Analysis of pathogenesis clauses and prescriptions of “Treatise on differentiation and treatment of epidemic febrile disease” related to clinical symptoms of COVID-19 / 中草药

ABSTRACT

Objective: To collect the clinical symptoms of novel coronavirus pneumonia, explore and analyze the clauses and prescriptions related to the clinical symptoms of 2019 novel coronavirus pneumonia in “Treatise on differentiation and treatment of epidemic febrile disease”, in order to provide a reference for clinical treatments of the disease. Methods: Searching literature from the databases CNKI and PubMed by entering “novel coronavirus” (in Chinese) and “2019 Novel Coronavirus” as key words, classifying typical symptoms depending on their reported frequencies of occurrence, comparing with related pathogenesis in “Treatise on differentiation and treatment of epidemic febrile disease”, and analyzing clauses and prescriptions combined with the sixth version of “New coronavirus pneumonia diagnosis and treatment scheme”. Results: We optimized 20 literatures published in Chinese or English for the review, in which, a total of 647 clinical cases were reported. Based on that, 28 typical symptoms were summarized, including respiratory symptoms, such as fever and cough; Gastrointestinal symptoms, such as poor appetite, nausea, vomiting, diarrhea; Other symptoms, such as myalgia, fatigue, and so forth. Among them, fever (558 cases), cough (395 cases), and fatigue (257 cases) were the top three clinical symptoms. By analysis, we optimized 15 clauses, 18 prescriptions, and 46 traditional Chinese medicines from “Treatise on differentiation and treatment of epidemic febrile disease”, including two clauses in the upper energizer, nine in the middle energizer, and four in the lower energizer; A total of seven prescriptions for treating dampness-heat, five for cold-dampness, and six for warm-heat diseases; as well as Chinese medicines Pinellia ternata (mentioned for six times), Cinnamomi Ramulus (five times), Tetrapanacis Medulla (five times), Poria cocos (four times), Talcum (four times), Coptis chinensis (four times) and Coicis Semen (four times), etc. P. ternata, Cinnamomi Ramulus, C. chinensis, Scutellaria baicalensis, and Zingiberis Rhizoma were selected to treat dampness-heat diseases, in order to “pungency opening and bitter discharging”; P. cocos, Tetrapanacis Medulla, Talcum, and Coicis Semen were selected for “eliminating dampness with bland medicinal”; Almond, Amomum kravanh, and Magnolia officinalis were used to “regulating qi movement”; Anemarrhenae Rhizoma, Gypsum Fibrosum, and Forsythiae Fructus were used to treat warm-hot diseases for “purging fire and removing toxin”. The formula of Sanren Decoction, Yiyizhuye Powder can be used for people in the stage of medical observation period; Sanren Decoction, Yiyizhuye Powder, Xingrenyiyi Decoction, Wuling Powder, Baihujiaguizhi Decoction, and Lingjiangzhugui Decoction for treating mild cases; Huangqin Huashi Tang, Xingren Huashi Decoction, and Fulingpi Decoction for severe cases; Jiaomei Decoction, Jianweiwumei Pill, Sini Decoction, and Taohua Porridge for critical patients, and Maidong Maren Decoction, Wuzhi Yin, and Niuru Yin for convalescents. Conclusion: The prescriptions of “Treatise on differentiation and treatment of epidemic febrile disease” can provide reference for the clinical treatments of 2019 novel coronavirus pneumonia.