Treatment strategy and thought on classical herbal formulae for coronavirus disease 2019 / 中国中药杂志

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.

Analysis on pattern of prescriptions and syndromes of traditional Chinese medicine for prevention and treatment of COVID-19 / 中国中药杂志

To investigate the regularity of prescription and clinical syndromes by analyzing the diagnosis and treatment protocols of traditional Chinese medicine(TCM) for coronavirus disease 2019(COVID-19), so as to provide references for syndrome differentiation and relevant researches. The diagnosis and treatment protocols of COVID-19 published by national and regional health authorities were searched, and information was extracted in regard to disease stages, type of syndromes, and prescriptions, etc. Frequency statistics and relative analysis were used to analyze the rule of syndrome differentiation and prescription with TCM, and further discussion on the pathogenesis and progress of the disease. A total of 26 diagnosis and treatment protocols of TCM for COVID-19 were retrieved after screening(including 1 national scheme and 25 regional ones), among which 16 contained aspects of both prevention and treatment, 7 only involved treatment contents and 3 were prevention schemes. The courses of COVID-19 can be divided into early stage, middle stage, severe stage and recovery stage. The pathogeny of COVID-19 in TCM is damp-toxin, with the core pathogenesis of damp-toxin retention in lung and Qi repression. Its pathological features can be summarized as "damp, toxin, obstruction, deficiency". The location of the disease is lung, always involving spleen and stomach, and may further affect heart and kidney in severe cases. The major treatments for each course are Fanghua Shizuo, Xuanfei Touxie(early stage); Qingre Jiedu, Xuanxie Feire(middle stage); Kaibi Gutuo, Huiyang Jiuni(severe stage); Qingjie Yure, Yiqi Yangyin(recovery stage). There were many diagnosis and treatment protocols for COVID-19 have been published, which generally followed the national edition, through with certain personalities in different regional protocols. There were common features with respect to the disease stage, syndrome differentiation, therapeutic principles and methods, as well as prescriptions; the treatment were generally carried out against the core pathogenesis and progress of the disease. Along with the deepening recognition of COVID-19, the diagnosis and treatment protocols are still need further concretization and standardization. We hope researchers and decision-makers can pay more attention to the treatment of Huayu Tongluo in severe and recovery period.

Application status of classical prescription in traditional Chinese medicine and Japanese Kampo medicine / 中草药

Classical prescription is long-lasting which is characterized by simple composition and obvious curative effect. It is popular over China and welcomed by many people. Japanese Kampo medicine and traditional Chinese medicine originated from the same resource but flowed into two branches. Some classical prescription experts are mostly influenced by Japanese Kampo medicine, emphasizing the correspondence between prescriptions and syndromes, physical identification and abdominal diagnosis, which have become the research direction of most classical prescription scholars. Traditional Chinese medicine and Japanese Kampo medicine differ in the dialectical system, application form, dose and dosage form of classical prescription. It is important to have a clear insight of the development status of classical prescription in Chinese medicine and that of Japanese Kampo medicine, understand the differences between them and make full use of advantages and avoid disadvantages. It can provide ideas for the correct development path of classical prescription and reference for the research of preparation of classical prescription in China.

Analysis of protective effects of Chaihu Jia Longgu Muli Tang against ischemic stroke by combining traditional Chinese medicine pathogenesis and efficacy with modern pathology and pharmacology / 中国中药杂志

Chaihu Jia Longgu Muli Tang is a classical Chinese formulas treating Shaoyang syndrome complicated with Yangming syndrome according to Treatise on Febrile Diseases. This formula is used in mental disorder, nervous system, gynecologic, andrologic, and cardiovascular disease. However, its therapeutic effect on ischemia stroke and its mechanism is far from clear. In clinical practice, we have found that this formula is effective in treating ischemic stroke, which can shorten the course of the disease and reduce recurrence. The characteristics of this formula include: Shaoyang cardinal disadvantageous syndrome, mental and nervous symptoms, retained fluid punched upward syndrome and accumulation of heat in the stomach and intestines. By combining traditional Chinese medicine (TCM) pathogenesis and efficacy with modern pathology and pharmacology, we proposed that the TCM pathogenesis of stroke, which is characterized by hyperactivity of heat combining with phlegm, stasis and water drink, is consistent with syndromes and corresponding pathology targeted by Chaihu Jia Longgu Muli Tang, including the stress brain edema zone around the ischemic lesion, the increase of intracranial pressure, the excitement of sympathetic nerve, the release of monoamine neurotransmitter, the hypofunction of autonomic nervous system after stroke, and gastrointestinal stress response. Furthermore, the pharmacological mechanism of Chaihu Jia Longgu Muli Tang is concentrated on regulation the neuroendocrinology system centered by hypothalamic-pituitary-adrenal axis (HPA), participating in the process of neuron regeneration and apoptosis, oxidative stress, hyperactivity of sympathetic nerve, and inflammatory reaction. These pathological processes are consistent with the pathological changes after ischemic stroke. Therefore, Chaihu Jia Longgu Muli Tang is a key formula for treating ischemic stroke.

Research on medication regularity of pattern of internal accumulation of zhuodu in chronic atrophic gastritis based on correspondence between prescription and syndrome / 中草药

To study the medication regularity of Huazhuo Jiedu Formula in treating the chronic atrophic gastritis (CAG), and to explore the stable relationship of correspondence between Huazhuo Jiedu Formula and the pattern of internal accumulation of zhuodu. Statistical analysis was conducted among 200 cases of CAG, whose case histories included their gender, age, electronic gastroscope, pathological results, clinical symptoms, and prescriptions of Chinese materia medica. On the basis of "golden section method", the association rule between drugs and syndromes was investigated using frequency statistic method and association rule analysis. Through data processing, 153 kinds of Chinese herbal decoction were obtained. According to the principle of "golden section method", 15 kinds of Chinese herbal decoction, whose frequency of use was over 61.8% (including 61.8%), were used as the therapeutical core drugs of pattern of internal accumulation of zhuodu in CAG. Ten kinds of clinical symptoms, which had the high ocurrence rate, were the main symptoms of the pattern of internal accumulation of zhuodu in CAG. According to association rules analysis, it was found that there was a strong correlation between drugs and pulses, which explained the high degree of correspondence of prescription and syndromes between the pattern of internal accumulation of zhuodu in CAG and Huazhuo Jiedu Decoction. It can be seen that there exists a relationship of correspondence between Huazhuo Jiedu Formula and the pattern of internal accumulation of zhuodu in CAG. And it shows that the key pathogenesis of CAG is internal accumulation of zhuodu, and the corresponding treatment is Huazhuo Jiedu Method.