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.