Chinese Herbal Medicine Treatment Plan For Novel Coronavirus Pneumonia

Corona Virus- Chinese medicine treatment plan

This is a translation of the diagnosis and treatment protocol for novel Corona Virus Pneumonia (新型冠状病毒肺炎诊疗方案).

It was released on March 3 2020 by the General Office of National Health Commission Office of State TCM Administration <Guideline on diagnosis and treatment of COVID-19 (Trial 7th)>.

This is not the full report. I have translated the section of the clinical treatment work plan suggested in the 7^th version of the Chinese National Health Commission.

• You can find the beginning of the report (Which I haven’t translated) in English here.
• The full Chinese text can be found here

Since December 2019 many cases of Corona virus pneumonia have been identified in Wuhan city Hubei Province. Nowadays the virus has spread all over the world and many countries including Israel are in a state of quarantine and home isolation due to the fast spread of the virus. There are some reports from China about the great contribution of Chinese herbal medicine when integrating it with western medicine. I don’t know if this integration will be possible in the west but for those of you who might look for an English translation to apply it in your healthcare clinics I have decided to translate these suggestions.

Please note that I don’t consider myself as a professional Chinese translator nor my mother tongue is English but I did my best. The clinical differentiation part and herbal formulas are well understood and reflect the meaning of this report.

Here is the section on Chinese herbal treatment for confirmed corona virus (COVID-19) patients:

Qing Fei Pai du tang (Clear lung, expel toxic decoction):

Formula’s general application ranges: All stages- mild, moderate and sever stages of COVID -19 (Corona virus) patients. In life threatening situations this formula can be applied with other formulas according to the actual circumstances.

 Ma huang 9g, Zhi gan cao 6g, Xing ren 9g, Sheng shi gao 15-30g, Gui zhi 9g, Ze xie 9g, Zhu ling 9g, Bai zhu 9g, Fu ling 15g, Chai hu 16g, Huang qin 6g, Jiang Ban xia ( with ginger) 9g, Sheng jiang 9g, Zi wan 9g, Kuan dong hua 9g, She gan 9g, Xi xin 6g, Shan yao 12g, Zhi shi 6g, Chen pi 6g, Hou xiang 9g.

Cook with water, one pack a day, drink morning and evening, 40 minute after meal.

Drink warm, three packs is one course of treatment. After drinking the formula drink half a bowl of rice soup. If the tongue is dry and Jin-Ye fluids are depleted, take up to one bowl of rice soup.

Attention: if the patient do not have fever the amount of Sheng Shi gao can be reduced and vice versa if the fever is high add more.

If the patient feels well but hasn’t cured completely go on with a second course of treatment, other herbs can be applied according to the circumstances.

This formula (Qing Fei Pai du tang – Clear lung, expel toxic decoction) is recommended by the Office of the State Administration of Traditional Chinese Medicine & the General Office of the National Health Commission. (2022 No.22).

There are few stages of corona virus patients:

A. Mild Corona virus cases:

in mild cases the patient won’t have pneumonia but mild symptoms. Western medicine for this type of patients is mainly symptomatic and supportive treatment. The common type has fever and respiratory symptoms. Traditional Chinese medicine adopts different treatments based on symptoms and syndromes. According to the symptoms and characteristics of the tongue and pulse:

Main pathologies:

1. Damp cold obstruction in the lungs:

Symptoms: fever, lack of strength, body ache, cough, sputum, low appetite, nausea vomiting, sticky stools. Tongue: swollen, white thick greasy coating. Pulse slippery.

Treatment strategy: expel cold, eliminate damp- phlegm.

Herbal formula: Ma xing yi gan tang jia jian:

Ma huang 6g, sheng shi gao 15g, Xing ren 9g, Qiang huo 15g, Ting li zi 15g, Guang zhong 9g, Di long 15g, Xu chang qing (Cynanchum paniculatum) 15g, Hou xiang15g, Pei lan 9g, Cang zhu 15g, Fu ling, 45g, Sheng bai zhu 30g, Jiao san xian （ Mai ya+ Shan zhu+ Shen qu）9g, Hou po 15g, Bing lang 9g, Wei cao guo （Amomum tsaoko） 9g, Sheng jiang 15g.

One pack a day, drink and divide 600 ml 3 times daily before meal

2. Damp heat accumulating in the lungs:

Symptoms:  low grade fever or no fever, little aversion to cold, fatigue, body and head heaviness, muscle ache, dry cough scanty sputum, throat pain, dry throat, some have chest oppression, no sweat or less sweat, soft stools or sticky not discharging well.  Red tongue, thin white thick sticky or thin yellow coating. A rapid slippery pulse.

Treatment strategy: acrid cold draining dampness. Transform damp, eliminate pathogen

Herbal formula: Bing lang 10g, Cao guo 10g, hou po 10g, Zhi mu 10g, Huang qin 10g, Chai hu 10g, Chi shao 10g, Lian qiao 15g, Qing hao 10g (add after), cang zhu 10g, Da qing ye 10g, Sheng gan cao 5g.

Other records use Sheng Jiang san Modification (升降散加减) Can Jiang 6, Chan tui 3, Jiang huang 9, Da huang 12

One pack per day, cook 400ml divide and drink morning and evening.

B. Moderate Corona virus cases:

most of patients will have fever, respiratory tract symptoms. The difference from mild is mainly manifested in the imaging findings of pneumonia. Western medicine treatment of Covid- 19 pneumonia has no difference between ordinary and mild cases, the treatment depends on symptomatic care.

Traditional Chinese medicine is still characterized by differential diagnosis, according to the main symptoms of such patients, combined with the characteristics of the tongue and pulse, it is roughly divided into:

1. Damp toxic evil in the lungs:

Symptoms: fever, cough with scanty sputum, or yellow sputum, chest obstruction/ suffocation, shortness of breath, abdominal fullness, constipation. Dark swollen red tongue, yellow sticky coating, or dry yellow, pulse is slippery, fast or wiry and slippery.

Treatment strategy: clear hear resolve toxins, diffuse the lungs, transform damp.

Herbal formula: Ma huang 9g, Xing ren 15g, Sheng shi gao 30g, Sheng yi yi ren 30g, Cang zhu 10g, Hou xiang 15g, Qing hao 12g, Hu zhang 12g, Ma bian cao 30g, Lu gen 30g, Ting li zi 15g, Ju hong 15g, Sheng gan cao 10g.

One pack per day, cook 400ml divide and drink morning and evening.

2. Damp cold obstruct the lungs:

Symptoms: low fever, low body temperature, dry cough, little phlegm, fatigue, fatigue, and chest obstruction, epigastric fullness, nausea, soft stools, pale tongue, white coating or white sticky coating. Soft pulse.

Treatment strategy: dispel cold and dampness, and eliminate epidemics.

Herbal formula: Cang zhu 15g, Chen pi 10g, Hou po 10g, Hou xiang 10g, Cao guo 6g, Sheng ma huang 6g, Qing huo 10g, Sheng jiang 10, Bing lang 10g.

One pack per day, cook 400ml divide and drink morning and evening.

C. Sever Corona virus cases:

1. Epidemic toxin blocking the lungs:

Symptoms: fever, red face, cough, yellow sticky sputum or with blood in sputum, wheezing and shortness of breath, fatigue and exhaustion, dry mouth, bitter sticky taste, nausea poor appetite, unsmooth stools, short red urine. Red tongue, yellow sticky coating, rapid slippery pulse.

Treatment strategy: transform damp, relieve toxic.

Herbal formula: Sheng ma huang 6g, Xing ren 9g, Sheng shi gao 15g, Gan cao 3g, Hou xiang 10g (add after), Hou po 10g, Cang zhu 15g, Cao guo 10g, Fa ban xia 9g, Fu ling 15g, Sheng da haung 5g (add after), Sheng huang qi 10g, Ting li zi 10g, Chi shao 10g.

1-2 packs a day, each time 100-200 ml 2-4 times daily, oral or nasal feeding.

2. Qi and Ying both ablaze (flaring heat)

High fever, great thirst, oppressed feeling and shortness of breath, delirium and clouded spirit, blurred vision, skin eruption or rash, spiting blood, nose bleeding, spasm of the four limbs, scarlet tongue, thin coating or no coating at all. Pulse: deep, thin or floating, big fast.

Treatment strategy: clear heat, nourish fluids open the orifices.

Herbal formula: Sheng shi gao 30-60g (cook first), Zhi mu 30g, Sheng di 30-60g, Shui niu jiao 30g (cook first), Chi shao 30g, Xuan shen 30g, Lian qiao 15g, Mu dan pi 15g, Huang lian 6g, Zhu ye 12g, Ting li zi 15g, Sheng gan cao 6g.

One pack a day, 100-200 ml each time, 2-4 times daily, oral or nasal feeding.

In addition to that they also advise for some Chinese medicine patent remedies that can be taken as a decoction or as herbal injection (I.V).

D. Critical Corona virus cases:

1. Internal blockage and external collapse:

Symptoms: difficult breathing, dyspnea, need for mechanical ventilation, cloud spirit- fainting, irritability, sweating and cold limbs, dark purple tongue, thick greasy coating or dry, unrooted, floating big pulse.

Herbal formula: Ren shen 15g, Hei shun pian ( black sliced aconite) 10g ( cook first), Shan zhu yu 15g.

Take with Su he xiang wan or An gong niu huang wan

Cases with mechanical ventilation accompanied with abdominal bloating or constipation add Da haung 5-10g.

Case with human machine un synchronized under the use of sedatives and muscle relaxants, add Da huang 5-10 g with Mang Xiao 5-10g.

Chinese medicine patent remedies are also recommended for individual use according to the condition, the usage can be done by injections (I.V) or decoctions.

Notes: It is recommended to use Traditional Chinese Medicine Injections for severe and critical cases.

E. Corona virus Recovery state:

1. Lung and Spleen qi deficiency:

Symptoms: Shortness of breath, fatigue, poor appetite and nausea, abdominal fullness, soft stools, Pale tongue, swollen greasy white coating.

Herbal formula: Fa ban xia 9g, Chen pi 10g, Dang shen 15g, Zhi huang qi 30g, Chao bai zhu 10g, Fu ling 15g, Hou xiang 10g, Sha ren 6g (add later), Gan cao 6g.

One pack per day, cook 400ml divide and drink morning and evening.

2. Qi and Yin deficiency:

Symptoms: fatigue, shortness of breath, dry mouth, thirst, palpitations, sweating, poor appetite, low grade fever or no fever, dry cough or little sputum. Dry tongue little fluids, Pulse: thin deficient no strength.

Herbal formula: Nan Bei sha shen 10g each, Mai dong 15g, Xi yang shen 6g, Wu wei zi 6g, Sheng shi gao 15g Dan zhu ye 10g, Sang ye 6g, Lu gen 15g, Dan shen 15g, Sheng gan cao 6g.

One pack per day, cook 400ml divide and drink morning and evening.