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[Treatment strategy and thought on classical herbal formulae for coronavirus disease 2019]
1Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine Nanjing 210028, China.
Insights
Traditional Chinese Medicine (TCM) offers effective treatment strategies for Coronavirus disease 2019 (COVID-19), addressing viral infections through personalized herbal prescriptions and proven therapeutic approaches.
Area of Science:
- Integrative Medicine
- Infectious Diseases
- Traditional Chinese Medicine (TCM)
Background:
- Coronavirus disease 2019 (COVID-19) is a highly infectious viral illness causing a global public health emergency.
- Traditional Chinese Medicine (TCM) has a historical precedent in managing plague-like illnesses and viral diseases.
- The absence of specific antiviral drugs for COVID-19 necessitates exploring alternative therapeutic avenues, such as TCM.
Purpose of the Study:
- To re-evaluate the modern application of TCM principles, specifically the "uniform of typhoid and febrile disease" concept, for COVID-19 treatment.
- To elucidate the pathogenesis of COVID-19 according to TCM theory, identifying distinct patterns across disease stages.
- To propose specific TCM herbal formulae and treatment strategies tailored to the different stages of COVID-19 progression.
Main Methods:
- Analysis of COVID-19 pathogenesis through the lens of TCM, categorizing disease progression from mild to severe and from superficial to deep.
- Identification of key TCM syndromes at different stages: Taiyang syndrome in the initial phase, Shaoyang and Yangming syndromes in the middle phase, phlegm-heat obstructing the lung in the critical phase, and lung and spleen deficiency in the recovery phase.
- Selection of classical TCM herbal formulae (e.g., Dayuan Yin, Xiaochaihu Decoction, Maxing Shigan Decoction, Tingli Dazao Xiefei Decoction) based on syndrome differentiation for each stage.
Main Results:
- TCM demonstrates efficacy in managing COVID-19, with strategies including inducing sweat, relieving exterior and interior symptoms, clearing heat, reducing phlegm, and nourishing deficiencies.
- Classical herbal formulae were shown to alleviate cytokine storms, regulate immune imbalances, and offer synergistic therapeutic effects.
- TCM interventions contributed to preventing disease progression, shortening fever duration, improving cough, increasing blood oxygen saturation, and reducing mortality rates.
Conclusions:
- TCM offers a valuable and effective approach to managing COVID-19, applicable across all disease stages from initial infection to recovery.
- Personalized treatment strategies based on TCM syndrome differentiation and classical herbal formulae are crucial for optimizing patient outcomes.
- The multi-component, multi-target nature of TCM provides a promising avenue for synergistic treatment of viral infections like COVID-19.
Abstract:
Coronavirus disease 2019(COVID-19) refers to the pneumonia caused by novel coronavirus(2019-nCoV) infection in 2019. It is highly infectious, with quick spreading and a wide range of impact. It has been broken out in many countries around the world and has become a public health emergency of international concern. Chinese medicine has a long history in treating plague, and viral disease is the clinical advantage in Chinese medicine. Under the premise that there is currently no specific drug treatment, Chinese medicine has achieved certain effects in the treatment of COVID-19, which has attracted much attention and has been upgraded to a national strategy. Regarding the treatment of COVID-19 with Chinese medicine, it is believed that in terms of the name of Chinese medicine, the modern connotation of "uniform of typhoid and febrile disease" should be re-recognized, and it is advisable to use drugs based on specific clinical prescriptions and indications. In terms of pathogenesis, the COVID-19 has the pathogenesis rules including from the mild to severe conditions, from the surface to the inside, from the excess syndrome to the deficiency syndrome. We should pay attention to the Taiyang syndrome damaged by wet disease in initial stage, Shaoyang syndrome complicated with Yangming syndrome in the middle stage, phlegm-heat obstructing lung in critical period, lung and spleen deficiency in the recovery stage. In terms of clinical treatment strategies, Dayuan Yin is recommended to induce sweat and disperse the stasis in early stage. Xiaochaihu Decoction and Maxing Shigan Decoction is used to relieve both exterior and interior symptoms in middle stage. In critical stage, Tingli Dazao Xiefei Decoction, Weijing Decoction, Xuanbai Chengqi Decoction, Xiaoxianxiong Decoction, and Sanzi Yangqin Decoction are considered to reduce phlegm and clear heat. We should pay attention to nourishing Qi and strengthening the spleen by Zhuye Shigao Decoction, Sha-shen Maidong Decoction, and Liujunzi Decoction in the later recovery period. It shall be noted that, no matter in the initial mild stage, the middle and critical stages, or in the later recovery stage, Chinese medicine plays an important role, including preventing mild to severe disease, shortening the fever time, improving cough symptoms, increasing blood oxygen saturation and reducing mortality. Many studies have shown that the classical herbal formulae can alleviate the cytokine storm, regulate the immune imbalance, and produce the potential effect of synergistic treatment for COVID-19 through multiple components, multiple targets, and multiple pathways.
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