Manual of Chinese Medical Intervention
for Suspected Mild COVID-19
Patient during Home Quarantine
At the early stage of the outbreak of COVID-19, Professor Zhang Zhiwen, a member of the Overseas Chinese Federation, a famous Chinese medical doctor of epidemic febrile disease, had been engaged in the1st and 2nd edition of the Manual of Chinese Medical Intervention for Suspected Mild COVID-19 Patient during Home Quarantine, which provides rational Chinese medical suggestions for people staying at home. On January 30th, Prof.Zhang was invited to "Sichuan News" program on preventing COVID-19 infection and introduced the suggested manual of preventing COVID-19 from Chinese medical point of view.
Everyone is obliged for their own health, and they need to know some basic sanitary and anti-epidemic knowledge. In addition to following the recommendations of the WHO guidelines and the diagnosis and treatment programs of the National Health Commission and the State Administration of Traditional Chinese Medicine, this manual makes Chinese medical suggestions for people at home. And it might fit for people with mild influenza as well.
Sanitary and Anti-epidemic Measures
Ventilate the room frequently, open the doors and windows once or twice a day, preferably for half an hour each time; do not go out during quarantine. Under special circumstances (such as visiting the hospital),one needs to wear a mask (to protect oneself and others from infection), and do not go to the places where the throng is rather denser and ventilation is poor.
Wash hands frequently (in the seven steps with soap and water or alcohol based hand sanitizer), especially after coughing or sneezing, nursing patients, using the bathroom, contacting with animal feces or disposing animal feces; before and after preparing food, before eating; or when hands are dirty.
Cook the food thoroughly, especially meat and eggs.
Do not eat wild animals.
Avoid close contact with anyone with cold or flu-like symptoms (including avoiding spitting in public, touching the eyes, nose or mouth with unwashed hands).
Cover your mouth and nose with a tissue or elbow when coughing and sneezing.
If one has feverish temperature, fatigue, dry cough and other symptoms, seek medical treatment as soon as possible.
空气消毒 Air Disinfection
"Preventing pathogenic qi" is mentioned in the Huangdi’s Internal Classic. According to ancient Chinese physicians, "one person"s illness is enough to infect an entire room." Therefore, great attention should be paid to the indoor air disinfection.
Fumigation and Steaming Therapy
Formula:mugwort leaves10g, grassleaf sweetflag rhizome10g, cyrtomii rhizoma10g, honeysuckle flower15g. Add 1000ml water into the above-mentioned medicinal, soak for 10 minutes, simmer over low heat for 30 minutes, and concentrate the liquid to 150ml.
Usage:It should be used indoors; fumigated medicinal liquid is added into the clean household air humidifier for electrified fumigation or into the pod for continuous cooking and evaporating, 1-2 times a day.
Chinese Medicine Sachet
Formula: equal amount of mugwort leaves, grassleaf sweetflag rhizome, fortune eupatorium herb, etc.
Usage: grind them into fine powder, put it in cloth bag, and hang it indoors, or wear it. It has the effect of dispelling filth by aroma and detoxification.
做好卫生清洁 Pay Attention to Hygiene and Cleaniness.
Including clothes, personal and oral cleaniness, etc.
增强正气 Enhance Vital Qi
Huangdi’s Internal Classic mentains that "as long as the vital qi exists, the pathogenic factors will not invade."
Keep a Healthy Balanced Diet
Cook food thoroughly and take in balanced nutrition. Eat high-protein food everyday such as eggs, milk, meat, soybeans, etc. Eating proper fresh vegetables and fruits and drinking plenty of water are also recommend. Some medicinal and edible plants are also advocated, such as radish, asparagus, yam, dandelion, coix seed, yellow soybean roll, lotus seed, wax gourd kernel, etc. And do not eat wild animals.
Keeping calm and not being in a panic during epidemic are important. Being in a good mood, keeping away from fretfulness and ensuring adequate sleep are also beneficial.
Exercise at home moderately so as not to increase the burden of lung .Some gentle exercises such as Tai chi can be chosen.
Prescription for Prevention
Formula: saposhnikovia root15g, astragalus root20g, wild buckwheat15g, weeping forsythia capsule5g, scutellaria root15g, agastache15g, licorice root 6g.
Decoction and usage: soak the herbs in water for 10 minutes, and after the water is boiled, simmer it for 30 minutes. Concentrate it into 600ml and drink one dose for two days. It is also good to drink traditional Chinese medicine as tea.
If the patient manifests fever with aversion to wind, headache, cough, thirst at the beginning, with signs of white tongue coating and float rapid pulse, the syndrome differentiation is wind heat with dampness, and the patient can take Chen Pingbo’s Decoction with modification.
Formula: wild buckwheat15g, peucedanum root15g, almond15g, Honeysuckle flower15g, Platycodonroot10g, mulberry leaf15g, mint15g, Agastache 15g, atractylodes rhizome10g, Liquorice root6g.
In case of slight dry cough with low fever or no fever, fatigue, muscle ache, headache, poor appetite, light or red tongue, white or yellowish greasy coating, soft or slippery pulse, Sanren decoction can be used with addition and subtraction: Agastache15g, scutellaria root10g, mint15g, almond15g, Coix seed15g, round cardamon kernel10g, reed rhizome20g, henon bamboo leaf15g, great burdock achene15g, liquorice root6g.
If the pathogen resides in Shaoyang, and the patient experience alternative cold and heat, sour muscle, dry and bitter mouth, with yellow and greasy tongue coating , then Haoqin Qingdan decoction can be used with addition and subtraction.
Formula: sweet wormwood15g, scutellaria root15g, Jasper powder 10g (bag), orange fruit10g, aged tangerine peel15g, pinellia rhizome in ginger juice10g, bamboo shavings15g, liquorice root 6g.
Modification: 1. If the patient has cough with excessive phlegm, trichosanthes peel15g should be added; 2. If the patient has the symptom of loose stool, kudzuvine root15g, Coix seed 20g and reed rhizome15g should be added; 3. If the patient has the symptom of coughing and retching, loquat leaves15g is necessary.
If the pathogen is in the lung and stomach, the patient may have symptoms of dry cough with sputum, asthma with signs of red tongue and yellow coating. In this case, patients can take Maxing Shigan Decoction and Xiaoxianxiong Decoction.
Formula：processed ephedra herb10g, bitter almonds10g, gypsum (fried first) 20g, licorice root6g, coptis rhizome6g, pinellia rhizome in ginger juice10g, trichosanthes peel15g, immature orange fruit15g.
Modification：1.When lung-stomach heat is extremely excessive, scutellaria root10g, giant knotweed rhizome10g, wild buckwheat30g are indispensable; 2.If heavy Asthma occurs, perilla fruit15g, gardenia10g, radish seed10g should be added. 3. If the patient has constipation, appropriate raw rhubarb root and rhizome are needed.
In the advanced stage of infectious disease, the pathogen lingers in the lung. If the patient has dry mouth and throat, dry cough with less sputum and lack of moisture in tongue and less coating, Sangxing Decoction should be taken.
Formula: mulberry leaf15g, bitter almonds10g, tendrilleaf fritillary bulb10g, straight ladybell root15g, henon bamboo leaf10g, pear peel10g, liquorice root6g.
Modification: 1.adding snakegourd root15g for seriously thirsty; 2. adding pinenut15g, arborvitae seed15g, orange peel 5g, peach seed 15g for constipation due to dryness of the bowel; 3.for mild abdominal distension,poor appetite when feeling hungry,mild greasy coating, Xue"s Wuye Lugen decoction should be taken.
Prescription: agastache leaf15g, fortune eupatorium leaf15g, loquat leaf 15g, lotus leaf15g, mint leaf10g, reed rhizome 15g, white gourd seed15g.
Decoction and usage: soak the herbs in water for 15 minutes, and after the water boiled, simmer for 25 minutes, and cook twice in a row. Take a mixture of the two time’s boiled liquids, and drink one dose of Chinese medicine decoction in 3 times for every day with 150ml each time.
Chinese patent medicine:
Huoxiangzhengqi Liquid, Jingfang particles, Lungre Kechuan Granules, Lotus Qingwen Capsules, Antiviral Granules, Polygonum Cuspidatum Detoxification Granules, Banlangen Granules, Jinhua Qinggan Granules. The above medicine should be used under the guidance of the Chinese medical doctor.
Acupuncture Methods for COVID-19
Prevention and Health Care
It is indispensable and substantial for combating the threatening COVID-19 to improve human immunity, which is also the embodiment of the concept of preventing and treating diseases advocated by Chinese medicine, "as long as the vital qi exists, the pathogenic factors will not invade.” On February 16th, Prof.Zeng Fang, a WHO consulting expert on traditional medicine, a member of the National Committee of the Chinese People"s Political Consultative Conference, a member of the Chinese People"s Political Consultative Conference of Sichuan Province, a vice-chairman of the Overseas Chinese Federation of Chengdu University of Traditional Chinese Medicine, and the director of the College of Acupuncture and moxibustion and Tuina/ The Third Affiliated Hospital presided over the preparation and demonstration of Sichuan "Acupuncture Methods for COVID-19 Prevention and Health Care". It was jointly released by Chengdu University of Traditional Chinese Medicine, Sichuan Acupuncture Clinical Research Center and Sichuan Acupuncture Society. This program has formulated two sets of operation plans of "acupressure" and "moxibustion", and provides operation methods in details. The practical tutorial videos are simple and clear, easy to learn and practice, and could help different social groups to manipulate.
Acupressure is a sort of manipulation that stimulates acupoints to achieve the purpose of dredging the meridians, regulating yin and yang and strengthening the body’s immunity. The manipulation can be divided into two steps, which are selecting acupoints and pressing acupoints. As for the current epidemic situation, we recommend the four acupoints: Da Zhui (DU14), Feng Chi (GB20), Zhong Fu (LU1) and Zu San Li (ST36). Let’s find these acupuncture points together!
Da Zhui (DU14) is located at the posterior mid-line of the neck and in the depression of the seventh cervical spinous process. The acupoint can be found while taking seated position with head drop; the most prominent vertebrae that can be touched on the neck is the seventh cervical vertebrae, and the depression under the seventh cervical vertebrae is DU14 acupoint. DU14 is an acupoint of the governor vessel which can invigorate yang and enhance the body’s ability to resist the pathogenic qi.
Feng Chi (GB20) is located below the occipital bone and in the depression between the upper end of the trapezius muscle and sternocleidomastoid muscle. The acupoint can be taken while sitting straightening your elbow and raising your hand, when the elbows are at the same height as shoulders, bend your elbows towards your head with fingers open naturally, palms of both hands cover the ears, fingers hold the head to push the thumbs up, the depression under the thumbs are GB20. GB20, an important acupoint for treating exogenous diseases such as headache and fever, can dispel pathogenic wind and expel pathogen.
Zhong Fu (LU1) is located on the upper lateral chest, 6 cun lateral to the anterior midline and at the same level with the first intercostal space. When taking the acupoint, please place your hands on your waist with elbows slightly forward and chest slightly backward, then find the triangular depression at the lower edge of the lateral end of the clavicle bone, pushes your finger vertically downward for about 1 cm, where the LU1 acupoint is. LU1 is an acupoint of lung meridian,indicated for respiratory diseases such as cough, asthma and chest pain.
Zu San Li (ST36) is located on the outside of the calf, 3 cun below Du Bi (ST35), and a horizontal finger (middle finger) length next to anterior tibia. When taking the acupoint, please take a seated position, straighten your calf, and find the upper outer edge of the kneecap, place part of the hand (between the thumb and index finger) surround the upper outer edge of the kneecap with four fingers pointing straight down, and the middle fingertip is the ST36 acupoints. ST36 is an important acupoint for health preserving, and it also has significance effect on replenishing the spleen and stomach.
After finding all the acupoints, we can use our finger pulp to press on the selected acupoints and then knead 3 times in clockwise direction, this method is called as ‘one press three knead’, repeat this method for 50-100 times. It is necessary to reach a degree of soreness and slight warm sensation on the local area for each time. Pressing the acupoint starts from DU14, following by both sides of GB20, LU1 and ST36, these points can be pressed once in morning and evening respectively. It maybe inconvenient for the elder people to press DU14,, you may ask family members for help or use another simple method to stimulate DU14 acupoint. Open your hands with palms slightly protruded, rub your palm quickly until you feel the palms are hot, then quickly place your palms on the DU14 point, so that the heat can penetrate through DU14. After that, use the palm of your hand to rub on DU14 points back and forth, repeat this method for 3-5 minutes.
When performing acupressure, there are following precautions:
1.When performing acupressure, keep our whole body muscles relaxed and breathe evenly.
2.The order of the acupoints can from up to down, left to right.
3.Apply the lasting force evenly, gently, and avoid pressing too hard.
4.Acupressure is not allowed on damaged skin.
Moxibustion can significantly improve the body"s immunity, and it has the function of antivirus, relieving cough and asthma, and relaxing emotion. The smoke produced by the burning of moxa sticks can dispel filth with aroma. It can be used for air sterilization. When using at home, we can choose warm moxibustion box or portable moxibustion according to the circumstance. According to the length of the three-hole moxibustion box, we take navel (Shen Que acupoint, CV8) as the center, and the rectangular area of about 9 cm above and below and about 4 cm left and right is used as the moxibustion site.
Shen Que acupoint (CV8), Qi Hai acupoint (CV6) and Guan Yuan acupoint (CV4) in this area are important health care acupoints, and they have the function of strengthening human immunity and resisting diseases and pathogen. Zhong Wan acupoint (CV12) and Tian Shu acupoint (ST25) can substantially regulate gastrointestinal function. The instruments prepared for moxibustion includes: three-hole moxibustion box, moxa sticks, lighters, knives, tweezers and small water utensils. Take a moxa stick and divide it evenly into three sections with a knife, light one end, respectively inserted into the holes above the moxibustion box.
You can supine on the bed, or on the sofa, and place the second hole of the rectangular three-hole moxibustion box directly to the navel (CV8). The long side of the moxibustion box is parallel to the longitudinal axis of the body, covering CV12, CV8, CV6 and CV4. The short side of the moxibustion box is parallel to the horizontal axis of the body, covering ST25. Moxibustion duration should be about 20 to 30 minutes at a time. Each section of moxibustion stick should be burnt at least 1/2 of the length, or until the moxibustion stick burns out. This can be adjusted according to your time or your tolerance towards warmth.
If you feel the moxibustion smoke is too heavy accept, you can divide the moxa stick into 5 segments, lit the end respectively, and put into the portable moxibustion box, then put the boxes in the matching bag to receive portable moxibustion. You can stand, tie the matching bag on the waist, putting the center moxibustion box right to the middle of the belly button, so that moxibustion area can cover the acupoints we just mentioned: CV 12, CV 8, RN 6, CV 4, ST 25. It takes about 20 to 30 minutes to accomplish moxibustion. Please pay attention to the following points when applying moxibustion.
1. Warm moxibustion box moxibustion is suitable for those who can tolerate heavy moxibustion smoke, and those who can"t receive moxibustion box moxibustion can choose portable moxibustion.
2. In the process of moxibustion, please close the doors and windows or cover the doors and windows slightly to ensure the efficacy of moxibustion smoke on indoor air disinfection.
3. When the local temperature of moxibustion decreases, place the moxibustion box on the ground at first, then take out the moxa stick, gently flick the end of moxa stick, so that moxa ash falls into the water container such as ceramic bowl, then insert moxa stick, and press down 0.5cm-1cm to adjust the local moxibustion temperature.
4. The aged, infirm and diabetic patients should be alert to the low temperature scald.
5. Drinking 100-150ml warm boiled water after moxibustion can relieve the dry mouth and nose after moxibustion.
6. After moxibustion, it must be placed in a ceramic bowl filled with water to extinguish.