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6"×9" b4078 Use of Patented TCM Against COVID-19: A Practice Manual
Preface
* “Chinese patent medicine” means the same as “Patented traditional Chinese medicine”.
For ease of reading, Chinese patent medicine is used in the following paragraphs.
Preface vii
Huaqiang Zhai
Chief Editor
April 2020
Huaqiang Zhai
Email: jz711@qq.com
Professor and doctoral supervisor of TCM; materia
medica experts of ISO(ISO/TC 249); director of
several academic associations and winner of several
national and provincial awards. Mainly engaged in
Chinese medicine standardization, Chinese medi-
cine dispensing technology research.
Yanping Wang
Deputy director of Institute of Basic Research in
Clinical Medicine, China Academy of Chinese
Medical Sciences; deputy secretary-general of two
committees of World Federation of Chinese
Medicine Societies; director of several academic
associations and winner of several national and pro-
vincial awards. Mainly engaged in Chinese medi-
cine clinical pharmacy and standardization research
and Chinese medicine culture construction and
academic heritage research.
ix
Yiheng Yang
Senior pharmacist and associate supervisor of phar-
maceutical preparation section, Peking University
Third Hospital. Mainly engaged in pharmaceutical
management, pharmaceutical quality control,
Chinese medicine clinical pharmacy and post-mar-
keting drug safety evaluation.
Xiaodong Li
Professor, postdoctor, doctoral supervisor; vice-
president of Hubei Provincial Hospital of Traditional
Chinese Medicine (TCM); director of Hepatology
Institute of TCM.
Yingjun Shao
Email:15210369502@163.com.
Postgraduate supervisor, associate professor of
translation & interpretation, Beijing University of
Chinese Medicine.
Editorial Board
Editors-in-Chief
Huaqiang Zhai, Yanping Wang,
Yiheng Yang, Xiaodong Li, Yingjun Shao
Associate Editors
Nan Zhang, Nannan Shi, Yuanshen Zhu , Ying Liu
Mengxin Wang, Jiao Liu, Zhaoning Xu, Jiankun Wu, Jie Tian
Xuanzhong Tan, Shuhe Chen, Rui Chen, Geng Li,
Hongli Wang, Xiaoli Li, Lihua Li, Xin Zhang, Yonglong Han
Xiangwen Kong, Minxia Zheng, Teng Wang, Fuqin Yan
xi
Contents
Prefacev
About the Editors-in-Chief ix
Editorial Board xi
xv
Section 3: L
ianhua Qingwen Capsule (Granule)
(see Table 3) 68
Section 4: Shufeng Jiedu Capsule (see Table 3) 74
Chapter 5 G
uidance on Rational Application of Chinese Patent
Medicine during Clinical Treatment Period 81
Section 1: Xiyanping Injection (see Table 1) 82
Section 2: Tanreqing Injection (see Table 1) 88
Section 3: Xuebijing Injection (see Table 1) 96
Section 4: Xingnaojing Injection (see Table 1) 101
Section 5: Reduning Injection (see Table 1) 106
Section 6: Shengmai Injection (see Table 1) 112
Section 7: Shenfu Injection (see Table 1) 118
Section 8: Shenmai Injection (see Table 1) 124
Appendix 139
Bibliography 147
Index169
Chapter 1
Understanding COVID-19
2. Pathogenic characteristics
The novel coronaviruses belong to the β genus. Their genetic characteris-
tics are significantly different from SARS-CoV and MERS-CoV. Current
research has shown that they share more than 85% homology with bat
SARS-like coronaviruses (bat-SL-CoVZC45). The new coronavirus is a
positive-strand RNA virus.
The virus is sensitive to ultraviolet and heat, which can be effectively
inactivated when exposed to 56°C for 30 minutes and lipid solvents (such
as ether, 75% ethanol, chlorine-containing disinfectant, peracetic acid,
and chloroform). Chlorhexidine has not been effective in inactivating the
virus.
II. Epidemiological Characteristics
1. Source of infection
The primary source of infection is patients infected with the new corona-
virus. Asymptomatic infection may also become a source of infection, and
the infectivity of patients at incubation and convalescence stages needs to
be further clarified.
Recessive infections may also become a source of infection, which
have not been observed in severe acute respiratory syndrome (SARS).
Recessively infected people have no symptoms, are difficult to diagnose
Understanding COVID-19 3
and quarantine in time, and are more likely to cause the accumulation of
infected people in the community, which makes it more difficult to control
disease transmission.
2. Transmission route
Transmission through respiratory tract droplets and close contact is
the main transmission route. In a relatively closed environment, there is
a possibility of spreading through aerosols when exposed to high-
concentration aerosols for a long time.
3. Susceptible population
Humans of all ages are generally susceptible. The elderly and those with
underlying diseases may develop severe conditions after infection, and the
symptoms of children are relatively mild.
III. Clinical Features
1. Clinical manifestations
The main manifestations of the disease are fever, dry cough, and fatigue.
Some patients have mild onset symptoms, even no apparent fever, and
may be accompanied by anorexia, nausea, vomiting, and muscle pain
in the limbs or the small of the back. With the progress of the disease,
dyspnea and (or) hypoxemia gradually appears in a week after the onset.
Severe patients may have acute respiratory distress syndrome, septic
shock, metabolic acidosis, and coagulation dysfunction. Patients with
mild symptoms only show low-grade fever and slight asthenia without
signs of pneumonia.
It is worth noting that severe and critical patients in the course of
the disease can show low fever or even no obvious fever. Based on the
current epidemiological survey, the incubation period is 1–14 days,
mostly 3–7 days.
Based on current cases treated, most patients have a good prognosis,
and a few patients are in critical condition.
2. Auxiliary tests
(1) Laboratory examination:
At the early stage of the disease, the total number of peripheral blood
leucocyte (PBL) of patients is normal or decreased, while the lymphocyte
count (LC) is reduced. Some patients may have elevated liver enzymes,
lactate dehydrogenase (LDH), creatase, and myoglobin. Some severe
patients may have increased troponin. Most patients’ C-reactive protein
(CRP) and erythrocyte sedimentation rate (ESR) increase, while the
procalcitonin appears normal. In severe cases, D-dimer increases, and
peripheral blood lymphocytes reduce progressively. Severe and critical
patients often have elevated inflammatory factors.
Understanding COVID-19 5
3. Diagnostic criteria
3.1. Suspected cases
A comprehensive analysis combined with the following epidemiological
history and clinical manifestations should be made to diagnose the
suspected cases.
Understanding COVID-19 7
4. Clinical classification
4.1. Mild cases
Patients have mild symptoms with no sign of pneumonia on imaging.
5. Differential diagnosis
(1) The mild manifestations of the new coronavirus infection must be
distinguished from upper respiratory tract infections caused by other
viruses.
Understanding COVID-19 9
I. Historical Review
According to the statistics of China’s Epidemic History, at least 321 large-
scale plagues have occurred in China from the Western Han Dynasty to the
late Qing Dynasty. During the Yuan, Ming, and Qing Dynasties, the occur-
rence of epidemics reached a peak in Chinese history. The duration of
years with epidemic disease during the Yuan Dynasty (1271–1368) added
up to 30 years; this figure jumped to 118 years during the Ming Dynasty
(1368–1644) and 134 years during the Qing Dynasty (1644–1911).
More than 3,000 years ago in the Shang Dynasty (1600 B.C.–1046 B.C.),
there were written records of the epidemic situation. Bamboo Slips on Qin
Dynasty evacuated from Yunmeng (Yunmeng Qin Jian) recorded that the
Qin Dynasty had set up a “refuge” to compel leprosy patients. The History
of Han Dynasty (Han Shu) stated how epidemic diseases were managed
in the 2nd Year since the start of the Han Dynasty: Vacate the premises,
establish separate places, and treat them with medicines for the infected
people.
The above records show that the ancient Chinese governments estab-
lished temporary public hospitals to control epidemics, indicating that
China had adopted isolation measures for infectious diseases as early
as 2 A.D.
As for the folk anti-epidemic habits of burning incense to avoid
filth, sweeping away filth, and disinfecting drinking water, it has a much
longer history and is extremely common in folk use. From Zhang
Zhongjing’s Treatise on Cold Damage and Miscellaneous Diseases
(Shang Han Za Bing Lun) in the Eastern Han Dynasty to Wu Youke’s first
monograph of On Pestilence (Wen Yi Lun) in the Ming Dynasty, TCM has
formed a system of preventing and controlling epidemic diseases with
relatively comprehensive theory and technical methods.
Since the establishment of a new China in 1949, China’s healthcare
conditions have greatly improved. However, looking back on public
health events after the founding of the People’s Republic of China, tradi-
tional Chinese medicine has still played its essential role and made
remarkable achievements.
II. Disease Name
According to the senior expert panel of the State Administration of
Traditional Chinese Medicine, the new Corona Virus Disease 2019 was
categorized as pestilence, upon observation of the clinical manifesta-
tions of patients in Wuhan, combined with the climate characteristics
of Wuhan.
Based on the relevant literature of epidemics in the past, it is consid-
ered that cold pestilence is the general term for acute epidemic infectious
exogenous diseases caused by an abnormal cold pathogen or epidemic
cold toxin, manifested as cold-damp pestilence and cold dryness pesti-
lence. The cold pestilence is characterized by a short spell of exterior cold
pattern at onset, followed by the pattern of exterior cold with interior heat.
Alternatively, at initial stage, the pattern presented is already exterior cold
with interior heat, which can be complicated by other diseases with the
progress of disease.
Understanding COVID-19 11
IV. Treatment by Stages
See New Coronavirus Pneumonia Diagnosis and Treatment Program
(Trial Version 7) jointly promulgated by the General Office of the
National Health Commission and the Office of the State Administration of
Traditional Chinese Medicine.