关键词: COVID-19, 湿热疫毒, 化瘀通络, 排痰解毒, SpO₂下降

Abstract: Objective To summarize the clinical efficacy of the self-designed traditional Chinese medicine (TCM) protocol on COVID-19, and analyze the thoughts and methods about diagnosis, treatment and preventing disease from progressing based on "damp-heat epidemic virus". Methods A total of 24 patients with COVID-19 continuously hospitalized in Beijing Huimin Hospital from February 3, 2020 to February 18, 2020 were enrolled. On the basis of routine antiviral and symptomatic treatment, all patients were treated with the self-designed TCM protocol. The treatment lasted 6 to 14 days. The efficacy was evaluated by temperature, symptoms, white blood cell (WBC), neutrophil count (NE), lymphocyte count (LY) and neutrophil lymphocyte ratio (NLR), and the changes of chest computed tomography(CT) manifestations. Results Clinical observation found that the disease is highly contagious, belongs to the damp-heat epidemic virus, invades lung and stomach. The main clinical manifestations are fever, pharyngoxerosis, pharyngalgia, cough, fatigue and muscle pain, anorexia, diarrhea, red tongue and yellow greasy coating. In the 24 patients, there were 15 patients with fever, whose average duration of fever (since the day of having a fever to the last fever day) was (6.23±3.67) days.Symptoms of the respiratory, digestive and nervous system were relieved. Decreased WBC, NE, and LY levels of 23 patients were significantly increased after the treatment (P<0.01). It is worth noting that, NLR of 3 patient among 5 patients older than 50 years with NLR over 3.13 decreased less than 2.90. Among 22 patients admitted to hospital with chest CT diagnosis, 6 patients had significant absorption, 11 had partial absorption, and 3 had no significant change. The improvement rate of the chest CT manifestations was 80.95%. Two patients with chest CT worsen were both over 60 years old, with NLR>3.13, and oxygen saturation(SpO₂) decreased. One of them was transferred. The other was treated with dispelling-dampness, draining-abscess and dissolving-blood-stasis herbal medicines. After treatment, the NLR decreased to 2.90, SpO₂ increased to more than 95%, and most of focus in chest CT were reduced. In this study, one moderate type case developed to severe type accounting for 4.2%. Conclusion It is significantly effective to treat COVID-19 with the self-designed TCM protocol based on "damp-heat epidemic virus". For the middle-aged and elderly population with collateral stasis or underlying diseases, it is suggested to pay attention to the early application of dissolving-blood-stasis and dredging-collateral herbal medicines. For those who had the tendency of damp-heat accumulating virulence and obstructing lung, it is suggested to clear and eliminate phlegm and obstruction, detoxify, dissolving-blood-stasis and dredging-collateral to prevent the disease progression.

Key words: COVID-19, damp-heat epidemic virus, dissolving-blood-stasis and dredging-collateral, eliminate phlegm and detoxify, decrease of SpO₂