PMC:7104236 / 38-65 JSONTXT 4 Projects

Herbal medicine and pattern identification for treating COVID-19: a rapid review of guidelines Abstract Background Coronavirus disease 2019 (COVID-19) is pandemic and has caused illness to many people worldwide. This review aimed to summarize and analyze the herbal formulae provided by the guidelines for their pattern identifications (PIs) and compositions of herbs to treat patients with COVID-19. Methods We searched 7 data sources for eligible traditional medicine guidelines up to March 6, 2020 and found a total of 28 traditional medicine guidelines that provide treatment measures for COVID-19. Results Of the 28 guidelines, there were 26 government-issued Chinese guidelines and 2 Korean guidelines. After standardizing the terminology of the PIs and herbal formulae, there were 8 PIs and 23 herbal formulae for the mild stage, 11 PIs and 31 herbal formulae for the moderate stage, 8 PIs and 21 herbal formulae for the severe stage, and 6 PIs and 23 herbal formulae for the recovery stage in the Chinese guidelines. In the Korean guidelines, there were 4 PIs and 15 herbal formulae for the mild stage, 3 PIs and 3 herbal formulae for the severe stage, and 2 PIs and 2 herbal formulae for the recovery stage. In the frequency analysis of herbs, Glycyrrhizae Radix et Rhizoma, Armeniacae Semen Amarum, Ephedrae Herba, and Gypsum Fibrosum were found to be the herbs with the high frequency of usage in the Chinese guidelines. Conclusion This review can be used as guidance for the traditional medicine treatment of COVID-19. Clinical evidence is needed in the future to evaluate the efficacy of traditional medicine. 1 Introduction Coronavirus disease 2019 (COVID-19) is a newly identified strain of coronavirus that causes illness ranging from effects similar to the common cold to fatal diseases in people across the world.1 This disease was first identified in early December 2019, and by the middle of March 2020, the World Health Organization (WHO) assessed COVID-19 as a pandemic.2 As of March 2020, there have been more than 178,700 confirmed cases in at least 140 countries. The majority of cases were reported in mainland China, followed by Italy, Iran, Spain and South Korea.3 The common symptoms of COVID-19 include fever, cough, and shortness of breath. In severe cases, pneumonia may occur and ultimately lead to organ failure and even death.4 Currently, there are no available vaccines or specific medicines for the treatment of COVID-19. In light of the outbreak, various treatment modalities have been considered, including traditional medicine, which has been widely used during the past epidemic outbreaks, such as severe acute respiratory syndrome (SARS) and H1N1 influenza.5 To date, 2 countries, China and South Korea, have issued traditional medicine treatment guidelines on the prevention and treatment of COVID-19. Up to March 2020, there have been 7 versions of diagnosis and treatment guidelines issued by the National Health Commission of China6 and 2 versions of guidelines issued in South Korea.7 A recent systematic review suggested that “Based on historical records and evidence of SARS and H1NI influenza prevention, Chinese herbal formula could be an alternative approach for the prevention of COVID-19 in high-risk populations”5 and it focused on prevention method but not treatment methods. Therefore, we aimed to systematically analyze the herbal formulae in the guidelines for pattern identifications and herbal compositions recommended for treating patients with COVID-19. 2 Methods 2.1 Data sources The following data sources were searched on February 25, 2020 for eligible traditional medicine guidelines and searched up to March 6 to retrieve the updated version of the guidelines provided:• Guidelines International Network (G-I-N)8 • “Chinese guidelines on Novel Coronavirus” resources9 by Evidence Aid • The official government websites of all 31 provinces in mainland China (including municipal and autonomous regions) • The Centre for Health Protection of the Hong Kong Special Administrative Region10 • Association of Korean Medicine and Korean Association of Traditional Pulmonary Medicine • Japanese Association for Infectious Diseases and Japanese Respiratory Society11 • Taiwan Centers for Disease Control12 2.2 Inclusion and exclusion criteria This study focused on the recommended treatment modalities related to traditional medicine for COVID-19. All guidelines that provide traditional medicine treatment measures were included regardless of language, and publication types and years. Guidelines that only provide preventive measures without treatment measures were excluded. Herbal formulae related to folk medicine were excluded only and other herbal formulae in these guidelines were included. As the guidelines were outlined based on regional characteristics, regional folk medicines, such as Tibetan medicine in Tibet, Mongolian medicine in Inner Mongolia, and Miao medicine in Guizhou province, were integrated into their guidelines. 2.3 Data extraction and analyses The data from each included guideline were extracted using a predefined data extraction table. The content of the data extraction tables comprised the stages of the disease, pattern identification, clinical symptoms, therapeutic principle, name and composition of herbal formulae, amount of herbs, and country or province of the provided guideline. The pattern identification and herbal formulae were analyzed according to the severity of the disease (mild, moderate, severe and recovered stages). The frequency of herbs recommended in the herbal formulae for each stage of disease was also computed and analyzed. 2.4 Terminology standardization The terminology of pattern identification were standardized based on the clinical manifestation provided in the guidelines and Clinic Terminology of Traditional Chinese Medical Diagnosis and Treatment-Syndromes.13 The herbal formulae with missing names were also renamed by comparing the compositions of these herbal formulae with other named herbal formulae and double-checked them with the Dictionary of Traditional Chinese Medicine Formula.14 All the terminologies were also standardized based on the WHO international standard terminologies for traditional medicine.15 3 Results A total of 28 traditional medicine guidelines that provide treatment measures for COVID-19 were found. Of the 28 guidelines, there were 26 government-issued Chinese guidelines and 2 Korean medicine-professional associations-issued Korean guidelines. The Japanese government did not officially issue any traditional medicine guidelines on COVID-19, but they adopted a translated version of the national guideline issued by the National Health Commission of China. In mainland China, there are currently 7 versions of national diagnosis and treatment guidelines, and traditional medicine content has been included since the third version.6 Using the government-issued national guidelines as a reference, 17 provinces, 4 municipalities and 4 autonomous regions in mainland China officially issued traditional medicine-related guidelines for the prevention and treatment of COVID-19. All the guidelines were devised by local health authorities according to regional characteristics and local prevalence of COVID-19 and have been continuously updated since the first issuance.5 In Korea, the Association of Korean Medicine and the Korean Association of Traditional Pulmonary Medicine each issued the first version of traditional medicine guidelines on the prevention and treatment of COVID-19 at the end of February 2020.7 Both guidelines were drafted by clinical experts who were also regularly updated by both associations to provide clinical guidance for the prevention and treatment of COVID-19 in South Korea. In the frequency analysis of the herbs used in the herbal formulae for treating patients with COVID-19 according to the patients’ disease stages and PIs (Table 1, Table 2, Table 3, Table 4, Table 5 ), the results showed that there were 8 PIs and 23 herbal formulae for the mild stage (Table 1); 11 PIs and 31 herbal formulae for the moderate stage (Table 2); 8 PIs and 21 herbal formulae for the severe stage (Table 3); and 6 PIs and 23 herbal formulae for the recovery stage (Table 4) in the Chinese guidelines. The Korean guidelines suggested 4 PIs and 15 herbal formulae for the mild stage, 3 PIs and 3 herbal formulae for the severe stage, and 2 PIs and 2 herbal formulae for the recovery stage (Table 5). Table 1 Herbal medicines and pattern identifications for treating mild stage patients with COVID-19 (Chinese guidelines) Pattern identification Name of herbal formula Composition of herbal formula (Latin name) Cold-Dampness Obstructing the Lung Sang Bei Zhisou San Mori Radicis Cortex, Fritillariae Thunbergii Bulbus, Stemonae Radix, Asteris Radix et Rhizoma, Cynanchi Stauntonii Rhizoma et Radix, Platycodonis Radix, Schizonepetae Spica, Citri Reticulatae Pericarpium, Armeniacae Semen Amarum, Glycyrrhizae Radix et Rhizoma Jia Jian Zhengqi San + Da Yuan Yin + Shen Shu San Agastachis Herba 10 g, Atractylodis Rhizoma 15 g, Citri Reticulatae Pericarpium 10 g, Magnoliae Officinalis Cortex 10 g, Amomi Tsao-ko Fructus 6 g, Ephedrae Herba 6 g, Osterici seu Notopterygii Radix et Rhizoma 10 g, Zingiberis Rhizoma Recens 10 g, Arecae Semen 10 g Agastachis Herba 10 g, Atractylodis Rhizoma 15 g, Citri Reticulatae Pericarpium 10 g, Magnoliae Officinalis Cortex 10 g, Amomi Tsao-ko Fructus 6 g, Ephedrae Herba 6 g, Armeniacae Semen Amarum 10 g Osterici seu Notopterygii Radix et Rhizoma 10 g, Zingiberis Rhizoma Recens 10 g, Arecae Semen 10 g Jia Jian Zhengqi Sana + Huo Po Xia Ling Tang Atractylodis Rhizoma 15 g, Citri Reticulatae Pericarpium 9 g, Pinelliae Rhizoma 9 g, Magnoliae Officinalis Cortex 9 g, Ephedrae Herba 6 g, Agastachis Herba 9 g, Amomi Tsao-ko Fructus 6 g, Osterici seu Notopterygii Radix et Rhizoma 9 g, Coptidis Rhizoma 6 g, Zingiberis Rhizoma Recens 9 g Qingwen Baidu Yin + Da Yuan Yin + Huo Po Xia Ling Tang + Sheng Jiang San Bupleuri Radix 20 g, Agastachis Herba 10 g, Atractylodis Rhizoma 10 g, Citri Reticulatae Pericarpium 10 g, Magnoliae Officinalis Cortex 10 g, Arecae Semen 15 g, Amomi Tsao-ko Fructus 6 g, Platycodonis Radix 10 g, Gypsum Fibrosum 20 g, Glycyrrhizae Radix et Rhizoma 6 g, Batryticatus Bombyx 10 g, Cicadae Periostracum 5 g Jing Fang Baidu San Schizonepetae Spica 10 g, Saposhnikoviae Radix 10 g, Osterici seu Notopterygii Radix et Rhizoma 10 g, Perillae Folium 10 g, Atractylodis Rhizoma 12 g, Citri Reticulatae Pericarpium 10 g, Magnoliae Officinalis Cortex 10 g, Amomi Tsao-ko Fructus 6 g, Lithospermi Radix 15 g, Forsythiae Fructus 15 g, Belamcandae Rhizoma 9 g, Dryopteridis Crassirhizomatis Rhizoma 10 g, Agastachis Herba 10 g Wind-Cold Assailing the Lung Jing Fang Baidu San + Jiuwei Qianghuo Pill Schizonepetae Spica 15 g, Saposhnikoviae Radix 15 g, Chuanxiong Rhizoma 15 g, Angelicae Dahuricae Radix 15 g, Menthae Herba 10 g, Platycodonis Radix 10 g, Schizonepetae Spica 10 g, Perillae Folium 10 g, Osterici seu Notopterygii Radix et Rhizoma 10 g, Isatidis Folium 10 g, Aurantii Fructus Immaturus 10 g, Citri Reticulatae Pericarpium 10 g, Alpiniae Katsumadai Semen 10 g Jing Fang Baidu San + Huo Po Xia Ling Tang Schizonepetae Spica 15 g, Saposhnikoviae Radix 15 g, Chuanxiong Rhizoma 15 g, Angelicae Dahuricae Radix 15 g, Menthae Herba 15 g, Platycodonis Radix 30 g, Pogostemonis Herba 15 g, Perillae Folium 15 g, Magnoliae Officinalis Cortex 15 g, Atractylodis Macrocephalae Rhizoma 30 g, Pinelliae Rhizoma Praeparatum15g, Massa Medicata Fermentata 15 g, Coicis Semen 30 g, Poria Sclerotium 30 g, Myristicae Semen 15 g, Armeniacae Semen Amarum 15 g, Crataegi Fructus 30 g, Dolichoris Semen 30 g, Phragmitis Rhizoma 30 g Schizonepetae Spica, Saposhnikoviae Radix, Bupleuri Radix, Cynanchi Stauntonii Rhizoma et Radix, Platycodonis Radix, Agastachis Herba, Magnoliae Officinalis Cortex, Pinelliae Rhizoma, Poria Sclerotium, Atractylodis Rhizoma Macrocephalae, Coicis Semen, Amomi Fructus Rotundus Wind-Heat Invading the Lung Yin Qiao San + Sheng Jiang San Lonicerae Flos 15 g, Forsythiae Fructus 15 g, Schizonepetae Spica 15 g, Arctii Semen 15 g, Menthae Herba 10 g, Platycodonis Radix 15 g, Armeniacae Semen Amarum 10 g, Cicadae Periostracum 10 g, Batryticatus Bombyx 10 g, Curcumae Longae Rhizoma 10 g, Glycyrrhizae Radix et Rhizoma 6 g Yin Qiao Sana Lonicerae Flos 15 g, Forsythiae Fructus 15 g, Saposhnikoviae Radix 9 g, Scutellariae Radix 15 g, Arctii Semen 9 g, Platycodonis Radix 9 g, Phragmitis Rhizoma 18 g, Bupleuri Radix 9 g, Citri Reticulatae Pericarpium 9 g, Glycyrrhizae Radix et Rhizoma 6 g Sang Ju Yin + Yin Qiao San Mori Folium 10 g, Chrysanthemi Flos 10 g, Armeniacae Semen Amarum 10 g, Lonicerae Flos 15 g, Forsythiae Fructus 10 g, Arctii Semen 10 g, Glycyrrhizae Radix et Rhizoma 5 g Yin Qiao San + Huo Po Xia Ling Tang Lonicerae Flos 30 g, Forsythiae Fructus 30 g, Schizonepetae Spica 15 g, Arctii Semen 15 g, Menthae Herba 15 g, Platycodonis Radix 30 g, Armeniacae Semen Amarum 15 g, Pogostemonis Herba 15 g, Magnoliae Officinalis Cortex 15 g, Poria Sclerotium 30 g, Pinelliae Rhizoma Praeparatum 15 g, Amomi Fructus Rotundus 15 g, Coicis Semen 30 g, Dolichoris Semen 30 g, Crataegi Fructus 30 g, Massa Medicata Fermentata 15 g, Phragmitis Rhizoma 30 g External Cold and Interior Heat Da Qing Long Tang + Qianjing Weijing Tang Ephedrae Herba, Cinnamomi Ramulus, Armeniacae Semen Amarum, Gypsum Fibrosum, Phragmitis Rhizoma, Benincasae Pericarpium, Persicae Semen, Zingiberis Rhizoma Recens, Coicis Semen, Zizyphi Fructus, Glycyrrhizae Radix et Rhizoma Warm Pathogen Invading the Lung Ma Xing Yi Gan Tang + Sheng Jiang San/Da Yuan Yin/Qianghuo Shengshi Tang Ephedrae Herba, Armeniacae Semen Amarum, Coicis Semen, Amomi Tsao-ko Fructus, Magnoliae Officinalis Cortex, Arecae Semen, Lasiosphaera seu Calvatia, Nelumbinis Folium, Artemisiae Annuae Herba, Forsythiae Fructus, Osterici seu Notopterygii Radix et Rhizoma, Atractylodis Rhizoma, Platycodonis Radix, Rhei Rhizoma Preparata cum Vinum Huo Po Xia Ling Tang + Xiao Chaihu Tang Agastachis Herba 10 g, Magnoliae Officinalis Cortex 10 g, Pinelliae Rhizoma Praeparatum10g, Poria Sclerotium 15 g, Bupleuri Radix 15 g, Scutellariae Radix 10 g, Codonopsis Pilosulae Radix 10 g, Armeniacae Semen Amarum 10 g, Coicis Semen 20 g, Polyporus 10 g, Alismatis Rhizoma 10 g, Amomi Fructus Rotundus 10 g, Sojae Semen Preparatum 10 g, Tetrapanacis Medulla 10 g, Zingiberis Rhizoma Recens 5 g, Zizyphi Fructus 5 g San Ren Tang + Sheng Jiang San + Xin Jia Xiang Ru Yin Armeniacae Semen Amarum 12 g, Talcum 15 g, Tetrapanacis Medulla 6 g, Amomi Fructus Rotundus 5 g, Lophatheri Herba 10 g, Magnoliae Officinalis Cortex 6 g, Coicis Semen 20 g, Pinelliae Rhizoma Praeparatum 6 g, Batryticatus Bombyx 6 g, Curcumae Longae Rhizoma 9 g, Cicadae Periostracum 6 g, Atractylodis Rhizoma 6 g, Scutellariae Radix 10 g, Artemisiae Annuae Herba 10 g, Bupleuri Radix 15 g, Moslae Herba 12 g, Forsythiae Fructus 15 g Huo Po Xia Ling Tang + Ma Xing Yi Gan Tang Not reported Sang Ju Yin + Yin Qiao San Mori Folium, Chrysanthemi Flos, Platycodonis Radix, Armeniacae Semen Amarum, Forsythiae Fructus, Phragmitis Rhizoma, Glycyrrhizae Radix et Rhizoma, Menthae Herba, Lonicerae Flos, Lophatheri Herba, Schizonepetae Spica, Sojae Semen Preparatum Xiao Chaihu Tang + Sang Xin Tang + Jiuwei Qianghuo Tang + Huoxiang Zhengqi San Bupleuri Radix 15 g, Pinelliae Rhizoma Praeparatum 9 g, Scutellariae Radix 9 g, Zizyphi Fructus 9 g, Zingiberis Rhizoma Recens 9 g, Mori Radicis Cortex 12 g, Armeniacae Semen Amarum 9 g, Fritillariae Thunbergii Bulbus 9 g, Adenophorae Radix 9 g, Gardeniae Fructus 9 g, Sojae Semen Preparatum 6 g, Scrophulariae Radix 12 g, Forsythiae Fructus 9 g, Glycyrrhizae Radix et Rhizoma 9 g Ganlu Xiaodu Dan + Huoxiang Zhengqi San Agastachis Herba, Perillae Folium, Platycodonis Radix, Menthae Herba, Forsythiae Fructus, Phragmitis Rhizoma, Talcum, Atractylodis Rhizoma Macrocephalae, Poria Sclerotium, Citri Reticulatae Pericarpium, Magnoliae Officinalis Cortex, Glycyrrhizae Radix et Rhizoma Ma Xing Yi Gan Tanga + Da Yuan Yin Ephedrae Herba 6 g, Gypsum Fibrosum 15 g, Armeniacae Semen Amarum 9 g, Osterici seu Notopterygii Radix et Rhizoma 15 g, Lepidii seu Descurainiae Semen 15 g, Dryopteridis Crassirhizomatis Rhizoma 9 g, Lumbricus 15 g, Cynanchi Paniculati Radix 15 g, Agastachis Herba 15 g, Eupatorii Herba 9 g, Atractylodis Rhizoma 15 g, Poria Sclerotium 45 g, Atractylodis Macrocephalae Rhizoma 30 g, Hordei Fructus Germinatus 9 g, Crataegi Fructus 9 g, Massa Medicata Fermentata 9 g, Magnoliae Officinalis Cortex 15 g, Arecae Semen 9 g, Amomi Tsao-ko Fructus 9 g, Zingiberis Rhizoma Recens 15 g Ma Xing Yi Gan Tang + Sheng Jiang San + Da Yuan Yin Ephedrae Herba 9 g, Armeniacae Semen Amarum 9 g, Amomi Tsao-ko Fructus 10 g, Arecae Semen 10 g, Cicadae Periostracum 6 g, Astragali Radix 15 g, Forsythiae Fructus 15 g, Atractylodis Rhizoma 15 g, Platycodonis Radix 15 g, Scutellariae Radix 12 g, Arctii Semen 10 g, Glycyrrhizae Radix et Rhizoma 6 g San Ren Tang + Huo Po Xia Ling Tang Armeniacae Semen Amarum 10 g, Amomi Fructus Rotundus 15 g, Pinelliae Rhizoma Zingibere et alumine 15 g, Citri Reticulatae Pericarpium 10 g, Poria Sclerotium 15 g, Coicis Semen 20 g, Tetrapanacis Medulla 15 g, Agastachis Herba 15 g, Magnoliae Officinalis Cortex 15 g, Atractylodis Macrocephalae Rhizoma 15 g, Smilacis Rhizoma 20 g, Lophatheri Herba 15 g, Phragmitis Rhizoma 15 g, Zingiberis Rhizoma Recens 10 g, Glycyrrhizae Radix et Rhizoma 10 g Ma Xing Yi Gan Tang + Sheng Jiang San + Da Yuan Yin Ephedrae Herba 5–10 g, Armeniacae Semen Amarum 5–10 g, Amomi Tsao-ko Fructus 5–10 g, Arecae Semen 5–10 g, Cicadae Periostracum 6–12 g, Forsythiae Fructus 10–20 g, Atractylodis Rhizoma 10–20 g, Scutellariae Radix 10–15 g, Coicis Semen 10–15 g, Glycyrrhizae Radix et Rhizoma 5–10 g Ephedrae Herba, Armeniacae Semen Amarum, Amomi Tsao-ko Fructus, Arecae Semen, Cicadae Periostracum, Forsythiae Fructus, Atractylodis Rhizoma, Platycodonis Radix, Scutellariae Radix, Arctii Semen, Glycyrrhizae Radix et Rhizoma Heat Pathogen Assailing the Lung Da Yuan Yina Arecae Semen 10 g, Amomi Tsao-ko Fructus 10 g, Magnoliae Officinalis Cortex 10 g, Anemarrhenae Rhizoma 10 g, Scutellariae Radix 10 g, Bupleuri Radix 10 g, Paeoniae Radix Rubra 10 g, Forsythiae Fructus 15 g, Artemisiae Annuae Herba 10 g, Atractylodis Rhizoma 10 g, Isatidis Folium 10 g, Glycyrrhizae Radix et Rhizoma 5 g Ma Xing Shi Gan Tang + Da Yuan Yin Ephedrae Herba 8 g, Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Glycyrrhizae Radix et Rhizoma 10 g, Arecae Semen 10 g, Magnoliae Officinalis Cortex 10 g, Amomi Tsao-ko Fructus 10 g, Anemarrhenae Rhizoma 10 g, Paeoniae Radix 10 g, Scutellariae Radix 15 g Yin Qiao San + Qingwen Baidu Yin Not reported Yin Qiao San + Ma Xing Shi Gan Tang Forsythiae Fructus, Lonicerae Flos los, Platycodonis Radix, Menthae Herba, Arctii Semen, Lophatheri Herba, Phragmitis Rhizoma, Sojae Semen Preparatum, Ephedrae Herba, Gypsum Fibrosum, Armeniacae Semen Amarum, Bupleuri Radix, Cicadae Periostracum, Glycyrrhizae Radix et Rhizoma Ma Xing Shi Gan Tang + Xiao Chaihu Tang Ephedrae Herba 5–10 g, Armeniacae Semen Amarum 5–10 g, Gypsum Fibrosum 30–50 g, Forsythiae Fructus 10–20 g, Scutellariae Radix 5–10 g, Bupleuri Radix 10–15 g, Coicis Semen 10–15 g, Magnoliae Officinalis Cortex 5–10 g, Poria Sclerotium 10–15 g, Glycyrrhizae Radix et Rhizoma 5–10 g Dampness Encumbering the Exterior and Interior Ma Xing Yi Gan Tang + Da Yuan Yin + Sheng Jiang San + Xiang Ru Yin Ephedrae Herba 6 g, Armeniacae Semen Amarum 15 g, Amomi Tsao-ko Fructus 6 g, Arecae Semen 10 g, Cicadae Periostracum 10 g, Forsythiae Fructus 20 g, Atractylodis Rhizoma 10 g, Platycodonis Radix 10 g, Scutellariae Radix 15 g, Coicis Semen 20 g, Arctii Semen 15 g, Moslae Herba 12 g Huo Po Xia Ling Tanga + Yin Qiao San Agastachis Herba 15 g, Perillae Folium 15 g, Sojae Semen Preparatum 15 g, Atractylodis Rhizoma 15 g, Magnoliae Officinalis Cortex 10 g, Angelicae Decursivae Radix 15 g, Bupleuri Radix 15 g, Scutellariae Radix 10 g, Artemisiae Annuae Herba 20 g, Armeniacae Semen Amarum 10 g, Osterici seu Notopterygii Radix et Rhizoma 10 g, Lonicerae Flos 15 g, Forsythiae Fructus 15 g Ma Xing Yi Gan Tanga + Huo Po Xia Ling Tang Ephedrae Herba 6 g, Armeniacae Semen Amarum 9 g, Coicis Semen 18 g, Amomi Fructus Rotundus 9 g, Agastachis Herba 9 g, Magnoliae Officinalis Cortex 12 g, Pinelliae Rhizoma Praeparatum cum alumine 9 g, Poria Sclerotium 12 g, Polyporus 9 g, Scutellariae Radix 9 g, Forsythiae Fructus 12 g, Glycyrrhizae Radix et Rhizoma 6 g Pathogen Invading the Stomach and Intestines Wang Shi Lian Po Yin + Huo Po Xia Ling Tang Coptidis Rhizoma, Magnoliae Officinalis Cortex, Pinelliae Rhizoma Praeparatum, Agastachis Herba, Poria Sclerotium, Polyporus, Talcum, Amomi Fructus Rotundus, Armeniacae Semen Amarum, Coicis Semen, Tetrapanacis Medulla, Alismatis Rhizoma No specific PI Qingfei Paidu Tang Ephedrae Herba 9 g, Glycyrrhizae Radix et Rhizoma 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 15–30 g, Cinnamomi Ramulus 9 g, Alismatis Rhizoma 9 g, Polyporus 9 g, Atractylodis Macrocephalae Rhizoma 9 g, Poria Sclerotium 15 g, Bupleuri Radix16g, Scutellariae Radix 6 g, Pinelliae Rhizoma 9 g, Zingiberis Rhizoma Recens 9 g, Asteris Radix 9 g, Farfare Flos 9 g, Belamcandae Rhizoma 9 g, Asari Herba 6 g, Dioscoreae Rhizoma 12 g, Aurantii Fructus 6 g, Citri Reticulatae Pericarpium 6 g, Agastachis Herba 9 g a Name of the herbal formula is originally not reported, and the authors named them based on Dictionary of Traditional Chinese Medicine Formula. Table 2 Herbal medicines and pattern identifications for treating moderate stage patients with COVID-19 (Chinese guidelines) Pattern identification Name of herbal formula Composition of herbal formula (Latin name) Warm Heat Pathogen Congesting the Lung Ma Xing Shi Gan Tang Ephedrae Herba 6 g, Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Glycyrrhizae Radix et Rhizoma 6 g, Cicadae Periostracum 6 g, Rhei Rhizoma Preparata cum Vinum 6 g, Agastachis Herba 10 g Ma Xing Shi Gan Tang + Yin Qiao San Ephedrae Herba, Armeniacae Semen Amarum, Gypsum Fibrosum, Mori Radicis Cortex, Lonicerae Flos, Forsythiae Fructus, Scutellariae Radix, Fritillariae Pallidiflorae Bulbus, Glycyrrhizae Radix et Rhizoma, Phragmitis Rhizoma Ephedrae Herba, Armeniacae Semen Amarum, Gypsum Fibrosum, Lonicerae Flos, Forsythiae Fructus, Scutellariae Radix, Curcumae longae Radix, Fritillariae Thunbergii Bulbus, Paeoniae Rubra Radix, Arisaematis Rhizoma Preparata cum Bovis Fel, Rhei Rhizoma Preparata cum Vinum, Coicis Semen Ma Xing Shi Gan Tanga + Ganlu Xiaodu Dan + Sangbaipi Yin Scutellariae Radix 15 g, Anemarrhenae Rhizoma 10 g, Ephedrae Herba 10 g, Armeniacae Semen Amarum 9 g, Amomi Fructus Rotundus 6 g, Coicis Semen 30 g, Mori Radicis Cortex 15 g, Atractylodis Rhizoma 10 g, Astragali Radix 10 g, Lepidii seu Descurainiae Semen 15 g Ma Xing Shi Gan Tang + Qianjing Weijing Tang Ephedrae Herba 9 g, Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Anemarrhenae Rhizoma 12 g, Poria Sclerotium 10 g, Phragmitis Rhizoma 30 g, Oryzae Semen 30 g, Benincasae Pericarpium 30 g, Persicae Semen 12 g, Fagopyri Radix 30 g, Scutellariae Radix 12 g, Platycodonis Radix 9 g, Pinelliae Rhizoma 9 g, Perillae Caulis 12 g, Sappan Lignum 12 g Qingqi Huatan Tang + Huo Po Xia Ling Tang Citri Reticulatae Pericarpium 10–15 g, Armeniacae Semen Amarum 10–15 g, Scutellariae Radix 10–15 g, Trichosanthis Pericarpium 10–15 g, Poria Sclerotium 15–30 g, Agastachis Herba 15 g, Magnoliae Cortex 10–20 g, Artemisiae Annuae Herba 20–30 g, Phragmitis Rhizoma 20–30 g, Lonicerae Flos 15–30 g, Pseudostellariae Radix 30 g, Glycyrrhizae Radix et Rhizoma 5–10 g Ma Xing Shi Gan Tang + Ganlu Xiaodu Dan + Sheng Jiang San Ephedrae Herba 5–10 g, Armeniacae Semen Amarum 5–10 g, Gypsum Fibrosum 30–50 g, Talcum 10–20 g, Artemisiae Scopariae Herba 10–30 g, Scutellariae Radix 10–15 g, Amomi Fructus Rotundus 5–10 g, Agastachis Herba 10–15 g, Atractylodis Rhizoma 10–15 g, Lepidii seu Descurainiae Semen 10–20 g, Forsythiae Fructus 10–15 g, Batryticatus Bombyx 5–10 g, Cicadae Periostracum 6–12 g, Curcumae Longae Rhizoma 5–10 g, Paeoniae Rubra Radix 10–15 g, Glycyrrhizae Radix et Rhizoma 5–10 g Exterior Cold and Interior Heat Complicated by Dampness Ma Xing Shi Gan Tang + Chuwen Huadu Tang + Sheng Jiang San Ephedrae Herba 6 g, Gypsum Fibrosum 30 g, Armeniacae Semen Amarum 10 g, Glycyrrhizae Radix et Rhizoma 6 g, Batryticatus Bombyx 10 g, Curcumae Longae Rhizoma 9 g, Cicadae Periostracum 6 g, Menthae Herba 6 g, Forsythiae Fructus 15 g, Lonicerae Flos 15 g, Scutellariae Radix 12 g, Phragmitis Rhizoma 15 g, Coicis Semen 20 g, Caryophylli Flos 2 g, Fritillariae Cirrhosae Bulbus 6 g, Akebiae Caulis 12 g, Moschus 0.4 g Chaihu Da Yuan Yin + Leng Xiao Pill Bupleuri Radix 12 g, Magnoliae Cortex 15 g, Amomi Tsao-ko Fructus 3 g, Scutellariae Radix 15 g, Aurantii Fructus 9 g, Platycodonis Radix 10 g, Arecae Semen 6 g, Coicis Semen 20 g, Ephedrae Herba 8 g, Asari Herba 2 g, Alumen 6 g, Asteris Radix 15 g, Peucedani Radix 15 g, Farfarae Flos 15 g, Gleditsia Fructus 6 g, Bambusae Silicea Concretio 5 g, Aconiti Radix Preparata 3 g, Moschus 0.4 g Dryness Invading the Lung Sang Xing Tang + Qingzao Jiufei Tang Mori Folium 10 g, Gypsum Fibrosum 30 g, Eriobotryae Folium 30 g, Armeniacae Semen Amarum 15 g, Ophiopogonis Radix 15 g, Rehmanniae Radix 15 g, Fritillariae Thunbergii Bulbus 15 g, Adenophorae Radix 15 g, Glycyrrhizae Radix et Rhizoma 6 g Cold-Dampness Obstructing the Lung Ma Xing Yi Gan Tang Ephedrae Herba 6 g, Armeniacae Semen Amarum 10 g, Coicis Semen 30 g, Glycyrrhizae Radix et Rhizoma 6 g, Agastachis Herba 10 g, Belamcandae Rhizoma 10 g, Perillae Folium 6 g, Atractylodis Rhizoma 3 g, Magnoliae Cortex 6 g, Citri Reticulatae Pericarpium 12 g Jia Jian Zhengqi Sana + Da Yuan Yin Atractylodis Rhizoma 15 g, Citri Reticulatae Pericarpium 10 g, Magnoliae Cortex 10 g, Agastachis Herba 10 g, Amomi Tsao-ko Fructus 6 g, Ephedrae Herba 6 g, Osterici seu Notopterygii Radix et Rhizoma 10 g, Zingiberis Rhizoma Recens 10 g, Arecae Semen 10 g Dampness Obstructing Middle Energizer Qianjing Weijing Tang + San Zi Yangqin Tang + Shengyang Yiwei Tang Phragmitis Rhizoma 20 g, Coicis Semen 20 g, Benincasae Pericarpium 30 g, Persicae Semen 20 g, Bupleuri Radix 12 g, Citri Reticulatae Pericarpium 12 g, Osterici seu Notopterygii Radix et Rhizoma 10 g, Pinelliae Rhizoma 12 g, Saposhnikoviae Radix 15 g, Astragali Radix 15 g, Atractylodis Macrocephalae Rhizoma 15 g, Panax ginseng Radix 6 g, Perilliae Semen 8 g, Raphani Semen 12 g, Moschus 0.4 g Yi Jia Jian Zhengqi San Agastachis Herba 15 g, Magnoliae Cortex 15 g, Armeniacae Semen Amarum 10 g, Poria Sclerotium 15 g, Citri Reticulatae Pericarpium 10 g, Massa Medicata Fermentata 15 g, Hordei Fructus Germinatus 15 g, Artemisiae Scopariae Herba 15 g, Arecae Pericarpium 10 g, Dolichoris Semen 30 g, Glycyrrhizae Radix et Rhizoma 6 g, Platycodonis Radix 10 g, Coicis Semen 30 g Dampness Obstructing the Lung Ma Xing Shi Gan Tanga + Qingqi Huatan Tang + Sangbaipi Yin Ephedrae Herba 9 g, Armeniacae Semen Amarum 10 g, Lepidii seu Descurainiae Semen 20 g, Mori Radicis Cortex 30 g, Scutellariae Radix 15 g, Benincasae Pericarpium 20 g, Pinelliae Rhizoma 10 g, Magnoliae Cortex 10 g, Perilliae Semen 15 g, Brassicae Semen 10 g, Trichosanthis Pericarpium 15 g, Inulae Flos 9 g, Cyperi Rhizoma 10 g, Curcumae longae Radix 10 g, Persicae Semen 10 g, Astragali Radix 20 g Ma Xing Yi Gan Tang + Da Yuan Yin Ephedrae Herba 10 g, Armeniacae Semen Amarum 15 g, Coicis Semen 20–30 g, Amomi Tsao-ko Fructus 10–20 g, Arecae Semen 10–15 g, Forsythiae Fructus 10–30 g, Atractylodis Rhizoma 10–15 g, Magnoliae Cortex 10–15 g, Scutellariae Radix 15 g, Glycyrrhizae Radix et Rhizoma 5–10 g Ma Xing Yi Gan Tang + Sheng Jiang San + Da Yuan Yin Ephedrae Herba, Armeniacae Semen Amarum, Coicis Semen, Amomi Tsao-ko Fructus, Arecae Semen, Cicadae Periostracum, Forsythiae Fructus, Atractylodis Rhizoma, Atractylodis Macrocephalae Rhizoma, Platycodonis Radix, Fritillariae Pallidiflorae Bulbus, Scutellariae Radix Dampness toxin Congesting the Lung Ma Xing Yi Gan Tanga + Da Yuan Yin Ephedrae Herba 6 g, Armeniacae Semen Amarum 15 g, Gypsum Fibrosum 30 g, Coicis Semen 30 g, Atractylodis Rhizoma 10 g, Agastachis Herba 15 g, Artemisiae Annuae Herba 12 g, Polygoni Cuspidati Rhizoma et Radix 20 g, Verbenae Herba 30 g, Phragmitis Rhizoma 30 g, Lepidii seu Descurainiae Semen 15 g, Citri Grandis Rubrum Exocarpium 15 g, Glycyrrhizae Radix et Rhizoma 10 g Phlegm-Heat Congesting the Lung Qingwen Baidu Yina + Sheng Jiang San Ephedrae Herba 9–12 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 30 g, Trichosanthis Fructus 30 g, Scutellariae Radix 12 g, Mori Radicis Cortex 30 g, Fritillariae Thunbergii Bulbus 9 g, Eriobotryae Folium 9 g, Adenophorae Radix 12 g, Cicadidae Periostracum 6 g Phlegm-Heat Congesting the Lung Ma Xing Shi Gan Tang + Ganlu Xiaodu Dan + Sheng Jiang San Ephedrae Herba 8 g, Armeniacae Semen Amarum 12 g, Gypsum Fibrosum 30 g, Glycyrrhizae Radix et Rhizoma 10 g, Talcum 30 g, Artemisiae Scopariae Herba 20 g, Scutellariae Radix 15 g, Amomi Fructus Rotundus 10 g, Agastachis Herba 15 g, Pinelliae Rhizoma 15 g, Atractylodis Rhizoma 15 g, Lepidii seu Descurainiae Semen 20 g, Forsythiae Fructus 15 g, Batryticatus Bombyx 5 g, Cicadae Periostracum 5 g, Curcumae Longae Rhizoma 10 g, Rhei Radix et Rhizoma 5 g, Paridis Rhizoma 10 g, Moutan Cortex Radicis 15 g, Paeoniae Rubra Radix 15 g, Curcumae longae Radix 15 g, Acori Tatarinowii Rhizoma 15 g, Rehmanniae Radix 15 g, Scrophulariae Radix 15 g Xuan Bai Cheng Qi Tang + Huanglian Jiedu Tang + Jiedu Huoxue Tang Ephedrae Herba 8 g, Armeniacae Semen Amarum 12 g, Gypsum Fibrosum 30 g, Rhei Radix et Rhizoma10g, Trichosanthis Fructus 30 g, Persicae Semen 10 g, Paeoniae Rubra Radix 15 g, Lepidii seu Descurainiae Semen 20 g, Coptidis Rhizoma 3 g, Scutellariae Radix 10 g, Mori Radicis Cortex 10 g, Paridis Rhizoma 10 g, Moutan Cortex Radicis 15 g, Curcumae longae Radix 15 g, Acori Tatarinowii Rhizoma 15 g, Rehmanniae Radix 15 g, Scrophulariae Radix 15 g Ma Xing Yi Gan Tang + Sheng Jiang San + Da Yuan Yin Ephedrae Herba 10 g, Armeniacae Semen Amarum 15 g, Gypsum Fibrosum 30 g, Coicis Semen 30 g, Amomi Tsao-ko Fructus 10 g, Arecae Semen 10 g, Cicadae Periostracum 10 g, Forsythiae Fructus 20 g, Atractylodis Rhizoma 15 g, Platycodonis Radix 15 g, Scutellariae Radix 15 g, Arctii Semen 15 g, Glycyrrhizae Radix et Rhizoma 10 g Ma Xing Shi Gan Tang + Qingqi Huatan Tang Ephedrae Herba 9 g, Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30–50 g, Glycyrrhizae Radix et Rhizoma 10 g, Fritillariae Thunbergii Bulbus 15 g, Trichosanthis Fructus 15 g, Scutellariae Radix 15 g, Platycodonis Radix 15 g, Aurantii Fructus 15 g, Poria Sclerotium 20 g, Lepidii seu Descurainiae Semen 15 g, Houttuyniae Herba 30 g, Atractylodis Macrocephalae Rhizoma 15 g, Atractylodis Rhizoma 15 g, Citri Reticulatae Pericarpium 10 g, Pinelliae Rhizoma 10 g Epidemic Toxin Blocking the Lung Ma Xing Gan Shi Tang Da Yuan Yin + Sheng Jiang San + Xuan Bai Cheng Qi Tang Ephedrae Herba 6 g, Ephedrae Herba 6 g, Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Amomi Tsao-ko Fructus 6 g, Arecae Semen 10 g, Atractylodis Rhizoma 10 g, Lepidii seu Descurainiae Semen 10 g, Persicae Semen 10 g, Batryticatus Bombyx 10 g, Cicadae Periostracum 10 g, Curcumae Longae Rhizoma 10 g Xuan Bai Cheng Qi Tang + San Xiao Yin + Huo Po Xia Ling Tang Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Trichosanthis Fructus 30 g, Rhei Radix et Rhizoma 6 g, Ephedrae Herba 6 g, Lepidii seu Descurainiae Semen 10 g, Persicae Semen 10 g, Amomi Tsao-ko Fructus 6 g, Arecae Semen 10 g, Atractylodis Rhizoma 10 g, Agastachis Herba 12 g, Moschus 0.4 g Ma Xing Gan Shi Tanga + Da Yuan Yin Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Trichosanthis Fructus 30 g, Rhei Radix et Rhizoma 6 g, Ephedrae Herba 6 g, Lepidii seu Descurainiae Semen 10 g, Persicae Semen 10 g, Amomi Tsao-ko Fructus 6 g, Arecae Semen 10 g, Atractylodis Rhizoma 10 g Ma Xing Shi Gan Tang + Huo Po Xia Ling Tang + Sheng Jiang San + Huanglian Wendan Tang Ephedrae Herba 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 30 g, Agastachis Herba 12 g, Pinelliae Rhizoma 12 g, Poria Sclerotium 15 g, Magnoliae Cortex 12 g, Amomi Fructus Rotundus 12 g, Coicis Semen 30 g, Alismatis Rhizoma 9 g, Sojae Semen Preparatum 12 g, Scrophulariae Radix 12 g, Trichosanthis Radix 12 g, Glycyrrhizae Radix et Rhizoma 9 g Xuan Bai Cheng Qi Tanga + Da Yuan Yin Ephedrae Herba 6 g, Ephedrae Herba 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 30 g, Lepidii seu Descurainiae Semen 9 g, Trichosanthis Fructus 30 g, Amomi Tsao-ko Fructus 6 g, Arecae Semen 12 g, Atractylodis Rhizoma 9 g, Persicae Semen 9 g, Rhei Radix et Rhizoma 6 g Heat Pathogen Assailing the Lung Xuan Bai Cheng Qi Tang + Huanglian Jiedu Tang Ephedrae Herba, Armeniacae Semen Amarum, Gypsum Fibrosum, Arisaematis Rhizoma Preparata cum Bovis Fel, Rhei Rhizoma Preparata cum Vinum, Lepidii seu Descurainiae Semen, Bubali Cornu, Persicae Semen, Paeoniae Rubra Radix, Hirudo, Coicis Semen, Glycyrrhizae Radix et Rhizoma Ma Xing Shi Gan Tang Ephedrae Herba 10 g, Gypsum Fibrosum 30 g, Armeniacae Semen Amarum 10 g, Glycyrrhizae Radix et Rhizoma 6 g, Trichosanthis Fructus 30 g, Rhei Radix et Rhizoma 6 g, Lepidii seu Descurainiae Semen 30 g, Perillae Folium 30 g, Amomi Tsao-ko Fructus 6 g, Arecae Semen 6 g, Atractylodis Rhizoma 10 g Bai Hu Tang + Qingying Tang + Qingwen Baidu Yin Gypsum Fibrosum 30 g, Scrophulariae Radix 20 g, Rehmanniae Radix 15 g, Moutan Cortex Radicis 15 g, Lophatheri Herba 10 g, Lonicerae Flos 15 g, Forsythiae Fructus 15 g, Scutellariae Radix 15 g, Menthae Herba 20 g, Paeoniae Rubra Radix 15 g, Curcumae longae Radix 15 g, Lepidii seu Descurainiae Semen 10 g, Glycyrrhizae Radix et Rhizoma 10 g Ma Xing Shi Gan Tang + Yin Qiao San Ephedrae Herba 9 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 30 g, Mori Radicis Cortex 15 g, Lonicerae Flos 20 g, Forsythiae Fructus 15 g, Scutellariae Radix 12 g, Fritillariae Thunbergii Bulbus 15 g, Glycyrrhizae Radix et Rhizoma 9 g, Dendrobii Herba 15 g, Panacis Quinquefolii Radix 15 g Ephedrae Herba, Armeniacae Semen Amarum, Gypsum Fibrosum, Mori Radicis Cortex, Lonicerae Flos, Forsythiae Fructus, Scutellariae Radix, Fritillariae Thunbergii Bulbus, Glycyrrhizae Radix et Rhizoma Ephedrae Herba 10 g, Armeniacae Semen Amarum 10–15 g, Gypsum Fibrosum 20–30 g, Mori Radicis Cortex 15 g, Lonicerae Flos 20–30 g, Forsythiae Fructus 20–30 g, Scutellariae Radix 15 g, Fritillariae Thunbergii Bulbus 15 g, Glycyrrhizae Radix et Rhizoma 5–10 g No specific PI Qingfei Paidu Tang Ephedrae Herba 9 g, Glycyrrhizae Radix et Rhizoma 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 15–30 g, Cinnamomi Ramulus 9 g, Alismatis Rhizoma 9 g, Polyporus 9 g, Atractylodis Macrocephalae Rhizoma 9 g, Poria Sclerotium 15 g, Bupleuri Radix 16g, Scutellariae Radix 6 g, Pinelliae Rhizoma 9 g, Zingiberis Rhizoma Recens 9 g, Asteris Radix 9 g, Farfare Flos 9 g, Belamcandae Rhizoma 9 g, Asari Herba 6 g, Dioscoreae Rhizoma 12 g, Aurantii Fructus 6 g, Citri Reticulatae Pericarpium 6 g, Agastachis Herba 9 g a Name of the herbal formula is originally not reported, and the authors named them based on Dictionary of Traditional Chinese Medicine Formula. Table 3 Herbal medicines and pattern identifications for treating severe stage patients with COVID-19 (Chinese guidelines) Pattern identification Name of herbal formula Composition of herbal formula (Latin name) Internal Block and External Collapse Shen Fu Tang + Su He Xiang Pill/Angong Niuhuang Pill Ginseng Radix 15 g, Aconiti Lateralis Radix Praeparata 10 g, Corni Fructus 15 g, Su He Xiang Pill/Angong Niuhuang Pill Shen Fu Tanga + Su He Xiang Pill/Angong Niuhuang Pill/Zi Xue San Ginseng Radix 15 g, Aconiti Lateralis Radix Praeparata 10 g, Corni Fructus 15 g, Su He Xiang Pill/Angong Niuhuang Pill/Zi Xue San Shen Fu Tang + Su He Xiang Pill/Angong Niuhuang Pill/Shexiang Niuhuang Pill Ginseng Radix 15 g, Aconiti Lateralis Radix Praeparata 10 g, Corni Fructus 15 g, Su He Xiang Pill/Angong Niuhuang Pill/Shexiang Niuhuang Pill Shen Fu Tang Panax ginseng Radix, Aconiti Lateralis Radix Praeparata, Asparagi Radix, Ophiopogonis Radix, Rhei Radix et Rhizoma, Lonicerae Flos, Bubali Cornu, Corni Fructus, Schisandrae Fructus, Phragmitis Rhizoma, Glycyrrhizae Radix et Rhizoma aGinseng Radix 15 g, Aconiti Lateralis Radix Praeparata 10 g, Acori Tatarinowii Rhizoma 10 g, Curcumae longae Radix 10 g, Corni Fructus 10 g, Schisandrae Fructus 10 g, Zingiberis Rhizoma 15 g, Glycyrrhizae Radix et Rhizoma 10 g Sheng Mai San + San Shi Tang + Angong Niuhuang Pill Panaciis Quinquefolii Radix, Ophiopogonis Radix, Schisandrae Fructus, Gypsum Rubrum, Talcum, Gypsum Fibrosum, Armeniacae Semen Amarum, Lonicerae Flos, Tetrapanacis Medulla, Bambusae Caulis in Taeniam, Angong Niuhuang Pill Si Ni Jia Renshen Tang + Angong Niuhuang Pill/Zi Xue San Ginseng Radix 15 g, Aconiti Lateralis Radix Praeparata 15 g, Corni Fructus 20 g, Angong Niuhuang Pill/Zi Xue San Ginseng Radix 5–10 g, Aconiti Lateralis Radix Praeparata 6–10 g, Corni Fructus 20–25 g, Angong Niuhuang Pill/Zi Xue San Ginseng Radix, Aconiti Lateralis Radix Praeparata, Corni Fructus, Bambusae Silicea Concretio, Angong Niuhuang Pill/Zi Xue San Si Ni Jia Renshen Tang + Zhi Xue San / Su He Xiang Pill/Angong Niuhuang Pill Panax ginseng Radix 20–30 g, Aconiti Lateralis Radix Praeparata 30–60 g, Corni Fructus 15–20 g, Zhi Xue San, Su He Xiang Pill/Angong Niuhuang Pill Xuanbai Chengqi Tang Armeniacae Semen Amarum 10 g, Gypsum Fibrosum 30 g, Trichosanthis Fructus 30 g, Rhei Radix et Rhizoma 6 g, Ephedrae Herba 6 g, Lepidii seu Descurainiae Semen 10 g, Persicae Semen 10 g, Magnoliae Cortex 10 g, Amomi Tsao-ko Fructus 6 g, Atractylodis Rhizoma 10 g aTrichosanthis Fructus 30 g, Curcumae longae Radix 10 g, Lepidii seu Descurainiae Semen 30 g, Salviae Miltiorrhizae Radix 30 g, Lumbricus Corpus 15 g, Bombycis Feces 15 g, Atractylodis Rhizoma 15 g, Polyporus 30 g, Rhei Radix et Rhizoma 10 g, Aurantii Immaturus Fructus 15 g, Gardeniae Fructus 15 g, Panax ginseng Radix 30 g Toxin Blocking the Lung Ma Xing Shi Gan Tang + Xuanbai Chengqi Tang Gypsum Fibrosum, Armeniacae Semen Amarum, Rhei Radix et Rhizoma, Trichosanthis Fructus, Ephedrae Herba, Anemarrhenae Rhizoma, Scutellariae Radix, Phragmitis Rhizoma, Glycyrrhizae Radix et Rhizoma aEphedrae Herba 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 15 g, Glycyrrhizae Radix et Rhizoma 3 g, Agastachis Herba 10 g, Magnoliae Cortex 10 g, Atractylodis Rhizoma 15 g, Amomi Tsao-ko Fructus 10 g, Pinelliae Rhizoma Praeparatum 9 g, Poria Sclerotium 15 g, Rhei Radix et Rhizoma 5 g, Astragali Radix 10 g, Lepidii seu Descurainiae Semen 10 g, Paeoniae Radix Rubra 10 g aGypsum Fibrosum 45 g, Ephedrae Herba 10 g, Armeniacae Semen Amarum 10 g, Lonicerae Flos 15 g, Anemarrhenae Rhizoma 10 g, Bubali Cornu 30 g, Fritillariae Thunbergii Bulbus 10 g, Trichosanthis Fructus 30 g, Rhei Radix et Rhizoma 10 g, Magnoliae Cortex 15 g, Lumbricus Corpus 20 g, Lepidii seu Descurainiae Semen 20 g, Paeoniae Radix Rubra 20 g, Astragali Radix 20 g Ma Xing Shi Gan Tang + Sang Bei San Ephedrae Herba, Armeniacae Semen Amarum, Gypsum Fibrosum, Mori Radicis Cortex, Fritillariae Thunbergii Bulbus, Glycyrrhizae Radix et Rhizoma Xuan Bai Cheng Qi Tang + Sang Bei San Armeniacae Semen Amarum, Gypsum Fibrosum, Trichosanthis Fructus, Rhei Radix et Rhizoma, Mori Radicis Cortex, Fritillariae Thunbergii Bulbus (Self-prescribed) Tingli Xiefei Tang Lepidii seu Descurainiae Semen 15 g, Trichosanthis Fructus 9 g, Fagopyri Radix 30 g, Tripterospermi Chinensis Herba 30 g, Scutellariae Radix 30 g, Perillae Fructus 9 g, Allii Macrostemi Bulbus 12 g, Pinelliae Praeparatum cum Zingiberis 12 g, Cinnamomi Ramulus 9 g, Paeoniae Radix Alba 15 g, Chuanxiong Rhizoma 15 g, Brassicae Semen 9 g Shen Fu Tang Ginseng Radix Rubra 10 g, Aconiti Lateralis Radix Praeparata 10 g, Corni Fructus 30 g, Ophiopogonis Radix 20 g, Notoginseng Radix 10 g Shen Fu Tang + Su He Xiang Pill/Angong Niuhuang Pill Panax ginseng Radix 30 g/Panax ginseng Radix 10 g, Panaciis Quinquefolii Radix 15 g, Aconiti Lateralis Radix Praeparata 15 g, Su He Xiang Pill/Angong Niuhuang Pill Xuanbai Chengqi Tang + Huanglian Jiedu Tang + Jiedu Huoxue Tang Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 30 g, Trichosanthis Fructus 15 g, Rhei Radix et Rhizoma 6 g, Ephedrae Herba 9 g, Lepidii seu Descurainiae Semen 15 g, Persicae Semen 10 g, Paeoniae Radix Rubra 15 g, Glycyrrhizae Radix et Rhizoma 9 g, Trichosanthis Radix 15 g, Ophiopogonis Radix 20 g Armeniacae Semen Amarum 5–10 g, Gypsum Fibrosum 30–50 g, Trichosanthis Fructus 10–15 g, Rhei Radix et Rhizoma 3–5 g, Ephedrae Herba 5–10 g, Lepidii seu Descurainiae Semen 10–20 g, Persicae Semen 5–10 g, Paeoniae Radix Rubra 10–15 g, Glycyrrhizae Radix et Rhizoma 5–10 g Armeniacae Semen Amarum 15 g, Gypsum Fibrosum 20–30 g, Trichosanthis Fructus 15 g, Rhei Radix et Rhizoma 5 g, Ephedrae Herba 10 g, Lepidii seu Descurainiae Semen 15–20 g, Persicae Semen 10 g, Paeoniae Radix Rubra 15 g, Glycyrrhizae Radix et Rhizoma 5–10 g Armeniacae Semen Amarum, Gypsum Fibrosum, Trichosanthis Fructus, Rhei Radix et Rhizoma, Ephedrae Herba, Lepidii seu Descurainiae Semen, Persicae Semen, Paeoniae Radix Rubra, Curcumae longae Radix, Glycyrrhizae Radix et Rhizoma Qingwen Baidu Yin + Jiedu Huoxue Tang Bubali Cornu 30 g, Rehmanniae Radix 15 g, Scutellariae Radix 15 g, Moutan Cortex Radicis 15 g, Gypsum Fibrosum 30–50 g, Gardeniae Fructus 10 g, Scrophulariae Radix 15 g, Fritillariae Thunbergii Bulbus 15 g, Forsythiae Fructus 15 g, Anemarrhenae Rhizoma 15 g, Platycodi Radix 15 g, Salviae Miltiorrhizae Radix 15 g, Persicae Semen 15 g, Lumbricus Corpus 15 g, Chuanxiong Rhizoma 15 g, Pseudostellariae Radix 15 g, Glycyrrhizae Radix et Rhizoma 10 g Blazing of both qi and nutrient Qingwen Baidu Yina Gypsum Fibrosum 30–60 g, Anemarrhenae Rhizoma 30 g, Rehmanniae Radix 30–60 g, Bubali Cornu 30 g, Paeoniae Radix Rubra 30 g, Scrophulariae Radix 30 g, Forsythiae Fructus 15 g, Moutan Cortex Radicis 15 g, Coptidis Rhizoma 6 g, Lophatheri Herba 12 g, Lepidii seu Descurainiae Semen 15 g, Glycyrrhizae Radix et Rhizoma 6 g Toxin Flowing through Five Viscera Xiang Sha Liu Junzi Tang + Shen Su Jiangqi Tang Ginseng Radix 7 g, Aucklandiae Radix 6 g, Magnoliae Cortex 30 g, Perillae Folium 8 g, Poria Sclerotium 15 g, Atractylodis Rhizoma Macrocephalae 15 g, Citri Reticulatae Pericarpium 12 g, Glycyrrhizae Radix et Rhizoma 6 g, Panax quinquefolius Radix 20 g, Aurantii Fructus 10 g, Cynanchi Stauntonii Rhizoma et Radix 15 g, Panacis Quinquefolii Radix 6 g, Fritillariae Thunbergii Bulbus 20 g, Moschus 0.4 g Depletion of Essential Qi Poge Jiuxin Tang + Gualou Xiebai Banxia Tang + Danshen Yin Aconiti Lateralis Radix Praeparata 20 g, Corni Fructus 20 g, Ossa Draconis and Concha Ostreae 20 g, Magnetitum 15 g, Fluoritum 20 g, Glycyrrhizae Radix et Rhizoma 12 g, Ginseng Radix 15 g, Feces Trogopterori 12 g, Allii Macrostemi Bulbus 12 g, Pinelliae Rhizoma 12 g, Poria Sclerotium 20 g, Zingiberis Rhizoma Recens 5 g, Dioscoreae Rhizoma 20 g, Lilii Bulbus 15 g, Zingiberis Rhizoma 5 g, Lycii Fructus 15 g, Psoraleae Fructus 12 g, Cuscutae Semen 15 g, Astragali Radix 15 g, Schisandrae Fructus 6 g, Persicae Semen 15 g, Armeniacae Semen Amarum 15 g, Asari Herba 3 g, Brassicae Semen 15 g, Bambusae Succus 20 g, Jujubae Fructus 10 pieces, Salviae Miltiorrhizae Radix 10 g, Santali Albi Lignum 3 g Exhaustion of Yin and Collapse Of Yang Shen Fu Long Mu Tang Ginseng Radix, Aconiti Lateralis Radix Praeparata, Ossa Draconis, Concha Ostreae Toxin Clouding the Orifices Zi Xue Dan/Zhi Bao Dan/Angong Niuhuang Pill/Su He Xiang Pill Not available Cold Epidemic Blocking the Lung Xiao Qinglong Tang Ephedrae Herba 10 g, Paeoniae Radix Alba 10 g, Asari Herba 3 g, Zingiberis Rhizoma 10 g, Glycyrrhizae Radix et Rhizoma 5 g, Cinnamomi Ramulus 10 g, Schisandrae Fructus 5 g, Pinelliae Rhizoma Praeparatum10g, Lepidii seu Descurainiae Semen 10 g, Citri Reticulatae Pericarpium 10 g, Atractylodis Rhizoma 10 g, Magnoliae Cortex 10 g, Codonopsis Pilosulae Radix 10 g No specific PI Qingfei Paidu Tang Ephedrae Herba 9 g, Glycyrrhizae Radix et Rhizoma 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 15–30 g, Cinnamomi Ramulus 9 g, Alismatis Rhizoma 9 g, Polyporus 9 g, Atractylodis Macrocephalae Rhizoma 9 g, Poria Sclerotium 15 g, Bupleuri Radix16g, Scutellariae Radix 6 g, Pinelliae Rhizoma 9 g, Zingiberis Rhizoma Recens 9 g, Asteris Radix 9 g, Farfare Flos 9 g, Belamcandae Rhizoma 9 g, Asari Herba 6 g, Dioscoreae Rhizoma 12 g, Aurantii Fructus 6 g, Citri Reticulatae Pericarpium 6 g, Agastachis Herba 9 g a Name of the herbal formula is originally not reported, and the authors named them based on Dictionary of Traditional Chinese Medicine Formula. Table 4 Herbal medicines and pattern identifications for treating recovery stage patients with COVID-19 (Chinese guidelines) Pattern identification Name of herbal formula Composition of herbal formula (Latin name) Dual eficiency of Qi and Yin Er Chen Tang + Wang Shi Qingshu Yiqi Tang Panacis Quinquefolii Radix 15 g, Dendrobii Herba 10 g, Ophiopogonis Radix 15 g, Anemarrhenae Rhizoma 9 g, Lophatheri Herba 10 g, Coptidis Rhizoma 6 g, Glycyrrhizae Radix et Rhizoma 6 g, Poria Sclerotium 15 g, Pinelliae Rhizoma Praeparatum 9 g, Citri Exocarpium Rubrum 10 g, Citri Reticulatae Pericarpium 15 g, Hordei Fructus Germinatus 20 g Panacis Quinquefolii Radix 20 g, Dendrobii Herba 10 g, Ophiopogonis Radix 10 g, Anemarrhenae Rhizoma 10 g, Lophatheri Herba 10 g, Coptidis Rhizoma 3 g, Glycyrrhizae Radix et Rhizoma 6 g, Poria Sclerotium 15 g, Pinelliae Rhizoma 10 g, Citri Exocarpium Rubrum 10 g, Citri Reticulatae Pericarpium 10 g, Hordei Fructus Germinatus 30 g Shengmai Sana + Shen Ling Baizhu San Codonopsis Radix 10 g, Poria Sclerotium 15 g, Atractylodis Macrocephalae Rhizoma 10 g, Citri Reticulatae Pericarpium 10 g, Bambusae Caulis in Taeniam 10 g, Glehniae Radix 15 g, Ophiopogonis Radix 10 g, Schisandrae Fructus 6 g, Albizziae Cortex 15 g, Setariae Fructus Germinatus 15 g, Hordei Fructus Germinatus 15 g, Glycyrrhizae Radix et Rhizoma 6 g Buzhong Yiqi Tanga + Shashen Maidong Tang Astragali Radix 15 g, Pseudostellariae Radix 15 g, Lophatheri Herba 15 g, Adenophorae Radix 15 g, Ophiopogonis Radix 15 g, Phragmitis Rhizoma 20 g, Trichosanthis Radix 9 g, Polygonati Odorati Rhizoma 6 g, Imperatae Rhizoma 20 g, Glycyrrhizae Radix et Rhizoma 10 g Maiwei Buzhong Yiqi Tang Pseudostellariae Radix, Ophiopogonis Radix, Schisandrae Fructus, Astragali Radix, Atractylodis Macrocephalae Rhizoma, Citri Reticulatae Pericarpium, Angelicae Sinensis Radix, Glehniae Radix, Armeniacae Semen Amarum, Eriobotryae Folium, Lilii Bulbus, Glycyrrhizae Radix et Rhizoma Shengmai San Pseudostellariae Radix 15 g, Ophiopogonis Radix 30 g, Schisandrae Fructus 10 g, Astragali Radix 30 g, Atractylodis Macrocephalae Rhizoma 20 g, Citri Reticulatae Pericarpium 10 g, Angelicae Sinensis Radix 15 g, Glehniae Radix 15 g, Armeniacae Semen Amarum 10 g, Glycyrrhizae Radix et Rhizoma 6 g Shashen Maidong Tanga Adenophorae Radix 15 g, Ophiopogonis Radix 15 g, Astragali Radix 15 g, Massa Medicata Fermentata 20 g, Paeoniae Radix Rubra 15 g, Mori Cortex 15 g, Lycii Cortex 15 g, Aurantii Fructus 10 g, Artemisiae Apiaceae Herba 15 g, Rehmanniae Radix Crudus 15 g Shashen Maidong Tanga + Zhuye Shigao Tang aAdenophorae Radix 10 g, Glehniae Radix 10 g, Ophiopogonis Radix 15 g, Panacis Quinquefolii Radix 6 g, Schisandrae Fructus 6 g, Gypsum Fibrosum 15 g, Lophatheri Herba 10 g, Mori Folium 10 g, Phragmitis Rhizoma 15 g, Salviae Miltiorrhizae Radix 15 g, Glycyrrhizae Radix et Rhizoma 6 g aAdenophorae Radix 15 g, Ginseng Radix 9 g, Codonopsis Radix 9 g, Pseudostellariae Radix 15 g, Ginseng Radix 9 g, Panacis Quinquefolii Radix 9 g, Asparagi Radix 9 g, Ophiopogonis Radix 9 g, Lophatheri Herba 9 g, Mori Folium 9 g, Cicadae Periostracum 6 g, Lycii Cortex 9 g, Atractylodis Rhizoma 15 g, Setariae Fructus Germinatus 15 g Spleen-Lung Qi Deficiency Buzhong Yiqi Tang + Caihu Sugan San Ginseng Radix Rubra, Astragali Radix praeparata cum melle, Citri Reticulatae Pericarpium, Angelicae Sinensis Radix, Bupleuri Radix, Platycodonis Radix, Corni Fructus, Amomi Fructus, Atractylodis Macrocephalae Rhizoma, Polygoni Multiflori Radix, Coicis Semen Huangqi Liu Junzi Tang Astragali Radix praeparata cum melle 30 g, Amomi Fructus 6 g, Codonopsis Radix 15 g, Poria Sclerotium 15 g, Atractylodis Macrocephalae Rhizoma 10 g, Citri Reticulatae Pericarpium 10 g, Pinelliae Rhizoma 9 g, Agastachis Herba 10 g, Glycyrrhizae Radix et Rhizoma 6 g Huangqi Xiangsha Liujunzi Tang Astragali Radix praeparata cum melle 30 g, Amomi Fructus 6 g, Codonopsis Radix 15 g, Poria Sclerotium 15 g, Citri Reticulatae Pericarpium 10 g, Pinelliae Rhizoma 9 g, Agastachis Herba 10 g Xiang Sha Liu Junzi Tang + Li Zhong Pill Pinelliae Rhizoma Praeparatum 9 g, Citri Reticulatae Pericarpium 10 g, Codonopsis Radix 15 g, Astragali Radix praeparata cum melle 30 g, Poria Sclerotium 15 g, Agastachis Herba 10 g, Amomi Fructus 6 g aCitri Reticulatae Pericarpium 10 g, Codonopsis Radix 15 g, Astragali Radix praeparata cum melle 30 g, Poria Sclerotium 15 g, Agastachis Herba 10 g, Amomi Fructus 6 g aPinelliae Rhizoma Praeparatum 9 g, Citri Reticulatae Pericarpium 10 g, Codonopsis Radix 15 g, Astragali Radix praeparata cum melle 30 g, Atractylodis Macrocephalae Rhizoma 10 g, Poria Sclerotium 15 g, Agastachis Herba 10 g, Amomi Fructus 6 g, Glycyrrhizae Radix et Rhizoma 6 g Xiang Sha Liu Junzi Tanga Codonopsis Radix 15 g, Astragali Radix praeparata cum melle 30 g, Poria Sclerotium 15 g, Pinelliae Rhizoma Praeparatum 9 g, Citri Reticulatae Pericarpium 9 g, Agastachis Herba 9 g, Amomi Fructus 6 g Shen Ling Baizhu San Panax ginseng 10 g, Atractylodis Macrocephalae Rhizoma 15 g, Poria Sclerotium 15 g, Lablab Semen Album 30 g, Amomi Fructus 6 g, Nelumbinis Semen 30 g, Glycyrrhizae Radix et Rhizoma 6 g, Platycodonis Radix 10 g, Dioscoreae Rhizoma 15 g, Coicis Semen 30 g, Hordei Fructus Germinatus 30 g, Massa Medicata Fermentata 10 g Xiang Sha Liu Junzi Tang Codonopsis Radix 12 g, Astragali Radix 20 g, Pinelliae Rhizoma Praeparatum 9 g, Citri Reticulatae Pericarpium 6 g, Poria Sclerotium 15 g, Oryzae Semen 30 g, Aucklandiae Radix 6 g, Amomi Fructus 5 g, Ophiopogonis Radix 12 g, Moutan Cortex 10 g, Glycyrrhizae Radix et Rhizoma 6 g aCodonopsis Radix 20 g, Astragali Radix praeparata cum melle 20 g, Atractylodis Macrocephalae Rhizoma 15 g, Poria Sclerotium 10 g, Juglandis Semen 6 g, Polygonati Rhizoma 15 g, Glehniae Radix 12 g, Ophiopogonis Radix 10 g, Inulae Flos 6 g, Rubiae Radix 10 g, Curcumae Radix 10 g, Coicis Semen 15 g, Benincasae Semen 20 g, Persicae Semen 12 g, Perillae Fructus 10 g, Dalbergiae Odoriferae Lignun 3 g, Glycyrrhizae Radix et Rhizoma 6 g Lung-Stomach Yin Deficiency Bufei Tang + San Zi Yangqin Tang Astragali Radix 15 g, Pseudostellariae Radix 15 g, Corni Fructus 15 g, Aurantii Immaturus Fructus 10 g, Perillae Fructus 10 g, Brassicae Semen 10 g, Schisandrae Fructus 10 g, Persicae Semen 10 g, Carthami Flos 10 g Shashen Maidong Tang Adenophorae Radix 15 g, Ophiopogonis Radix 15 g, Polygonati Odorati Rhizoma 10 g, Lablab Semen Album 20 g, Mori Folium 10 g, Trichosanthis Radix 20 g, Glycyrrhizae Radix et Rhizoma 6 g Shengmai Yina + Maimendong Tang Pseudostellariae Radix/Panacis Quinquefolii Radix 15 g, Ophiopogonis Radix 18 g, Schisandrae Fructus 9 g, Pinelliae Rhizoma Praeparatum 9 g, Citri Reticulatae Pericarpium 9 g, Poria Sclerotium 15 g, Fructus Amomi 6 g, Lablab Semen Album 15 g Dual Damage of Qi and Fluid Shengyang Yiwei Tang + Zhuye Shigao Tang + Xiao Chaihu Tang) + Buzhong Yiqi Tang + Shengmai Yin Astragali Radix 18 g, Codonopsis Radix 9 g, Poria Sclerotium 15 g, Atractylodis Macrocephalae Rhizoma 12 g, Pinelliae Rhizoma Praeparatum 9 g, Paeoniae Radix Alba 9 g, Lophatheri Herba 6 g, Alismatis Rhizoma 12 g, Angelicae Pubescentis Radix 9 g, Notopterygii Rhizoma seu Radix 9 g, Bupleuri Radix 9 g, Scrophulariae Radix 12 g, Trichosanthis Radix 12 g, Glycyrrhizae Radix et Rhizoma 6 g Liver Depression and Spleen Deficiency Xiaoyao San + Si Ni San Bupleuri Radix 6 g, Aurantii Fructus 10 g, Paeoniae Radix Rubra 10 g, Angelicae Sinensis Radix 10 g, Poria Sclerotium 30 g, Atractylodis Macrocephalae Rhizoma 15 g, Menthae Herba 10 g, Glycyrrhizae Radix et Rhizoma 6 g Unclear Residual Heat Maimendong Tang + Chaihu Qingzao Tang Panax quinquefolius Radix 20 g, Ophiopogonis Radix 12 g, Citri Reticulatae Pericarpium 12 g, Platycodonis Radix 9 g, Trichosanthis Fructus 12 g, Saposhnikoviae Radix 12 g, Anemarrhenae Rhizoma 10 g, Crassirhizomae Rhizoma 12 g, Atractylodis Rhizoma 6 g Zhuye Shigao Tang + Qingzao Jiufei Tang Lophatheri Herba 15 g, Gypsum Fibrosum 20 g, Pseudostellariae Radix 15 g, Ophiopogonis Radix 20 g, Pinelliae Rhizoma 10 g, Eriobotryae Folium 15 g, Polygonati Odorati Rhizoma 15 g, Scrophulariae Radix 15 g, Armeniacae Semen Amarum 10 g, Glycyrrhizae Radix et Rhizoma 10 g Zhuye Shigao Tang + Si Junzi Tang Lophatheri Herba 15 g, Gypsum Fibrosum 15–20 g, Pseudostellariae Radix 20–30 g, Ophiopogonis Radix 10–15 g, Pinelliae Rhizoma 10 g, Atractylodis Macrocephalae Rhizoma 15–20 g, Poria Sclerotium 15–20 g, Glycyrrhizae Radix et Rhizoma 5–10 g Zhuye Shigao Tang Lophatheri Herba, Gypsum Fibrosum, Pseudostellariae Radix, Ophiopogonis Radix, Pinelliae Rhizoma, Oryzae Semen, Phragmitis Rhizoma, Setariae Fructus Germinatus, Glycyrrhizae Radix et Rhizoma No specific PI Qingfei Paidu Tang Ephedrae Herba 9 g, Glycyrrhizae Radix et Rhizoma 6 g, Armeniacae Amarum Semen 9 g, Gypsum Fibrosum 15∼30 g, Cinnamomi Ramulus 9 g, Alismatis Rhizoma 9 g, Polyporus 9 g, Atractylodis Macrocephalae Rhizoma 9 g, Poria Sclerotium 15 g, Bupleuri Radix16g, Scutellariae Radix 6 g, Pinelliae Rhizoma 9 g, Zingiberis Rhizoma Recens 9 g, Asteris Radix 9 g, Farfare Flos 9 g, Belamcandae Rhizoma 9 g, Asari Herba 6 g, Dioscoreae Rhizoma 12 g, Aurantii Fructus 6 g, Citri Reticulatae Pericarpium 6 g, Agastachis Herba 9 g a Name of the herbal formula is originally not reported, and the authors named them based on Dictionary of Traditional Chinese Medicine Formula. Table 5 Herbal medicines and pattern identifications for treating patients with COVID-19 (Korean guidelines) Pattern identification Name of herbal formula Composition of herbal formula (Latin name) Mild Exterior heat Jinfang Baidu San Osterici Radix 4 g, Araliae Continentalis Radix 4 g, Bupleuri Radix 4 g, Angelicae Decursivae Radix 4 g, Poria Sclerotium 4 g, Ginseng Radix 4 g, Aurantii Fructus Immaturus 4 g, Platycodi Radix 4 g, Cnidii Rhizoma 4 g, Schizonepetae Spica 4 g, Saposhnikoviae Radix 4 g, Glycyrrhizae Radix et Rhizoma 2 g Jiuwei Qianghuo Tang Osterici Radix 6 g, Saposhnikoviae Radix 6 g, Atractylodis Rhizoma 4.8 g, Cnidii Rhizoma 4.8 g, Angelicae Dahuricae Radix 4.8 g, Scutellariae Radix 4.8 g, Rehmanniae Radix Crudus 4.8 g, Asiasari Radix et Rhizoma 2 g, Glycyrrhizae Radix et Rhizoma 2 g, Zingiberis Rhizoma Crudus 4 g, Zizyphi Fructus 4 g, Allii Fistulosi Bulbus 4 g Sang Ju Yin Armeniacae Semen 8 g, Forsythiae Fructus 6 g, Menthae Herba 3.2 g, Mori Folium 10 g, Chrysanthemi Flos 4 g, Platycodi Radix 8 g, Glycyrrhizae Radix et Rhizoma 3.2 g, Phragmitis Rhizoma 8 g Yin Qiao San Lonicerae Flos 40 g, Forsythiae Fructus 40 g, Platycodi Radix 24 g, Menthae Herba 24 g, Arctii Semen 24 g, Glycine Semen Preparatum 20 g, Glycyrrhizae Radix et Rhizoma 20 g, Lophatheri Herba 16 g, Schizonepetae Spica 16 g Gegen Jieji Tang Puerariae Radix 12 g, Ephedrae Herba 8 g, Scutellariae Radix 8 g, Paeoniae Radix 6 g, Cinnamomi Ramulus 4 g, Glycyrrhizae Radix et Rhizoma 3.2 g, Zingiberis Rhizoma Crudus 4 g, Zizyphi Fructus 4 g Daochi Jiangqi Tang Rehmanniae Radix Crudus 12 g, Akebiae Caulis 8 g, Scrophulariae Radix 6 g, Trichosanthis Semen 6 g, Angelicae Decursivae Radix 4 g, Osterici Radix 4 g, Araliae Continentalis Radix 4 g, Schizonepetae Spica 4 g, Poria Sclerotium 4 g, Saposhnikoviae Radix 4 g, Alismatis Rhizoma 4 g Qingjin Jianghuo Tang Citri Unshius Pericarpium 6 g, Armeniacae Semen 6 g, Poria Sclerotium 4 g, Pinelliae Tuber 4 g, Platycodi Radix 4 g, Fritillariae Thunbergii Bulbus 4 g, Angelicae Decursivae Radix 4 g, Trichosanthis Semen 4 g, Scutellariae Radix 4 g, Gypsum Fibrosum 4 g, Aurantii Fructus Immaturus 3.2 g, Glycyrrhizae Radix et Rhizoma 1.2 g, Zingiberis Rhizoma Crudus 4 g Ma Xing Gan Shi Tang) + Qianjin Weijing Tang + Xiao Xianxiong Tang Ephedrae Herba 5 g, Armeniacae Semen 10 g, Gypsum Fibrosum 20 g, Glycyrrhizae Radix et Rhizoma 10 g, Phragmitis Rhizoma 20 g, Benincasae Pericarpium 15 g, Coicis Semen 20 g, Persicae Semen 10 g, Trichosanthis Pericarpium 10 g, Scutellariae Radix 10 g, Pinelliae Rhizoma 10 g, Rhei Radix et Rhizoma 5–10 g, Paeoniae Radix 10 g, Aurantii Fructus Immaturus 10 g, Arecae Semen 10 g, Lepidii seu Descurainiae Semen 15 g, Perillae Folium 10 g, Platycodi Radix 10 g, Anemarrhenae Rhizoma 10 g Ma Xing Shi Gan Tang + Qing qi Huatan Tang Ephedrae Herba 9 g, Armeniacae Semen 10 g, Gypsum Fibrosum 30–50 g, Glycyrrhizae Radix et Rhizoma 10 g, Fritillariae Thunbergii Bulbus 15 g, Trichosanthis Fructus 15 g, Scutellariae Radix 15 g, Platycodi Radix 15 g, Aurantii Fructus Immaturus 15 g, Poria Sclerotium 20 g, Lepidii seu Descurainiae Semen 15 g, Houttuyniae Herba 30 g, Atractylodis Rhizoma Alba 15 g, Atractylodis Rhizoma 15 g, Citri Reticulatae Pericarpium 10 g, Pinelliae Rhizoma 10 g Dampness Huoxiang Zhengqi San Agastachis Herba 6 g, Perillae Folium 4 g, Angelicae Dahuricae Radix 2 g, Arecae Pericarpium 2 g, Poria Sclerotium 2 g, Magnoliae Cortex 2 g, Atractylodis Rhizoma Alba 2 g, Citri Unshius Pericarpium 2 g, Pinelliae Tuber 2 g, Platycodi Radix 2 g, Glycyrrhizae Radix et Rhizoma 2 g, Zingiberis Rhizoma Crudus 4 g, Zizyphi Fructus 4 g Huo Po Xia Ling Tang Coicis Semen 16 g, Poria Sclerotium 12 g, Armeniacae Semen 12 g, Glycine Semen Preparatum 12 g, Agastachis Herba 8 g, Pinelliae Tuber 6 g, Polyporus 6 g, Alismatis Rhizoma 6 g, Magnoliae Cortex 4 g, Amomi Fructus Rotundus 2.4 g Da Yuan Yin Arecae Semen 10 g, Amomi Tsao-ko Fructus 10 g, Magnoliae Cortex 10 g, Anemarrhenae Rhizoma 10 g, Scutellariae Radix 10 g, Bupleuri Radix 10 g, Paeoniae Radix Rubra 10 g, Forsythiae Fructus 15 g, Artemisiae Annuae Herba 10 g, Atractylodis Rhizoma 10 g, Isatidis Folium 10 g, Glycyrrhizae Radix et Rhizoma 5 g Yin Qiao San + San Ren Tang Lonicerae Flos 15 g, Forsythiae Fructus 15 g, Platycodi Radix 10 g, Arctii Semen 10 g, Phragmitis Rhizoma 20 g, Menthae Herba 10 g, Armeniacae Semen 10 g, Amomi Fructus Rotundus 6 g, Coicis Semen 20 g, Tetrapanacis Medulla 10 g, Paeoniae Radix 10 g, Pinelliae Rhizoma 10 g, Talcum 20 g, Arecae Semen 10 g, Amomi Tsao-ko Fructus 5 g, Scutellariae Radix 10 g, Glycyrrhizae Radix et Rhizoma 5 g Cold-Dampness Obstructing the Lung Gegen Jieji Tang + Buhuanjin Zhengqi San Puerariae Radix 12 g, Ephedrae Herba 8 g, Scutellariae Radix 8 g, Atractylodis Rhizoma 8 g, Paeoniae Radix 6 g, Cinnamomi Ramulus 4 g, Agastachis Herba 4 g, Pinelliae Tuber 4 g, Citri Unshius Pericarpium 4 g, Magnoliae Cortex 4 g, Glycyrrhizae Radix et Rhizoma 3.2 g, Zingiberis Rhizoma Crudus 4 g, Zizyphi Fructus 4 g Dampness-Heat Obstructing the Lung Xiao Chaihu Tang + Buhuanjin Zhengqi San Bupleuri Radix 12 g, Scutellariae Radix 8 g, Atractylodis Rhizoma 8 g, Pinelliae Tuber 4 g, Ginseng Radix 4 g, Agastachis Herba 4 g, Citri Unshius Pericarpium 4 g, Magnoliae Cortex 4 g, Glycyrrhizae Radix et Rhizoma 2 g, Zingiberis Rhizoma Crudus 4 g, Zizyphi Fructus 4 g 

 Severe No specific PI Qingfei Paidu Tang Ephedrae Herba 9 g, Glycyrrhizae Radix et Rhizoma 6 g, Armeniacae Amarum Semen 9 g, Gypsum Fibrosum 15–30 g, Cinnamomi Ramulus 9 g, Alismatis Rhizoma 9 g, Polyporus 9 g, Atractylodis Macrocephalae Rhizoma 9 g, Poria Sclerotium 15 g, Bupleuri Radix16g, Scutellariae Radix 6 g, Pinelliae Rhizoma 9 g, Zingiberis Rhizoma Recens 9 g, Asteris Radix 9 g, Belamcandae Rhizoma 9 g, Asari Herba 6 g, Dioscoreae Rhizoma 12 g, Aurantii Fructus 6 g, Citri Unshius Pericarpium 6 g, Agastachis Herba 9 g Toxin Blocking the Lung Ma Xing Shi Gan Tang aEphedrae Herba 6 g, Armeniacae Amarum Semen 9 g, Gypsum Fibrosum 15 g, Glycyrrhizae Radix et Rhizoma 3 g, Agastachis Herba 10 g, Magnoliae Cortex 10 g, Atractylodis Rhizoma 15 g, Amomi Tsao-ko Fructus 10 g, Pinelliae Rhizoma Praeparatum 9 g, Poria Sclerotium 15 g, Rhei Radix et Rhizoma 5 g, Astragali Radix 10 g, Lepidii seu Descurainiae Semen 10 g, Paeoniae Radix 10 g Toxin Blocking the Lung Shen Fu Tang + Su He Xiang Pill Ginseng Radix 15 g, Aconiti Lateralis Radix Praeparata 10 g, Corni Fructus 15 g, Su He Xiang Pill 

 Recovery No specific PI Shen Zhu Jianpi Tang + Shengmai San Liriopis Tuber 8 g, Ginseng Radix 4 g, Atractylodis Rhizoma Alba 4 g, Poria Sclerotium 4 g, Crataegi Fructus 4 g, Citri Unshius Pericarpium 4 g, Magnoliae Cortex 4 g, Schisandrae Fructus 4 g, Paeoniae Radix 3.2 g, Ponciri Fructus Immaturus 3.2 g, Glycyrrhizae Radix et Rhizoma 2 g, Hordei Fructus Germinatus 2 g, Amomi Fructus 2 g, Massa Medicata Fermentata 2 g, Zingiberis Rhizoma Crudus 4 g, Zizyphi Fructus 4 g No specific PI Shen Zhu Jianpi Tang + Qingshu Yiqi Tang Atractylodis Rhizoma 6 g, Poria Sclerotium 4 g, Atractylodis Rhizoma Alba 3 g, Crataegi Fructus 4 g, Ginseng Radix 3 g, Citri Unshius Pericarpium 3 g, Magnoliae Cortex 4 g, Cimicifugae Rhizoma 4 g, Astragali Radix 4 g, Paeoniae Radix 3.2 g, Ponciri Fructus Immaturus 3.2 g, Alismatis Rhizoma 2 g, Puerariae Radix 2 g, Angelicae Gigantis Radix 2 g, Liriopis Tuber 2 g, Citri Unshius Pericarpium Immaturus 2 g, Glycyrrhizae Radix et Rhizoma 2 g, Hordei Fructus Germinatus 2 g, Amomi Fructus 2 g, Massa Medicata Fermentata 2 g, Phellodendri Cortex 1.2 g, Schisandrae Fructus 9 g a Name of the herbal formula is originally not reported, and the authors named them based on Dictionary of Traditional Chinese Medicine Formula. Among the Chinese guidelines, we also found that most of the herbal formulae were recommended once in the respective guidelines. However, 17 herbal formulae were recommended several times by different guidelines, with a slight difference in the herbal compositions. The herbal formulae with the highest frequency of recommendation were the herbal formula of Shen Fu Tang with Su He Xiang Pill or Angong Niuhuang Pill in the severe stage and the combined formula of Xiang Sha Liu Junzi Tang and Li Zhong Pill in the recovery stage. In particular, Angong Niuhuang Pill, Zhi Bao Dan, Zi Xue San, and Su He Xiang Pill were the only prescriptions that were not required in the form of decoction and were only prescribed in the severe stage. On the other hand, the herbal formula of Qingfei Paidu Tang, which is a combination of 4 different herbal formulae with 21 herbs (Table 1, Table 2, Table 3, Table 4), was recommended by the Chinese national diagnosis and treatment guidelines in the treatment of COVID-19 regardless of disease stage or regional status. This herbal formula was also recommended for the treatment of severe stage in the Korean guidelines (Table 5). In addition, the frequency of the herbs used in the herbal formulae recommended by the Chinese guidelines for every stage and in total were computed (Fig. 1 ). The results showed that these formulae contain 12 herbs with a frequency of use 30 or more times in the treatment formulae in all stages. Both Armeniacae Semen Amarum and Ephedrae Herba were found to be the top 10 herbs with the highest frequency of use in the mild, moderate and severe stages. The Gypsum Fibrosum and Lepidii seu Descurainiae Semen were also the top 10 most common herbs used in the moderate and severe stages. In addition, Agastachis Herba, Forsythiae Fructus, Atractylodis Rhizoma, and Scutellariae Radix were also highly used in both the mild and moderate stages. Notably, Glycyrrhizae Radix et Rhizoma was found in the top 10 herbs with the highest usage frequency in all four stages. It was also the herb with the highest frequency of usage in total. Fig. 1 Frequency of commonly used herbs in the herbal formulae for treating patients with COVID-19 in (A) mild stage; (B) moderate stage; (C) severe stage; (D) recovery stage; (E) all stages. 4 Discussion In this review, we systematically summarized and analyzed all the herbal formulae provided by the guidelines according to their pattern identification and herbal compositions. The Chinese medicine herbs used for the prevention of COVID-19 based on 23 provincial guidelines issued in mainland China were reviewed and analyzed in a recent publication.5 With reference to it, but in contrast, our review focused on the traditional medicine treatment measures recommended by all available guidelines. We extended our search of guidelines to nearby countries and reviewed guidelines issued by mainland China (25 provincial guidelines and 1 national guideline) and South Korea to conduct a more comprehensive review. For the frequency analysis of herbs used in every Chinese guideline for COVID-19, each stage has several herbs that were not shown in the list of top 10 frequently used herbs for other stages. For instance, Magnoliae Officinalis Cortex and Platycodonis Radix could only be seen for the mild stage. Magnoliae Officinalis Cortex is often prescribed for the treatment of various gastrointestinal problems, such as fullness in the stomach, vomiting, and diarrhea from dampness. Platycodonis Radix is usually prescribed for coughs with excessive phlegm and sore throat due to exogenous pathogens.16 It could be inferred that gastrointestinal symptoms due to dampness and sore throat as well as coughing with sputum are the primary clinical manifestation in the mild stage of COVID-19. The active components contained in these 2 herbs also showed anti-inflammatory benefits in the in vivo studies of the acute lung injury model.17, 18 In the severe stage, Aconiti Lateralis Radix Praeparata and Rhei Radix et Rhizoma were identified to be frequently used but not in other stages. This could be due to the extreme PIs and clinical manifestations that are only found in severe patients. Aconiti Lateralis Radix Praeparata is known to treat heart failure and has anti-asthmatic and anti-epileptic properties.19, 20 The combination of Aconiti Lateralis Radix Praeparata and Rhei Radix et Rhizoma is also highly compatible, and this combination is often used in various herbal formulae. As these herbs have a certain degree of toxicity, they have to be used in caution and preferably are reserved for extreme cases.21 Moreover, there are 4 herbal medicines available only in the severe stage. Angong Niuhuang Pill, Zhi Bao Dan, Zi Xue San, and Su He Xiang Pill played a significant role in the severe stage treatment. Angong Niuhuang Pill, Zhi Bao Dan, Zi Xue San belongs to the First Aid Three Treasures of Chinese Medicine22, which is cold in nature and is used when the patient loses consciousness due to infectious disease-induced heat. In contrast, Su He Xiang Pill is an aromatic warm-natured medicine and is used when the patient loses consciousness due to a cold pathogen. All 4 herbal medicines were prescribed in different conditions of extremely severe or critical stages based on the patients’ clinical manifestation, and they shared the same therapeutic principle to clear the orifices. Pinelliae Praeparatum cum Zingiberis and Citri Reticulatae Pericarpium were only identified in the list of frequently used herbs in the recovery stage where patients may suffer from white and thin phlegm after their recovery. Pinelliae Praeparatum cum Zingiberis and Citri Reticulatae Pericarpium are major components of the herbal formula Er Chen Tang, which is usually prescribed to clear phlegm and dampness.16 Another herb, Ophiopogonis Radix, is conventionally used for nourishing yin and promoting fluid production. This herb is prescribed for dry cough caused by yin deficiency and is especially suitable for patients in the recovered stage.16 Glycyrrhizae Radix et Rhizoma is the herb with the highest frequency use overall regardless of disease stage. It is one of the antiviral herbal medicine which is approved by the China Food and Drug Administration (CFDA). Many studies have reported that this herb inhibits viral attachment, entry and replication, which is previously used in combating SARS.23, 24 Moreover, Glycyrrhizae Radix et Rhizoma also has an anti-inflammatory quality which is suitable for the treatment of inflammatory lung condition in COVID-19.25 The herbal formula Qingfei Paidu Tang was recommended by both Chinese and Korean guidelines. In the Chinese guidelines, this formula is recommended for all stages. According to a recent publication,26 this herbal formula increases immunology and reduces inflammation by targeting the lung and spleen, which are the disease pathways of COVID-19. However, the herb Farfarae Flos was removed in the Korean guidelines due to its safety and toxicity.27 This review has several limitations. First, the results of this review were obtained after standardizing the terms of the PIs and herbal formulae. Therefore, there might be a difference in the terms used in the provided guidelines. Second, this review does not include any direct evidence on the efficacy of traditional medicine in the clinical treatment of COVID-19. The results provided by this review are a summary of the traditional medicine guidelines, which can only be considered as guidance, and clinical verification is still required. Third, although this review summarized the most recent version of the national and provincial guidelines available up to March 6, 2020, the guidelines issued on COVID-19 by the Chinese government are constantly and frequently updated. In conclusion, this review can be used as a reference in the traditional medicine treatment of COVID-19. Clinical studies are required to evaluate the efficacy and safety of traditional medicine and to provide clinical evidence. The integration of traditional medicine into conventional treatment may be an alternative approach for the treatment of COVID-19 in the future. Appendix I Supplementary data The following are Supplementary data to this article: Acknowledgment The authors thank the American Journal Experts for offering free editing services for this paper as an article on COVID-19. Supplementary Table S1. English and Chinese terms of pattern identification, herbal formulae and herbs name can be found in the online version, at http://dx.doi.org/10.1016/j.imr.2020.100407.

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