4. Discussion
Through a retrospective review of inpatient medical records, we found
that the TCM symptoms of patients with COVID-19 in Wanzhou were mainly
poor appetite, cough, fatigue, aversion to cold, and fever. The TCM
prescriptions most commonly prescribed to these patients were
Sashanopong Decoction, Sijunzi Decoction, Maxing Shigan Decoction,
Sanren Decoction and Xiaochaihu Decoction. These prescriptions
correspond to the TCM symptoms experienced by patients. After TCM
treatment, chest inflammation decreased, leukocytes and lymphocytes
increased, and CRP decreased.
Patients with COVID-19 have presented with different TCM symptoms in
different regions of China. In Hubei province, fever and fatigue were
dominant(J et
al.,2020), in Guangdong and Zhejiang province, fever and cough were
dominant(X et al.,2020; S et al.,2020), in Gansu and Shaanxi province,
cough and fever were dominant (Z et al.,2020; Y et al.,2020), and in
Tianjin, poor appetite and diarrhea were dominant(H et al.,2020). The
dominant clinical symptoms of patients with COVID-19 in Chongqing were
poor appetite, cough and fatigue, which may be related to the
geographical and climate of the region. Specifically, Chongqing has a
subtropical monsoon humid climate. The spleen likes dryness and dislikes
dampness. Humid climate often hinders the transport and transformation
of the spleen, resulting in symptoms such as poor appetite, cough,
fatigue and other symptoms.
Our finding of the five most common TCM prescriptions given to patients
with COVID-19 makes sense when considering patients’ predominant
symptoms and the typical indications for the prescriptions. Dryness
damages the lungs and dampness impedes the spleen. Thus, when COVID-19
invades the respiratory system, it mainly presents with symptoms such as
fever, cold, cough, shortness of breath, fatigue, stuffy nose, runny
nose, and sore throat. When it invades the spleen and digestive system,
symptoms like poor appetite and diarrhea will occur. The two most common
TCM prescriptions in this study (i.e., Sashen Maidong Decoction and
Sijunzi Decoction) are consistent with the most common TCM symptoms
experienced by patients (e.g., numbness and cough). These, in turn, are
consistent with the fact that the lung and spleen are the main viscera
invaded by COVID-19(W et al.,2020).
In the relationship between ”dryness” and ”dampness” in the etiology of
COVID-19, the ”dryness” pathogen occupies a dominant position (Y et
al.,2020). In the early stage of external infection, the “pathogenic
heat” obstructs the lungs and presents symptoms such as cough. Maxing
Shigan Decoction clears the lungs of asthma. In the middle stage of the
disease, the Xiaochaihu Decoction with reconciling Shaoyang combats the
“evil qi in the Half exterior and half interior.” In the late stage of
the disease, there is a “Consumption of Qi and injury of Yin,” and the
lungs and spleen are mainly affected by COVID-19. Therefore, the Shashen
Maidong decoction can nourish yin and moisten the lung and stomach.
Finally, when COVID-19 invades the spleen and stomach, it causes poor
appetite and weakness in the spleen due to dampness. Sanren Decoction
clears away dampness and heat, while Sijunzi Decoction cultivates the
spleen and lung.