1. 华中科技大学同济医学院附属协和医院
2. 河北省中医院
3. 华润武钢总医院
4. 中国中医科学院西苑医院
5. 首都医科大学附属北京中医医院
纸质出版:2020
移动端阅览
[1]陈瑞,罗亚萍,徐勋华,苗青,王玉光.武汉地区52例新型冠状病毒肺炎中医证治初探及典型病案分析[J].中医杂志,2020,61(09):741-744.
[1]陈瑞,罗亚萍,徐勋华,苗青,王玉光.武汉地区52例新型冠状病毒肺炎中医证治初探及典型病案分析[J].中医杂志,2020,61(09):741-744. DOI: 10.13288/j.11-2166/r.2020.09.002.
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.
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