九、轻型新冠肺炎患者的中医治疗方案是什么？

9. What is the recommended treatment protocol for mild cases of COVID-19 pneumonia? 

(一)寒湿郁肺证

临床表现：发热，乏力，周身酸痛，咳嗽，咯痰，胸紧憋气，纳呆，恶心，呕吐，大便粘膩不爽。舌质淡胖齿痕或淡红,苔白厚腐腻或白腻，脉濡或滑。

(A)Damp-cold Obstructing the Lung Pattern

Clinical Presentation: fever, fatigue, soreness and pain over the entire body, cough, coughing up phlegm, tightness in the chest with difficulty breathing, low appetite, nausea, vomiting, or incomplete, sticky bowel movements. Tongue: pale with teeth marks, thick white coat that is degenerated and greasy, or white and greasy. Pulse: soggy or slippery 

推荐处方：生麻黄6克、生石膏15克、杏仁9克、羌活15克、葶苈子15克、贯众9克、地龙15克、徐长卿15克、藿香15克、佩兰9克、苍术15克、云苓45克、生白术30克、焦三仙各9克、厚朴15克、焦槟榔9克、煨草果9克、生姜15克。

服法：每日1剂，水煎600毫升,分3次服用，早中晚各1次,饭前服用。

Recommended Formula: Sheng Ma Huang (Herba Ephedrae) 6g, Sheng Shi Gao (Gypsum Fibrosum) 15g, Xing Ren (Semen Armeniacae Amarum) 9g, Qiang Huo (Rhizoma et Radix Notopterygii) 15g, Ting Li Zi (Semen Descurainiae) 15g, Guan Zhong (Rhizoma Cyrtomii) 9g, Di Long (Pheretima) 15g, Xu Chang Qing (Radix et Rhizoma Cynanchi Paniculati) 15g, Huo Xiang (Herba Agastachis) 15g, Pei lan (Herba Eupatorii) 9g, Cang Zhu (Rhizoma Atractylodis) 15g, Yunnan Fu Ling (Poria) 45g, Sheng Bai Zhu (Rhizoma Atractylodis Macrocephalae) 30g, Jiao Shan Zha (Fructus Crataegi) 9g, Jiao Shen Qu (Massa Medicata Fermentata) 9g, Jiao Mai Ya (Fructus Hordei Germinatus) 9g, Hou Po (Cortex Magnoliae Officinalis) 15g, Jiao Bing Lang (Semen Arecae Praepareta) 9g, Wei Cao Guo (Fructus Tsaoko) 9g, Sheng Jiang (Rhizoma Zingiberis Recens) 15g

Administration: one bag per day; boil in 600mg of water and divide into three doses, drink before meals three times per day

(二)湿热蕴肺证

临床表现：低热或不发热，微恶寒，乏力，头身困重，肌肉酸痛，干咳痰少，咽痛，口干不欲多饮，或伴有胸闷万痞，无汗或汗出不畅，或见呕恶纳呆，便溏或大便粘滞不爽。舌淡红，苔白厚腻或薄黄，脉滑数或濡。

(B)Damp-heat Brewing in the Lung Pattern

Clinical Presentation: low-grade fever or no fever, slight aversion to cold, weakness, heaviness and awkwardness in the head and body, muscle pain and soreness, dry cough with scant phlegm, sore throat, dry mouth but little desire to drink; there may be stuffiness in the chest with fullness in the epigastric area; no sweating or inability to completely sweat; nausea and vomiting with low appetite; watery stools or sticky stools that are incomplete, Togue: pale red with white, think and greasy coat or a thin yellow coat; Pulse: slippery and rapid, or soggy

推荐处方：槟榔10克、草果10克、厚朴10克、知母10克、黄芩10克、柴胡10克、赤芍10克、连翘15克、青蒿10克(后下)、苍术10克、大青叶10克、生甘草5克。

服法：每日1剂，水煎400毫升,分2次服用，早晩各1次。

Recommended Formula: Bing Lang (Semen Arecae Praepareta) 10g, Cao Guo (Fructus Tsaoko) 10g, Hou Po (Cortex Magnoliae Officinalis) 10g, Zhi Mu (Rhizoma Anemarrhenae) 10g, Huang Qin (Radix Scutellariae) 10g, Chai Hu (Radix Bupleuri) 10g, Chi Shao (Radix Paeoniae Rubra) 10g, Lian Qiao (Fructus Forsythiae) 15g, Qing Hao (Herba Artemisiae Annuae) 10g (post-add), Cang Zhu (Rhizoma Atractylodis) 10g, Da Qing Ye (Rhizoma Atractylodis) 10g, Sheng Gan Cao (Radix et Rhizoma Glycyrrhizae) 5g

Adminstration: one bag per day; boil in 400mg of water and divide into two doses, drink two times per day, morning and evening

十、对普通型新冠肺炎患者，中医如何治疗？

10. What Chinese medicine treatments are there for patients with moderate COVID-19 pneumonia?

(一)湿毒郁肺证

临床表现：发热，咳嗽痰少，或有黄痰，憋闷气促，腹胀,便秘不畅。舌质暗红，舌体胖，苔黄腻或黄燥，脉滑数或弦滑。

推荐处方：生麻黄6克、苦杏仁15克、生石膏30克、生薏苡仁30克、茅苍术10克、广藿香15克、青蒿草12克、虎杖20克、马鞭草30克、干芦根30克、葶苈子15克、化橘红15克、生甘草10克。

服法：每日1剂，水煎400毫升,分2次服用，早晩各1次。

(A)Damp-toxin Depressing and Blocking the Lung Pattern

Clinical Presentation: fever, cough with scant phlegm or yellow phlegm

Recommended Formula: Sheng Ma Huang (Herba Ephedrae) (raw) 6g, Xing Ren (Semen Armeniacae Amarum) 15g, Sheng Shi Gao (Gypsum Fibrosum) 30g, Sheng Yi Yi Ren (Semen Coicis) (raw) 30g, Cang Zhu (Rhizoma Atractylodis) 10g, Huo Xiang (Herba Agastachis) 15g，Qing Hao Cao (Herba Artemisiae Annuae) 12g, Hu Zhang (Rhizoma Polygoni Cuspidati) 20g, Ma Bian Cao (Herba Verbenae) 30g, Lu Gen (Rhizoma Phragmitis) 30g, Ting Li Zi (Semen Descurainiae) 15g, Ju Hong (Exocarpium Citri Rubrum) 15g, Sheng Gan Cao (Radix et Rhizoma Glycyrrhizae)  (raw) 10g 

Administration: one bag per day; boil in 400mg of water and divide into two doses, drink two times per day, morning and evening

(二)寒湿阻肺证

临床表现：低热，身热不扬，或未热，干咳，少痰，倦怠乏力，胸闷，脘痞，或呕恶，便溏。舌质淡或淡红，苔白或白腻，脉濡。

推荐处方：苍术15克、陈皮10克、厚朴10克、藿香10克、草果6克、生麻黄6克、羌活10克、生姜10克、槟榔10克。

服法：每日1剂，水煎400毫升,分2次服用，早晩各1次。

(B)Cold-damp Inhibiting the Lung Pattern

Clinical Presentation: low-grade fever, heat in the body that does not effuse outward, or no heat or fever, dry cough or scant phlegm, fatigue and weakness, stuffiness in the chest, distention with hardness (pi-glomus) in the epigastric area; there may be nausea and vomiting or diarrhea. Tongue: pale or pale red; white or white and greasy coat.  Pulse: soggy

Recommended Formula: Cang Zhu (Rhizoma Atractylodis) 15g, Chen Pi (Pericarpium Citri Reticulatae) 10g, Hou Po (Cortex Magnoliae Officinalis) 10g, Huo Xiang (Herba Agastachis) 10g, Cao Guo (Fructus Tsaoko) 6g, Sheng Ma Huang (Herba Ephedrae) (raw) 6g, Qiang Huo (Rhizoma et Radix Notopterygii) 10g, Sheng Jiang (Rhizoma Zingiberis Recens) 10g, Bing Lang (Semen Arecae Praepareta) 10g

Administration: one bag per day; boil in 400mg of water and divide into two doses, drink two times per day, morning and evening

十一、中医对重型新冠肺炎患者的治疗方案是什么?

11. What is the Chinese medicine treatment plan for serious cases of COVID-19 pneumonia?

(一)疫毒闭肺证

临床表现：发热面红，咳嗽，痰黄粘少，或痰中带血，喘憋气促，疲乏倦怠，口干苦粘，恶心不食，大便不畅，小便短赤。舌红，苔黄腻，脉滑数。

推荐处方：化湿败毒方

(A)Pestilent Toxin Closing-Down the Lung Pattern

Clinical Presentation: fever with red face, cough, phlegm that is yellow, sticky and scant, or phlegm with traces of blood; rough, difficult breathing with wheezing, fatigue and weakness, dry mouth with a bitter, sticky taste in the mouth, nausea with no appetite, incomplete bowel movements, short voidings of reddish urine. Tongue: red with a yellow, greasy coat. Pulse: slippery and rapid.

基础方剂：生麻黄6克、杏仁9克、生石膏15克、甘草3克、藿香10克（后下）、厚朴10克、苍术15克、草果10克、法半夏9克、茯苓15克、生大黄5克（后下）、生黄芪10克、葶苈子10克、赤芍10克。

服法：每日1~2剂，水煎服，每次100~200毫升,一日2~4次，口服或鼻饲。

Basic Formula (that may need to be modified): Sheng Ma Huang (Herba Ephedrae) (raw) 6g, Xing Ren (Semen Armeniacae Amarum) 9g, Sheng Shi Gao (Gypsum Fibrosum) 15, Gan Cao (Radix et Rhizoma Glycyrrhizae) 3g, Huo Xiang (Herba Agastachis) 10g (post-add), Hou Po (Cortex Magnoliae Officinalis) 10g, Cang Zhu (Rhizoma Atractylodis) 15g, Cao Guo (Fructus Tsaoko) 10g, Fa Ban Xai (Rhizoma Pinelliae Praeparatum)9g, Fu Ling (Poria) 15g, Sheng Da Huang (Radix et Rhizoma Rhei) 5g (post-add), Sheng Huang Qi (Radix Astragali) 10g, Ting Li Zi (Semen Descurainiae) 10g, Chi Shao (Radix Paeoniae Rubra) 10g.

Administration: one or two bags per day, decoct in water. Give the patient 100-200ml each time, 2-4 times per day, administered orally or through a nasal feeding tube.

（二）气营两燔证

临床表现：大热烦渴，喘憋气促，谵语神昏，视物错瞀，或发斑疹，或吐血、衄血，或四肢抽搐。舌绛少苔或无苔，脉沉细数，或浮大而数。

(B)Scorched Qi and Ying-nutritive Pattern

Clinical Presentation: high fever with severe thirst, wheezing and shortness of breath with rough breathing, lack of desire to speak or loss of consciousness, unable to recognize objects; there may be macules or papules, spitting up blood, nose bleeds, or tremors and spasms in the four limbs. Tongue: orangish with scant coat or no coat. Pulse: deep, thin, rapid or floating, large and rapid.  

推荐处方：生石膏30~60克（先煎）、知母30克、生地30~60克、水牛角30克（先煎）、赤芍30克、玄参30克、连翘15克、丹皮15克、黄连6克、竹叶12克、葶苈子15克、生甘草6克。

服法：每日1剂，水煎服，先煎石膏、水牛角后下诸药，每次100毫升~200毫升,每日2~4次，口服或鼻饲。

Recommended Formula: Sheng Shi Gao (Gypsum Fibrosum) 30-60g (pre-cook), Zhi Mu (Rhizoma Anemarrhenae) 30g, Sheng Di Huang (Radix Rehmanniae Recens) 30-60g, Shui Niu Jiao (Cornu Bubali) 30g (pre-cook), Chi Shao (Radix Paeoniae Rubra) 30g, Xuan Shen (Radix Scrophulariae) 30g, Lian Qiao (Fructus Forsythiae) 15g, Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) 15g, Huang Lian (Rhizoma Coptidis) 6g, Zhu Ye (Folium Phyllostachydis Henonis) 12g, Ting Li Zi (Semen Descurainiae) 15g, Sheng Gan Cao (Radix et Rhizoma Glycyrrhizae) 6g.

Administration: one bag per day, decocted in water; pre-cook Sheng Shi Gao (Gypsum Fibrosum) and Shui Niu Jiao (Cornu Bubali), then add the rest of the medicinals. Give the patient 100-200 ml each time, 2-4 times per day, give orally or through a nasal feeding tube.

推荐中成药：喜炎平注射液、血必净注射液、热毒宁注射液、痰热清注射液、醒脑静注

射液。功效相近的药物根据个体情况可选择一种，也可根据临床症状联合使用两种。中药注射剂可与中药汤剂联合使用。

Recommended Prepared Medicines: Xi Yan Ping Injection Fluid, Xue Bi Jing Injection Fluid, Re Du Ning Injection Fluid, Tan Re Qing Injection Fluid, Xing Nao Jing Injection Fluid. Some of these are similar and the physician can select one based on the condition of the patient. Two may also be used together when appropriate. Injections of Chinese medicine may be combined with decoctions. 

十二、危重型新冠肺炎患者中医是如何治疗的?

12. How do we treat serious cases of COVID-19 pneumonia with Chinese medicine?

内闭外脱证

临床表现：呼吸困难、动辄气喘或需要机械通气，伴神昏，烦躁，汗出肢冷，舌质紫暗，苔厚腻或燥，脉浮大无根。

Pattern: Internal Blockage and External Evacuation 

Clinical Presentation: difficulty breathing, shortness of breath with the slightest movement or assisted machine breathing, patient may be somewhat delirious and have, irritability, sweating on the four limbs. Tongue: dark and purple, with a thick and greasy coat or a dry tongue body; Pulse: floating and large without a root

推荐处方：人参15克、黑顺片10克（先煎）、山茱萸15克,送服苏合香丸或安宫牛黄丸。

Recommended Formula: Ren Shen (Radix et Rhizoma Ginseng) 15g, Hei Shun Pian (Radix Aconiti Lateralis Praeparata) 10g (Pre-cook), Shan Zhu Yu (Fructus Corni)15g. When drinking this decoction liquid, swallow the following pills at the same time: Su He Xiang pills or An Gong Niu Huang pills.  

出现机械通气伴腹胀便秘或大便不畅者，可用生大黄5~10克。出现人机不同步情况，在镇静和肌松剂使用的情况下，可用生大黄5~10克和芒硝5~10克。

If the patient is put on mechanical breathing support or exhibits abdominal distention and constipation or difficult bowel movements, one can add 5-10g of Sheng Da Huang (Radix et Rhizoma Rhei). If the patient’s breathing is out of sync with the ventilator and sedative or muscle-relaxers are being given, one can add 5-10g of Sheng Da Huang (Radix et Rhizoma Rhei) along with 5-10g of Mang Xiao (Natrii Sulfas).

推荐中成药：血必净注射液、热毒宁注射液、痰热清注射液、醒脑静注射液、参附注射液、生脉注射液、参麦注射液。功效相近的药物根据个体情况可选择一种，也可根据临床症状联合使用两种。中药注射剂可与中药汤剂联合使用。

Recommended Prepared Medicines:  

Xue Bi Jing Injection Fluid, Re Du Ning Injection Fluid, Tan Re Qing Injection Fluid, Xing Nao Jing Injection Fluid, Shen Fu Injection Fluid, Sheng Mai Injection Fluid, and Shen Mai Injection Fluid. Select one that is appropriate for the patient at the time it is given, or combine two based on clinical symptoms. Decoctions and injections can be used together. 

注：重型和危重型中药注射剂推荐用法

中药注射剂的使用遵照药品说明书从小剂量开始、逐步辨证调整的原则，推荐用法如下：

Important Note: Recommended Methods of Administration for Chinese Medicine Injection Fluids for Serious and Critical Patients:

Follow the instructions in the accompanying clinical insert. Start with a small dose and gradually increase, basing prescriptions on Chinese medicine differential pattern diagnosis. General Recommendations are as follows:

病毒感染或合并轻度细菌感染：0.9%氯化钠注射液250毫升加喜炎平注射液100毫克，每日两次,或0.9%氯化钠注射液250毫升加热毒宁注射液20毫升,或0.9%氯化钠注射液250毫升加痰热清注射液40毫升，每日两次。

For viral infection or viral and mild bacterial infection combined: give 250ml of 0.9% sodium chloride injection with 100mg of Xi Yan Ping injection, twice a day, or 250ml of 0.9% sodium chloride injection with 20ml of Re Du Ning injection, or 250ml of 0.9% sodium chloride injection with 40ml of Tan Re Qing Injection, twice a day.

高热伴意识障碍：0.9%氯化钠注射液250毫升加醒脑静注射液20毫升，每日两次。

全身炎症反应综合征或/和多脏器功能衰竭：0.9%氯化钠注射液250毫升加血必净注射液100毫升，每日两次。

免疫抑制：葡萄糖注射液250毫升加参麦注射液100毫升或生脉注射液20~60毫升，每日两次。

For high fever with impairment of consciousness: give 250 ml of 0.9% sodium chloride injection with 20 ml of Xing Nao Jing injection, twice a day.

General inflammatory response or/and multiple organ failure: 250 ml of 0.9% sodium chloride injection with 100 ml of Xue Bi Jing injection, twice a day.

Immune Suppression: 250 ml glucose injection with 100 ml Shen Mai injection or 20-60 ml Sheng Mai injection, twice a day.