Abstract: OBJECTIVE To analyze the contents of syndrome differentiation in the regional schemes of TCM in preventing and controlling severe COVID-19， and review the revised supplementary diagnosis and treatment strategies of local programs based on national programs. METHODS We searched the official websites of national and regional health committees， the administration of traditional Chinese medicine， and the Chinese literature Database， sought TCM prevention and control programs and related interpretations and fetched information with standardization disposal. Descriptive statistics and systematic cluster analyses were performed on the data. RESULTS Firstly， compared with the national scheme， regional schemes for severe patients further highlighted the significance of dryness-heat pathogenesis and the transformation and combination of damp-turbidity constraint transforming into dryness-heat， dryness-heat bind phlegm-stasis， wei-qi-ying-blood transformation， along with pleurodiaphragmatic spaces and triple energizer. Secondly， regional schemes categorized severe patients' symptoms into three abnormal exuberance pathogenic factors， including epidemic， heat and dampness toxin， or two kinds， that is， constrained and obstructed lung， as well as intense-heat blocking the lung. Thirdly， regional schemes revised the national one and implemented the thoughts and methods of prescription to treating dryness-heat. Besides， as for the symptoms induced by epidemic toxin and intense lung heat and block， the local scheme supplemented the thoughts and methods of syndrome differentiation from phlegm-turbidity and zang-fu disease involving both the exterior and the interior. CONCLUSION Differentiation on pathogenesis of COVID-19 in different stages is critical to define the diagnosis and treatment strategy. On the basis of further understanding of pathogenesis evolution， the new diagnosis and treatment strategy offered by regional schemes can be viewed as an effective supplement to the national scheme.