摘要
新型冠状病毒肺炎属于中医学"瘟疫"范畴。通过归纳52例确诊病例(其中初期32例,进展期16例,极期2例,恢复期2例)中医四诊信息和证治经验,认为本病为"湿毒"类疫疠之气侵袭肺脾。中医治疗宜辨病与辨证结合分期论治:1)初期:湿重风热轻,湿毒侵袭肺脾,枢机不利;治宜辟秽解毒,分消走泄,疏风清热;方以银翘散合甘露消毒丹加减。2)进展期:湿毒闭肺,毒损肺络,腑气不通;治宜辟秽解毒,分消走泄,宣肺排痰;方以千金苇茎汤合升降散加减。3)极期:内闭外脱;治宜辟秽解毒,开闭固脱,回阳救逆;方以参附四逆汤加减,或温病"三宝"(安宫牛黄丸、紫雪丹、至宝丹),或苏合香丸。4)恢复期:肺脾气虚,湿浊留恋;治宜辟秽解毒,清解余邪;方以五叶芦根汤加减。各期治疗均以辟秽解毒为核心,并以升麻、当归为基础药物,分消走泄、宣畅气机、化瘀通络贯穿始终。
Coronavirus disease 2019(COVID-19) belongs to the category of "pestilence" of traditional Chinese medicine(TCM). According to the information of TCM diagnosis and treatment experience in 52 confirmed cases including 32 cases in the initial stage, 16 cases in the advanced stage, 2 cases in the extreme stage, and 2 cases in the recovery period, it is believed that the pestilence is related to dampness toxin invading the lungs and spleen. TCM treatment should be based on the combination of disease identification and syndrome differentiation in stages: firstly, initial stage: with heavy dampness and light wind heat, dampness toxin attacks lung and spleen, and obstructing normal physiological functioning;the treatment should be to remove dirt and to resolve toxin, elimination of pathogens through purgation and diuresis, scattering wind and clearing heat. The prescription is modified Yinqiao Powder and Ganlu Xiaodu Pills(银翘散合甘露消毒丹). Secondly, progressive stage: dampness toxin blocking the lung, toxin injuring meridians, Fu Qi being obstructed;the treatment should be to remove dirt and detoxification, to eliminate pathogens through purgation and diuresis, and to diffuse the lung to expel phlegm. The prescription is modified Qianjin Weijing Decoction Heshengjiang Powder(千金苇茎汤合升降散). 3) Extreme period: internal block and external collapse;the treatment should be removing dirt and dissolve toxin, opening the block and collasping, and restoring yang to save from collapse. The prescription is modified Sini Decoction or the three treasures of warm disease Angong Niuhuang Pills(安宫牛黄丸), Zixue Pills(紫雪丹) and Zhibao Pills(至宝丹) or Suhexiang Pills(苏合香丸). 4) Recovery period: Deficiency of lung and spleen qi, retaining of damp-turbidity;the treatment should be remove the dirt and detoxification, clear away remaining pathogen;the prescription is modified Wuye Lugen Decoction. The treatment of all phases is based on removing the dirt and detoxification, with Rhizoma Cimicifugae and Radix Angelicae Sinensis as the basic drugs. It respectively expels evils, dissipating diarrhea, dissipating the qi movement and diarrhea, and removing blood stasis and unlocking the collateral.
作者
陈瑞
罗亚萍
徐勋华
苗青
王玉光
CHEN Rui;LUO Yaping;XU Xunhua;MIAO Qing;WANG Yuguang(Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan,430022;Hebei Traditional Chinese Medicine Hospital;General Hospital of China Resources Wuhan Iron and Steel;Xiyuan Hospital,China Academy of Chinese Medical Sciences;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University)
出处
《中医杂志》
CSCD
北大核心
2020年第9期741-744,共4页
Journal of Traditional Chinese Medicine
基金
国家中医药管理局中医药传承与创新“百千万”人才工程(歧黄工程)2017年中医优秀人才项目(国中医药办人教函[2017]124号)。
关键词
新型冠状病毒肺炎
湿毒
辟秽解毒
coronavirus disease 2019
dampness-toxin
removing the dirt and detoxification
