modified according to the actual situation in the second course of treatment, and the drug will be stopped when the symptoms disappear.
Source of prescription: Notice of the General Office of the National Health and Wellness Commission and the Office of state administration of traditional chinese medicine on Recommending the Use of Qingfei Paidu Decoction in the Treatment of Pneumonia Infected by novel coronavirus with Integrated Traditional Chinese and Western Medicine (No.22 [2020] of the Office of Traditional Chinese Medicine).
2.2 heat-sensitive moxibustion treatment
Scope of application: it is suitable for mild, common, clinical observation period and recovery period of lung and spleen deficiency syndrome.
Therapeutic effect: benefiting the temperature and spleen, aromatic and dampness.
2.2.1 Moxibustion points: Shenque, Tian Shu (double) and Daheng (double).
2.2.2 Posture: Take a comfortable supine position and relax the whole body.
2.2.3 Operation:
The moxibustion victim lies on his back, respectively ignites two sections of moxa sticks with a diameter of 2.5 cm and a length of 4cm, and inserts them into a special moxibustion device with an moxa heat reflecting cavity and capable of adjusting the unit heat, wherein the moxibustion device is 22 cm long and 16 cm wide, and the smoke outlet of the moxibustion device is connected with a portable smoke eliminator, and the moxibustion device is placed horizontally with the navel as the center. In the process of moxibustion, the intensity of moxa heat can be adjusted by adjusting the handle of each moxibustion unit, so that the abdominal acupoint area of moxibustion feels hot, uniform, comfortable and not burning. By moving the moxibustion tool up and down, left and right on the navel, we can find the position where the heat sensation is permeated, spread, diffused and comfortable, and then let it stand for moxibustion. During the whole moxibustion process, it is necessary to ensure that the heat is uniform, comfortable and not burning, and the heat-sensitive induction such as deep heat, distal heat, body drying heat and forehead sweating subsides to a certain degree.
2.2.4 Moxibustion amount: once a day, about 40 to 60 minutes, and each moxibustion should not exceed 60 minutes.
2.3 light
(1) Cold-dampness stagnation of lung syndrome
Clinical manifestations: fever, fatigue, body aches, cough, expectoration, chest tightness, anorexia, nausea, vomiting, and sticky stool. The tongue is light, fat, with teeth marks or reddish, and the coating is white, thick, rotten or white, with moist or slippery pulse.
Recommended prescription: Dispelling cold, removing dampness and resisting toxin.
Raw Herba Ephedrae 6g, almond 9g, Ramulus Cinnamomi 9g, Radix Glycyrrhizae Preparata 6g, fried atractylodes 9g, Perilla 6g, Rhizoma Pinelliae Preparata 9g, Pericarpium Citri Tangerinae 9g, Radix Peucedani 9g, Radix Platycodi 9g, Fructus Aurantii 9g, Poria 9g, Ginger 9g and Jujube 9g.
For those with cold and heat, 9g of Bupleurum and 9 g of Scutellaria baicalensis Georgi are added; For those with obvious vomiting and diarrhea, Huoxiang Zhengqi Powder is used.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening, before meals.
(2) Syndrome of damp-heat accumulating in lung
Clinical manifestations: low or no fever, slight aversion to cold, fatigue, heavy head and body drowsiness, muscle aches, dry expectoration, sore throat, dry mouth and no desire to drink more, or accompanied by chest tightness, anorexia, loose stool or sticky stool. The tongue is reddish, the coating is white, thick and greasy or thin and yellow, and the pulse is slippery or moist.
Recommended prescription: Qingre Huashi Antitoxic Formula
Semen Armeniacae Amarum 9g, Scutellariae Radix 9g, Fructus Forsythiae 9g, Poria 9g, Fructus Amomi Rotundus 6g (bottom), Talcum 9g (fried), Folium Mori 9g, Herba Ephedrae 6g, Semen Coicis 15g, and Radix Glycyrrhizae 6g.
Bitter mouth, nausea and vomiting, combined with Xiaochaihu decoction; Nausea and nausea with joint pain, combined with Chaihu Guizhi decoction; Asthma, chest tightness, combined with "Xuanbi Decoction" in Treatise on Epidemic Febrile Diseases.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.
2.4 Ordinary type
(1) Damp-toxic stagnation of lung syndrome
Clinical manifestations: fever, cough with little phlegm, or yellow phlegm, shortness of breath, abdominal distension and constipation. The tongue is dark red, the tongue is fat, the coating is yellow and greasy or yellow and dry, and the pulse is slippery or stringy.
Recommended prescription: Modified Qingre Huashi Antitoxic Formula
Semen Armeniacae Amarum 9g, Scutellariae Radix 9g, Fructus Forsythiae 9g, Poria 9g, Fructus Amomi Rotundus 6g (bottom), Talcum 9g (fried), Folium Mori 9g, Rhizoma Phragmitis 9g, Semen Benincasae 9g, Semen Persicae 6g, and Semen Coicis 15g.
For patients with mild diarrhea, 9 g of Radix Puerariae is added; Cough with yellow phlegm, add 9g of buckwheat and 9 g of houttuynia cordata; Cough and rest, don’t lie down, and combine the jujube and xiefei decoction; Throat blocking sore throat, combined with Yinqiao Mabo powder.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.
(2) Cold-dampness blocking lung syndrome
Clinical manifestations: low fever, low body heat, or no fever, dry cough, less phlegm, fatigue, chest tightness, fullness, or nausea, loose stool. The tongue is pale or reddish, with white or greasy fur and moist pulse.
Recommended prescription: Modified formula for dispelling cold, removing dampness and resisting toxin.
Raw Herba Ephedrae 6g, almond 9g, cassia twig 9g, Radix Glycyrrhizae Preparata 6g, fried atractylodes 9g, Herba Agastaches 9g, Magnolia Officinalis 9g, Poria 9g, Pericarpium Citri Tangerinae 9g, Massa Medicata Fermentata 9g, stir-fried malt 9g, Pericarpium Arecae 6g, Herba Artemisiae Scopariae 6g and Bupleuri 9g.
Thirsty, cough phlegm is not easy to come out, add gypsum 915 g; Cough leads to chest pain, combined with Qianjin Weijing Decoction.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.
2.5 heavy duty
(1) Syndrome of lung-closing due to epidemic toxin
Clinical manifestations: red fever, cough, yellow sticky sputum, or blood in sputum, shortness of breath, fatigue, dry mouth, nausea, poor stool, short and red urine. Red tongue, yellow greasy fur, and slippery pulse.
Recommended prescription: 6g of raw ephedra, 9g of almond, 15g of gypsum Fibrosum, 3g of licorice, 10g of Pogostemon Pogostemonis (lower back), 10g of Magnolia officinalis, 15g of Atractylodes lancea, 10g of Amomum tsaoko, 9g of Rhizoma Pinelliae Preparata, 15g of Poria, 5g of raw rhubarb (lower back), 10g of raw Astragalus, 10g of Lepidium Seed and 10g of Paeonia Rubra.
9g of cogongrass rhizome is added for those with obvious blood in sputum.
Administration: 12 doses a day, decocted in water, 100 ml and 200 ml each time, 24 times a day, orally or by nasal feeding.
(2) gas camp two burnt certificates
Clinical manifestations: fever, polydipsia, shortness of breath, delirium, wrong vision, or rash, or vomiting blood, epistaxis, or limb convulsions. The tongue is crimson with little or no coating, and the pulse is heavy and thin, or it is large and numerous.
Recommended prescription: Gypsum Fibrosum 3060g (fried first), Anemarrhena asphodeloides 30g, Radix Rehmanniae 3060g, Cornu Bubali 30g (fried first), Radix Paeoniae Rubra 30g, Radix Scrophulariae 30g, Fructus Forsythiae 15g, Cortex Moutan 15g, Rhizoma Coptidis 6g, Folium Bambusae 12g, Semen Lepidii 15g and Radix Glycyrrhizae 6g.
Administration method: 1 dose per day, decocted with water, first decocted with gypsum and buffalo horn, 100 ml and 200 ml each time, 24 times a day, orally or by nasal feeding.
Recommended Chinese patent medicines: Xiyanping injection, Xuebijing injection, Reduning injection, Tanreqing injection and Xingnaojing injection. Drugs with similar efficacy can be selected according to individual conditions, or they can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.
2.6 Critical type (syndrome of internal closure and external detachment)
Clinical manifestations: dyspnea, frequent wheezing or mechanical ventilation, dizziness, dysphoria, sweating with cold limbs, dark purple tongue, thick greasy or dry fur, floating pulse without roots.
Recommended prescription: 15g of Ginseng, 10g of Heishun Tablet (fried first) and 15g of Cornus officinalis. Take Suhexiang Pill or Angong Niuhuang Pill.
Recommended Chinese patent medicines: Xuebijing injection, Reduning injection, Tanreqing injection, Xingnaojing injection, Shenfu injection, Shengmai injection and Shenmai injection. Drugs with similar efficacy can be selected according to individual conditions, or they can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.
Note: Recommended usage of heavy and critical traditional Chinese medicine injections.
The use of traditional Chinese medicine injections follows the principle of small dosage and gradual dialectical adjustment in the drug instructions. The recommended usage is as follows:
Virus infection or mild bacterial infection: 0.9% sodium chloride injection 250ml plus Xiyanping injection 100mg bid, or 0.9% sodium chloride injection 250ml plus Reduning injection 20ml, or 0.9% sodium chloride injection 250ml plus Tanreqing injection 40ml bid.
High fever with disturbance of consciousness: 250ml of 0.9% sodium chloride injection and 20 ml of Xingnaojing injection bid.
Systemic inflammatory response syndrome or/and multiple organ failure: 250ml of 0.9% sodium chloride injection and 100 ml of Xuebijing injection.
Immunosuppression: 250ml of 0.9% sodium chloride injection and 100ml bid of Shenmai injection.
Shock: 250ml of 0.9% sodium chloride injection and 100ml bid of Shenfu injection.
2.7 recovery period
(1) Deficiency of lung and spleen-qi syndrome
Clinical manifestations: shortness of breath, fatigue, anorexia, nausea, fullness, weak stool and loose stool’s discomfort. The tongue is pale and fat, and the coating is white and greasy.
Recommended prescription: Rhizoma Pinelliae Preparata 9g, Pericarpium Citri Tangerinae 10g, Radix Codonopsis 15g, Radix Astragali Preparata 30g, fried atractylodes 10g, Poria 15g, Herba Agastaches 10g, Fructus Amomi 6g (below) and Radix Glycyrrhizae 6g.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.
Recommended Chinese patent medicines: Shenling Baizhu Powder and Xiangsha Liujun Pill.
Adjuvant dietotherapy: the monkey in the river is thin with rice.
(2) Deficiency of both Qi and Yin
Clinical manifestations: fatigue, shortness of breath, dry mouth, thirst, palpitation, excessive sweating, anorexia, low or moderate fever, dry cough and little phlegm. The tongue is dry with little body fluid, and the pulse is thin or weak.
Recommended prescription: 10g Radix Adenophorae, 10g Radix Ophiopogonis, 6g Radix Panacis Quinquefolii, 6g Fructus Schisandrae Chinensis, 15g Gypsum Fibrosum, 10g Folium Bambusae, 10g Folium Mori, 15g Rhizoma Phragmitis, 15g Radix Salviae Miltiorrhizae and 6g Radix Glycyrrhizae.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.
(3) yang deficiency, phlegm and blood stasis syndrome
Clinical manifestations: chest tightness and suffocation, shortness of breath when moving, paroxysmal dry cough and choking cough, or coughing a small amount of white phlegm, white face and fear of cold. The tongue is dull, the coating is thin, white or greasy, and the pulse is heavy or astringent.
Chest CT showed obvious signs of pulmonary interstitial lesions.
Recommended prescription: Warming Lung and Chemical Fiber Decoction
15g of cornu Cervi Degelatinatum, 4g of Cinnamomum cassia, 10g of Rhizoma Zingiberis Preparata, 10g of Herba Ephedrae, 20g of Radix Rehmanniae Preparata, 10g of Semen Sinapis Albae, 6g of Radix Glycyrrhizae Preparata, 10g of Lumbricus, 10g of Eupolyphaga Seu Steleophaga, 10g of Rhizoma Chuanxiong, 10g of Semen Persicae and 10g of Carthami Flos.
15g of stir-fried malt and 15g of stir-fried rice buds are added to those who accept the poor; If qi deficiency is prominent, such as shortness of breath, mental fatigue and laziness, Buzhong Yiqi Decoction should be combined; People with yin deficiency such as dry mouth, dry throat, less fur, etc., combined with Shengmai drink; For patients with obvious cough, add 10g of Radix Asteris, 10g of Flos Farfarae, 10g of Stemonae and 10g of Perilla.
Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.
Recommended Chinese patent medicine: Jinshuibao capsule (tablet)
Source: Provincial Administration of Traditional Chinese Medicine and Jiangxi Provincial Hospital of Traditional Chinese Medicine.
Nanchang release
Wechat WeChat official account: nc_fabu
Original title: "Authoritative release! The recommended Chinese medicine prescription for preventing COVID-19 is coming! Get out of here "
