新型冠狀病毒肺炎診療方案(試行第七版)中醫(yī)方案部分(中英對照)

新型冠狀病毒肺炎診療方案(試行第七版)

中醫(yī)方案部分

本病屬于中醫(yī)“疫”病范疇，病因為感受“疫戾”之氣，各地可根據(jù)病情、當(dāng)?shù)貧夂蛱攸c以及不同體質(zhì)等情況，參照下列方案進行辨證論治。涉及到超藥典劑量，應(yīng)當(dāng)在醫(yī)師指導(dǎo)下使用。

1 醫(yī)學(xué)觀察期

臨床表現(xiàn)1：乏力伴胃腸不適

推薦中成藥：藿香正氣膠囊(丸、水、口服液)

臨床表現(xiàn)2：乏力伴發(fā)熱

推薦中成藥：金花清感顆粒、連花清瘟膠囊(顆粒)、疏風(fēng)解毒膠囊(顆粒)

2 臨床治療期(確診病例)

2.1 清肺排毒湯

適用范圍：結(jié)合多地醫(yī)生臨床觀察，適用于輕型、普通型、重型患者，在危重型患者救治中可結(jié)合患者實際情況合理使用。

基礎(chǔ)方劑：麻黃9 g、炙甘草6 g、杏仁9 g、生石膏15～30 g(先煎)、桂枝9 g、澤瀉9 g、豬苓9 g、白術(shù)9 g、茯苓15 g、柴胡16 g、黃芩6 g、姜半夏9 g、生姜9 g、紫菀9 g、冬花9 g、射干9 g、細辛6 g、山藥12 g、枳實6 g、陳皮6 g、藿香9 g。

服法：傳統(tǒng)中藥飲片，水煎服。每天一付，早晚各一次(飯后四十分鐘)，溫服，三付一個療程。

如有條件，每次服完藥可加服大米湯半碗，舌干津液虧虛者可多服至一碗。(注：如患者不發(fā)熱則生石膏的用量要小，發(fā)熱或壯熱可加大生石膏用量)。若癥狀好轉(zhuǎn)而未痊愈則服用第二個療程，若患者有特殊情況或其他基礎(chǔ)病，第二療程可以根據(jù)實際情況修改處方，癥狀消失則停藥。

處方來源：國家衛(wèi)生健康委辦公廳 國家中醫(yī)藥管理局辦公室《關(guān)于推薦在中西醫(yī)結(jié)合救治新型冠狀病毒感染的肺炎中使用“清肺排毒湯”的通知》(國中醫(yī)藥辦醫(yī)政函〔2020〕22號)。

2.2 輕型

2.2.1 寒濕郁肺證

臨床表現(xiàn)：發(fā)熱，乏力，周身酸痛，咳嗽，咯痰，胸緊憋氣，納呆，惡心，嘔吐，大便粘膩不爽。舌質(zhì)淡胖齒痕或淡紅，苔白厚腐膩或白膩，脈濡或滑。

推薦處方：生麻黃6 g、生石膏15 g、杏仁9 g、羌活15 g、葶藶子15 g、貫眾9 g、地龍15 g、徐長卿15 g、藿香15 g、佩蘭9 g、蒼術(shù)15 g、云苓45 g、生白術(shù)30 g、焦三仙各9 g、厚樸15 g、焦檳榔9 g、煨草果9 g、生姜15 g。

服法：每日1劑，水煎600 mL，分3次服用，早中晚各1次，飯前服用。

2.2.2 濕熱蘊肺證

臨床表現(xiàn)：低熱或不發(fā)熱，微惡寒，乏力，頭身困重，肌肉酸痛，干咳痰少，咽痛，口干不欲多飲，或伴有胸悶脘痞，無汗或汗出不暢，或見嘔惡納呆，便溏或大便粘滯不爽。舌淡紅，苔白厚膩或薄黃，脈滑數(shù)或濡。

推薦處方：檳榔10 g、草果10 g、厚樸10 g、知母10 g、黃芩10 g、柴胡10 g、赤芍10 g、連翹15 g、青蒿10 g(后下)、蒼術(shù)10 g、大青葉10 g、生甘草5 g。

服法：每日1劑，水煎400 mL，分2次服用，早晚各1次。

2.3 普通型

2.3.1 濕毒郁肺證

臨床表現(xiàn)：發(fā)熱，咳嗽痰少，或有黃痰，憋悶氣促，腹脹，便秘不暢。舌質(zhì)暗紅，舌體胖，苔黃膩或黃燥，脈滑數(shù)或弦滑。

推薦處方：生麻黃6 g、苦杏仁15 g、生石膏30 g、生薏苡仁30 g、茅蒼術(shù)10 g、廣藿香15 g、青蒿草12 g、虎杖20 g、馬鞭草30 g、干蘆根30 g、葶藶子15 g、化橘紅15 g、生甘草10 g。

服法：每日1劑，水煎400 mL，分2次服用，早晚各1次。

2.3.2 寒濕阻肺證

臨床表現(xiàn)：低熱，身熱不揚，或未熱，干咳，少痰，倦怠乏力，胸悶，脘痞，或嘔惡，便溏。舌質(zhì)淡或淡紅，苔白或白膩，脈濡。

推薦處方：蒼術(shù)15 g、陳皮10 g、厚樸10 g、藿香10 g、草果6 g、生麻黃6 g、羌活10 g、生姜10 g、檳榔10 g。

服法：每日1劑，水煎400 mL，分2次服用，早晚各1次。

2.4 重型

2.4.1 疫毒閉肺證

臨床表現(xiàn)：發(fā)熱面紅，咳嗽，痰黃粘少，或痰中帶血，喘憋氣促，疲乏倦怠，口干苦粘，惡心不食，大便不暢，小便短赤。舌紅，苔黃膩，脈滑數(shù)。

推薦處方：化濕敗毒方

基礎(chǔ)方劑：生麻黃6 g、杏仁9 g、生石膏15 g、甘草3 g、藿香10 g(后下)、厚樸10 g、蒼術(shù)15 g、草果10 g、法半夏9 g、茯苓15 g、生大黃5 g(后下)、生黃芪10 g、葶藶子10 g、赤芍10 g。

服法：每日1～2劑，水煎服，每次100 mL～200 mL，一日2～4次，口服或鼻飼。

2.4.2 氣營兩燔證

臨床表現(xiàn)：大熱煩渴，喘憋氣促，譫語神昏，視物錯瞀，或發(fā)斑疹，或吐血、衄血，或四肢抽搐。舌絳少苔或無苔，脈沉細數(shù)，或浮大而數(shù)。

推薦處方：生石膏30～60 g(先煎)、知母30 g、生地30～60 g、水牛角30 g(先煎)、赤芍30 g、玄參30 g、連翹15 g、丹皮15 g、黃連6 g、竹葉12 g、葶藶子15 g、生甘草6 g。

服法：每日1劑，水煎服，先煎石膏、水牛角后下諸藥，每次100 mL～200 mL，每日2～4次，口服或鼻飼。

推薦中成藥：喜炎平注射液、血必凈注射液、熱毒寧注射液、痰熱清注射液、醒腦靜注射液。功效相近的藥物根據(jù)個體情況可選擇一種，也可根據(jù)臨床癥狀聯(lián)合使用兩種。中藥注射劑可與中藥湯劑聯(lián)合使用。

2.5 危重型

2.5.1 內(nèi)閉外脫證

臨床表現(xiàn)：呼吸困難、動輒氣喘或需要機械通氣，伴神昏，煩躁，汗出肢冷，舌質(zhì)紫暗，苔厚膩或燥，脈浮大無根。

推薦處方：人參15 g、黑順片10 g(先煎)、山茱萸15 g，送服蘇合香丸或安宮牛黃丸。

出現(xiàn)機械通氣伴腹脹便秘或大便不暢者，可用生大黃5～10 g。出現(xiàn)人機不同步情況，在鎮(zhèn)靜和肌松劑使用的情況下，可用生大黃5～10 g和芒硝5～10 g。

推薦中成藥：血必凈注射液、熱毒寧注射液、痰熱清注射液、醒腦靜注射液、參附注射液、生脈注射液、參麥注射液。功效相近的藥物根據(jù)個體情況可選擇一種，也可根據(jù)臨床癥狀聯(lián)合使用兩種。中藥注射劑可與中藥湯劑聯(lián)合使用。

注：重型和危重型中藥注射劑推薦用法

中藥注射劑的使用遵照藥品說明書從小劑量開始、逐步辨證調(diào)整的原則，推薦用法如下：

病毒感染或合并輕度細菌感染：0.9%氯化鈉注射液250 mL加喜炎平注射液100 mg bid，或0.9% 氯化鈉注射液250 mL加熱毒寧注射液20 mL，或0.9%氯化鈉注射液250 mL加痰熱清注射液40 mL bid。

高熱伴意識障礙：0.9%氯化鈉注射液250 mL加醒腦靜注射液20 mL bid。

全身炎癥反應(yīng)綜合征或/和多臟器功能衰竭：0.9%氯化鈉注射液250 mL加血必凈注射液100 mL bid。

免疫抑制：葡萄糖注射液250 mL加參麥注射液100 mL或生脈注射液20～60 mL, 2次/d。

2.6 恢復(fù)期

2.6.1 肺脾氣虛證

臨床表現(xiàn)：氣短，倦怠乏力，納差嘔惡，痞滿，大便無力，便溏不爽。舌淡胖，苔白膩。

推薦處方：法半夏9 g、陳皮10 g、黨參15 g、炙黃芪30 g、炒白術(shù)10 g、茯苓15 g、藿香10 g、砂仁6 g(后下)、甘草6 g。

服法：每日1劑，水煎400 mL，分2次服用，早晚各1次。

2.6.2 氣陰兩虛證

臨床表現(xiàn)：乏力，氣短，口干，口渴，心悸，汗多，納差，低熱或不熱，干咳少痰。舌干少津，脈細或虛無力。

推薦處方：南北沙參各10 g、麥冬15 g、西洋參6 g，五味子6 g、生石膏15 g、淡竹葉10 g、桑葉10 g、蘆根15 g、丹參15 g、 生甘草6 g。

服法：每日1劑，水煎400 mL，分2次服用，早晚各1次。

本文轉(zhuǎn)載自： 國家中醫(yī)藥管理局網(wǎng)站，

http://ghs.satcm.gov.cn/gongzuodongtai/2020-03-20/14089.html,公益?zhèn)鞑ァ?/p>

Diagnosis and Treatment Protocol for COVID-19(Trial Version 7)Traditional Chinese medicine (TCM) treatment

The COVID-19 belongs to plague in TCM with the etiology of epidemic factor exposure. Different regions can refer to the following plans for syndrome differentiation and treatment, according to the disease, local climate characteristics and different constitutions. Prescriptions which exceed maximum dose according to pharmacopoeia should be used under the guidance of a physician.

1 Medical observation period

1.1 Clinical manifestation: fatigue with gastrointestinal discomfort

Recommended Chinese patent medicine: Huoxiang Zhengqi Capsule (Pill, Liquid, Oral liquid)

1.2 Clinical manifestation: fatigue with fever

Recommended Chinese patent medicines: Jinhua Qinggan Granule, Lianhua Qingwen Capsule (Granule), Shufeng Jiedu Capsule (Granule)

2 Clinical treatment period (confirmed cases)

2.1 Qingfei Paidu Decoction

Scope of application: in accordance with the clinical observations of doctors in various locations, it is suitable for mild, moderate and severe cases, and can be used reasonably with the consideration of the actual conditions of critically ill patients.

The basic formula: Ma Huang (Ephedrae Herba) 9 g, Zhi Gan Cao (Glycyrrhizae Radix) 6g, Xing Ren (Armeniacae Semen) 9 g, Sheng Shi Gao (Gypsum fibrosum) (decocted first) 15-30 g, Gui Zhi (Cinnamomi Ramulus) 9 g, Ze Xie (Alismatis Rhizoma) 9 g, Zhu Ling (Polyporus) 9 g, Bai Zhu (Atractylodis macrocephalae Rhizoma) 9 g, Fu Ling (Poria) 15 g, Chai Hu (Bupleuri Radix) 16 g, Huang Qin (Scutellariae Radix) 6 g, Jiang Ban Xia (Pinellinae Rhizoma Praeparatum) 9 g, Sheng Jiang (Zingiberis Rhizoma recens) 9 g, Zi Wan (Asteris Radix) 9 g, Kuan Dong Hua (Farfarae Flos) 9 g, She Gan (Belamcandae Rhizoma) 9 g, Xi Xin (Asari Radix et Rhizoma) 6 g, Shan Yao (Dioscoreae Rhizoma) 12 g, Zhi Shi (Aurantii Fructus immaturus) 6 g, Chen Pi (Citri reticulatae Pericarpium) 6 g, Huo Xiang (Pogostemonis Herba) 9 g.

Administration: traditional Chinese herbal pieces in decoction. One package per day. Take warm twice (40 minutes after meal in the morning and evening). One course of treatment is for three packages.

If possible, half bowl of rice soup after taking the decoction is advised. For the patients with dry tongue due to fluid depletion, one bowl of rice soup is suggested. (Note: If no fever, the dosage of gypsum should be reduced. In case with fever or high fever, the amount of gypsum can be increased. If the symptoms improve but not toally recovered, continue the second course of treatment. If the patient has a special condition or other underlying diseases, the formula can be modified according to the actual situation in the second course. If the symptoms disappear, the drug should be discontinued.

Reference: The General Office of the National Health Commission of the people’s Republic of China The Office of the National Administration of Traditional Chinese Medicine “Notice on Recommending the Use of Qingfei Paidu Decoction in Pneumonia Treated with Integrated Chinese and Western Medicine for the COVID-19 Infection” (National Administration of Traditional Chinese Medicine Office Medical Letter [2020] No.22)

2.2 Mild case

2.2.1 Cold-damp constraint in the lung pattern

Clinical manifestation: fever, fatigue, generalized body aches, cough, expectoration, chest tightness and labored breathing, poor appetite, nausea, vomiting and sticky stool, pale enlarged tongue with tooth marks or light red tongue and coating which is white, thick, curd-like, and greasy or white and greasy, and soggy of slippery pulse.

Recommended formula: Sheng Ma Huang (Ephedrae Herba) 6 g, Sheng Shi Gao (Gypsum fibrosum) 15 g, Xing Ren (Armeniacae Semen) 9 g, Qiang Huo (Notopterygii Rhizoma seu Radix) 15 g, Ting Li Zi (Lepidii/Descurainiae Semen) 15 g, Guan Zhong (Cyrtomii Rhizoma) 9 g, Di Long (Pheretima) 15 g, Xu Chang Qing (Cynanchi paniculati Radix) 15 g, Huo Xiang (Pogostemonis Herba) 15 g, Pei Lan (Eupatorii Herba) 9 g, Cang Zhu (Atractylodis Rhizoma) 15 g, Yun Ling (Poria) 45 g, Sheng Bai Zhu (Atractylodis macrocephalae Rhizoma) 30 g, Jiao San Xian (Jiao Shan Zha (Crataegi Fructus), Jiao Shen Qu (Massa medicate fermentata), and Jiao Mai Ya (Hordei Fructus germinatus)) 9 g each, Hou Po (Magnoliae officinalis Cortex) 15 g, Jiao Bing Lang (Arecae Semen) 9 g, Wei Cao Guo (Tsaoko Fructus) 9 g, Sheng Jiang (Zingiberis Rhizoma recens) 15 g.

Administration: one package daily, 600 mL after decocting, divide into three times, equally in the morning, afternoon and evening, take before meal.

2.2.2 Damp-heat accumulation in the lung pattern

Clinical manifestation: low-grade fever or absence of fever, slight aversion to cold, fatigue, heavy sensation in the head and body, muscle soreness, dry cough with little sputum, sore throat, thirst without desire to drink, or accompanied with chest tightness and epigastric fullness, absence of sweating or disturbed hidrosis, or vomiting with anorexia, loose stool or sticky stool. The tongue is light red and coating is white, thick and greasy or thin and yellow. The pulse is slippery and rapid or soggy.

Recommended formula: Bing Lang (Arecae Semen) 10 g, Cao Guo (Tsaoko Fructus) 10 g, Hou Po (Magnoliae officinalis Cortex) 10 g, Zhi Mu (Anemarrhenae Rhizoma) 10 g, Huang Qin (Scutellariae Radix) 10 g, Chai Hu (Bupleuri Radix) 10 g, Chi Shao (Paeoniae Radix rubra) 10 g, Lian Qiao (Forsythiae Fructus) 15 g, Qing Hao (Artemisiae annuae Herba) (added later) 10 g, Cang Zhu (Atractylodis Rhizoma) 10 g, Da Qjng Ye (Isatidis Folium) 10 g, Sheng Gan Cao (Glycyrrhizae Radix) 5 g.

Administration: one pack daily, 400 mL after decocting, divide into twice, and half in the morning and half in the evening.

2.3 Moderate case

2.3.1 Damp-toxin constraint in the lung pattern

Clinical manifestation: fever, cough with little sputum or yellow sputum, chest tightness and shortness of breath, abdominal distension, and constipation with difficult defecation. The tongue body is dark-red, and tongue shape is enlarged. The cotaing is yellow greasy or yellow dry. The pulse is slippery and rapid or wiry and slippery.

Recommended formula: Sheng Ma Huang (Ephedrae Herba) 6 g, Ku Xing Ren (Armeniacae Semen) 15 g, Sheng Shi Gao (Gypsum fibrosum) 30 g, Sheng Yi Yi Ren (Coicis Semen) 30 g, Mao Cang Zhu (Atractylodis Rhizoma) 10 g, Guang Huo Xiang (Pogostemonis Herba) 15 g, Qing Hao Cao (Artemisiae annuae Herba) 12 g, Hu Zhang (Polygoni cuspidati Rhizoma) 20g, Ma Bian Cao (Verbenae Herba) 30 g, Gan Lu Gen (Phragmitis Rhizoma) 30 g, Ting Li Zi (Lepidii/Descurainiae Semen) 15 g, Hua Ju Hong (Citri grandis Exocarpium rubrum) 15 g, Sheng Gan Cao (Glycyrrhizae Radix) 10 g.

Administration: one package daily, 400 mL after decocting, and equally divide into twice, in the morning and evening.

2.3.2 Cold-damp obstructing the lung pattern

Clinical manifestation: low-grade fever, unsurfaced fever or no fever, dry cough with little sputum, lassitude and fatigue, chest tightness, stomach discomfort, or nausea, and loose stool. The tongue is pale or light red and coating is white or white greasy. The pulse is soggy.

Recommended formula: Cang Zhu (Atractylodis Rhizoma) 15 g, Chen Pi (Citri reticulatae Pericarpium) 10 g, Hou Po (Magnoliae officinalis Cortex) 10 g, Huo Xiang (Pogostemonis Herba) 10 g, Cao Guo (Tsaoko Fructus) 6 g, ShengMa Huang (Ephedrae Herba) 6g, Qiang Huo (Notopterygii Rhizoma seu Radix) 10 g, Sheng Jiang (Zingiberis Rhizoma recens) 10 g, Bing Lang (Arecae Semen) 10 g.

Administration: one package daily, 400 mL after decocting, and equally divide into twice, in the morning and evening.

2.4 Severe case

2.4.1 Epidemic toxin blocking the lung pattern

Clinical manifestation: fever with red face, cough with little yellow and sticky sputum, or blood-stained sputum, chest tightness and short of breath, lassitude, dryness, bitterness and stickiness in the mouth, nausea and loss of appetite, difficult defecation, and scanty dark urine. The tongue is red with yellow greasy coating. The pulse is slippery and rapid.

Recommended formula: Huashi Baidu Formula

The basic formula: Sheng Ma Huang (Ephedrae Herba) 6 g, Xing Ren (Armeniacae Semen) 9 g, Sheng Shi Gao (Gypsum fibrosum) 15 g, Gan Cao (Glycyrrhizae Radix) 3 g, Huo Xiang (Pogostemonis Herba) (added later) 10 g, Hou Po (Magnoliae officinalis Cortex) 10 g, Cang Zhu (Atractylodis Rhizoma) 15 g, Cao Guo (Tsaoko Fructus) 10 g, Fa Ban Xia (Pinellinae Rhizoma Praeparatum) 9 g, Fu Ling (Poria) 15 g, Sheng Da Huang (Rhei Radix et Rhizoma) (added later) 5 g, Sheng Huang Qi (Astragali Radix) 10 g, Ting Li Zi (Lepidii/Descurainiae Semen) 10 g, Chi Shao (Paeoniae Radix rubra) 10 g.

Administration: 1-2 packages daily, decoction, 100-200 mL each time, 2-4 times per day, oral administration or nasal feeding.

2.4.2 Blazing of both qi and ying pattern

Clinical manifestation: high fever with polydipsia, tachypnoea and shortness of breath, delirium and unconsciousness, blurred vision or accompanied with macules and papules, or hematemesis, epistaxis or convulsion of the four limbs. The tongue is crimson with little or no coating. The pulse is deep, thready and rapid, or floating, large and rapid pulse.

Recommended formula: Sheng Shi Gao (Gypsum fibrosum) (decocted first) 30-60 g, Zhi Mu (Anemarrhenae Rhizoma) 30 g, Sheng Di (Rehmanniae Radix) 30-60 g, Shui Niu Jiao (Bubali Cornu) (decocted first) 30 g, Chi Shao (Paeoniae Radix rubra) 30 g, Xuan Shen (Scrophulariae Radix) 30 g, Lian Qiao (Forsythiae Fructus) 15 g, Dan Pi (Moutan Cortex) 15 g, Huang Lian (Coptidis Rhizoma) 6 g, Zhu Ye (Phyllostachys nigrae Folium) 12 g, Ting Li Zi (Lepidii/Descurainiae Semen) 15 g, Sheng Gan Cao (Glycyrrhizae Radix) 6 g.

Administration: one pack daily, decoction, Shi Gao and Shui Niu Jiao should be decocted first, 100-200 mL each time, 2-4 times per day, oral administration or nasal feeding.

Recommended Chinese patent medicines: Xiyanping injection, Xuebijing injection, Reduning injection, Tanreqing injection, and Xingnaojing injection. Drugs with similar effects can be selected according to individual conditions, or can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used together with TCM decoction.

2.5 Critical case

2.5.1 Internal blockage and external desertion pattern

Clinical manifestation: Dyspnea, panting on exertion or mechanical ventilation required, accompanied with unconsciousness and dysphoria, sweating, cold extremities. The tongue is dark and purple with thick greasy or dry coating. The pulse is floating and large without root.

Recommended formula: Take Su He Xiang Wan or Angong Niuhuang Wan with the following decoction composed of Ren Shen (Ginseng Radix) 15 g, Hei Shun Pian (Aconiti Radix lateralis praeparata) (decocted first) 10 g, Shan Zhu Yu (Corni Fructus) 15 g.

If there is mechanical ventilation with abdominal distension, constipation or difficult defecation, 5-10 g of Sheng Da Huang (Rhei Radix et Rhizoma) can be considered. If patient-ventilator asynchrony occurs, 5-10 g of Sheng Da Huang and 5-10g of Mang Xiao (Natrii Sulfas) can be used together with sedation and muscle relaxant.

Recommended Chinese patent medicines: Xuebijing injection, Reduning injection, Tanreqing injection, Xingnaojing injection, Shenfu injection, Shengmai injection, and Shenmai injection. Drugs with similar effects can be selected according to individual conditions, or can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used together with TCM decoction.

Note: Recommended usage of TCM injections for severe and critical cases

The use of TCM injections follows the principle of starting from a small dosage and modifying based on pattern identification in the instructions. The recommended usage is as follows:

Viral infection or combined with mild bacterial infection: 0.9% sodium chloride injection 250 mL with Xiyanping injection 100 mg (bid), or 0.9% sodium chloride injection 250 mL with Reduning injection 20 mL, or 0.9% sodium chloride injection 250 mL with Tanreqing injection 40 mL (bid).

High fever with disturbance of consciousness: 0.9% sodium chloride injection 250 mL with Xingnaojing injection 20 mL (bid).

Systemic inflammatory response syndrome (SIRS) or / and multiple organ failure (MOF): 0.9% sodium chloride injection 250 mL with Xuebijing injection 100 mL (bid).

Immunosuppression: glucose injection 250 mL with Shenmai injection 100 mL or Shengmai injection 20-60 mL (bid).

2.6 Convalescence

2.6.1 Lung-spleen qi deficiency pattern

Clinical manifestation: shortness of breath, lassitude and fatigue, poor appetite with nausea and vomiting, abdominal fullness, a sense of incomplete evacuation, and sticky loose stool. The tongue is pale and enlarged with white greasy coating.

Recommended formula: Fa Ban Xia (Pinellinae Rhizoma Praeparatum) 9 g, Chen Pi (Citri reticulatae Pericarpium) 10 g, Dang Shen (Codonopsis Radix) 15 g, Zhi Huang Qi (Astragali Radix) 30 g, Chao Bai Zhu (Atractylodis macrocephalae Rhizoma) 10 g, Fu Ling (Poria) 15 g, Huo Xiang (Pogostemonis Herba) 10g, Sha Ren (AmomiFructus) (added later) 6 g, Gan Cao (Glycyrrhizae Radix) 6 g.

Administration: one package daily, 400 mL after decocting, and equally divide into twice in the morning and evening.

2.6.2 Deficiency of both qi and yin pattern

Clinical manifestation: fatigue, shortness of breath, dry mouth, thirst, heart palpitation, profuse sweating, poor appetite, low-grade fever or no fever, dry cough with little sputum. The tongue is dry tongue with scanty fluid. The pulse is thready or weak and forceless.

Recommended formula: Nan Sha Shen (Adenophorae Radix) 10 g, Bei Sha Shen (Glehniae Radix) 10 g, Mai Dong (Ophiopogonis Radix) 15 g, Xi Yang Shen (Panacis quinquefolii Radix) 6 g, Wu Wei Zi (Schisandrae Fructus) 6 g, Sheng Shi Gao (Gypsum fibrosum) 15 g, Dan Zhu Ye (Lophatheri Herba) 10 g, Sang Ye (Mori Folium) 10 g, Lu Gen (Phragmitis Rhizoma) 15 g, Dan Shen (Salviae miltiorrhizae Radix) 15 g, Sheng Gan Cao (Glycyrrhizae Radix) 6 g.

Administration: one package daily, 400 mL after decocting, and equally divide into twice in the morning and evening.