Chinese Medicine Treating Corona Virus Pneumonia (COVID 19)

By: Keren Zelicha

In the previous article on Corona virus pneumonia- traditional Chinese medicine pathopysiolgy, I have discussed the characteristics and mechanism of damp toxicity as the major pathogenic factor for corona virus disease. This epidemic evil can block the qi axis, suppress yang, damage qi transformation & transportation and produce a toxic damp pathology. Damp Toxic evil qi attacks the lungs and the Mo yuan (source membrane) related to the San jiao triple warmer.

The characteristics of corona virus (COVID-19) disease

The nature of the disease is a composition of damp toxicity leading to heat and qi flow obstruction.

In the beginning, the disease will have mild symptoms of fever, dry cough, sometimes fatigue and muscle pain. This is regarded as a Wei qi level type of Wen Bing disease.

When the disease advance and enters the lung membranes (related to the Mo Yuan), the acute inflammation and the lack of oxygenation may lead to some mixed excess-deficient symptoms. We can see Qi level symptoms such as: high fever, dry cough, pneumonia, with Zheng qi deficiency symptoms such as: difficulty in inhalation, dark complexion, liver and kidney organ failure due to the hypoxia.

The damage of corona virus in the body

Since the main pathogen is damp toxicity, it can hide in the Mo Yuan (source membrane) and damage the triple warmer:

1. In the upper Jiao it blocks the lung qi.
2. In the middle Jiao it disrupts the digestive system transformation and transportation (spleen-stomach- large intestine).
3. In the lower Jiao it can also harm water passages -kidney functions.

Clinical thoughts before choosing Chinese medicine herbs or formulas for Corona virus (COVID-19):

1. It is very important not to make a mistake when treating the disease and make sure if the condition is damp toxicity transforming into heat or heat toxicity with dampness. These are two different situations and different treatment strategies to choose.
2. Corona virus belongs to damp toxicity pathogen. In this disease we should not use clearing heat and resolving toxic herbs- they are too cold. In the mild cases, cold herbs can aggravate the dampness and also lead to cold warping up heat. Using low doses of clearing heat toxic herbs is sometimes necessary during the qi level phase, when the inflammation is acute. The low dose here is important! Why? Because we need to consider two things:

• We must not forget that coronavirus patients are already taking antibiotics to treat their pulmonary inflammation. These medications are considered to be cold nature so there is no need to add strong cooling herbs.
• Clearing heat toxic herbs are cold and may have a huge attacking effect to the Zheng qi.

3. Using acrid warm herbs such as Ma huang or Gui zhi can easily cause the disease to transfer category into heat and dryness. When using them think on balancing the warmth of the formula. Despite what has been said, Ma huang is a key herb treating Corona virus. We see many corona virus formulas using 10-15 grams of Ma huang. This herbs is essential since it opens the entire chest cavity and since it can open water passages above the lungs by increasing urination. That way damp accumulation can be dissipated from the lungs.
4. Using antipyretic herbs as Shi gao should be well considered, since they are bitter, cold. They might cause gastro- intestinal symptoms and damage the intestine before the pathogen is cleared. This may also damage the Zheng qi and slow the healing process.

Chinese medicine treatment principles for corona virus

According to Chinese doctors, when treating COVID-19 disease the focus should be on ventilating the qi mechanism by:

1. Resolving damp turbidity with acrid aromatic herbs.
2. Diffusing the upper.
3. Regulating the qi dynamics of the middle jiao spleen- stomach.
4. Percolating the lower Jiao by opening and discharging.

As the dampness will be resolved, stagnant heat and toxicity will be able to disperse. This may improve the symptoms manifestations.

Treating Corona virus with Chinese medicine herbs & formulas

From the experience of Chinese doctors:

1. Preventive stage

The main way to prevent disease is to pay attention to healthcare, reasonable diet, combination of physical activity and rest. A virus must find an appropriate surface within the body to take hold and replicate itself. The corona virus has a damp toxic nature. Therefore, we need to adjust our diet and choose food that will prevent damage to spleen- stomach qi and yang. Eat lighter, easy to digest- cooked- warm food.  Use fragrant herbs and spices in your meals.

For high risk patients (old patients) consider Yu Ping Feng San modification: [1]

Huang qi 15g, Fang feng 10g, Bai zhu 12g, Jin yin hua 10g, Hou xiang 10g, Su ye 10g, Sheng Gan cao 6g.

Drink as a water decoction.

The most frequently used herbs for preventing corona virus are: Huang qi, Gan cao, Fang feng,

Bai zhu, Jin yin hua, and Lian qiao. [2]

According to regional climate differences modification can be done. In the north of china, due to the dry climate, two additional herbs for nourishing Yin were used such as: Mai men dong and Sha shen. In the south of China, due to the humid climate, aromatic- resolving dampness and turbidity herbs were used such as: Hou xiang, Pei lan. [3]

Fragrant herbal bags:

Another traditional way to suppress epidemic disease is through inhaling aromatic herbs. These aromatic substances enter the human body through the respiratory tract, which can stimulate the nervous system and the body’s immune system. The herbs promote the production of antibodies and improve the body’s disease resistance. The herbs are aromatic fragrant, antitoxic and transform dampness. They are grounded into powder and inserted into small cloth bags. Each bag is around 10-15g. The bag is hanged around the neck or chest.

Use herbs such as: (Composition of Xi xi hospital- Hangzhou) [4]

Ding xiang 3g, Cang zhu 6g, Hou xiang 9g, Rou gui 3g, Bo he 9g, Ai ye 9g, Zi su ye 2g, Bai zhi 6g, Shan nai 6g, Fang feng 3g, Bing pian 1g, Shi chang pu 3g, Xiao hui xiang 3g, Chen xiang 3g, Hu zhang 9g,

When treating coronavirus, we need to pay attention to the stage of the disease and the physical strength of the patient. Since COVID-19 is an epidemic disease, some patients have a rapid change and a rapid aggravation in their symptoms.  Therefore, a close assessment should be done every other day.

The herbal treatment for novel corona virus pneumonia

2. Confirmed corona virus patients

China’s General office of the national health and health commission announced a recommended formula for all provinces in the treatment of COVID-19 patients. This formula is called Qing Fei Pai Du Tang 清肺排毒汤.

The formula is a combination of Ma Xing Shi Gan Tang with She Gan Ma Huang Tang.

Qing Fei Pai Du Tang:

General application ranges: all stages- mild, common and sever stages of COVID -19 (Corona virus) patients. In life threatening situations this formula can be applied with 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.

Qing Fei Pai Du Tang treatment strategy

By analyzing the herbs, we see that Qing Fei Pai Du tang can release the exterior, diffuse lung qi and clear lung heat, expel damp toxic evil, regulate qi and promote fluid transformation.

Corona virus is an epidemic damp disease (湿疫) which can be mixed with cold or heat depending on the climate, the stage of the disease and individual constitution. Qing Fei Pai Du tang is acrid and cooling in nature. Therefore, an important differential diagnosis and evaluation of the disease should be done before prescribing it.

Treating confirmed corona virus patients according to their disease stage

The Chinese National Guidelines divided the treatment into 5 stages:

1. Mild stage of corona virus epidemic
2. Moderate stage of corona virus epidemic
3. Sever stage of corona virus epidemic
4. Critical stage of corona virus epidemic
5. recovery stage of corona virus epidemic

I have translated the the clinical report and posted it in a different article since it it very long. To read the guidelines please click on the button below.

Bibliography:

[1] Discussion on the theory and clinical practice of tcm for covid-19 Zhe jiang university

[2] Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs. Luo Hui, Tang qiao ling et al.

[3] ibid

[4] Discussion on the theory and clinical practice of tcm for covid-19 Zhe jiang university