基于“疮疡理论”辨治新型冠状病毒肺炎

Syndrome Differentiation and Treatment of Coronavirus Disease 2019 Based on“Sore and Ulcer Theory”

【目的】结合舌象与临床特点探讨基于“疮疡理论”辨治新型冠状病毒肺炎(新冠肺炎)的可行性。【方法】通过总结惠州地区58例新冠肺炎患者的舌象与临床特点,分析新冠肺炎与疮疡的相似性,提出基于“疮疡理论”辨治新冠肺炎的治则。【结果】惠州地区58例新冠肺炎确诊患者舌象以红或红暗舌[53.45%(31/58)]、腻苔[86.21%(50/58)]为主,多数伴有齿痕舌[55.17%(32/58)]、裂纹舌[43.10%(25/58)]、胖大舌[24.14%(14/58)];首发症状以发热[62.07%(36/58)]多见,入院后常见症状有咳嗽[55.17%(32/58)]、口干口苦[55.17%(32/58)]、便溏[55.17%(32/58)]等;胸部影像学检查提示肺部有渗出灶者占94.83%(55/58)。【结论】根据舌象与临床特点,可知新冠肺炎的病因以“湿”为主,且多有“湿毒化热”之象,进一步研究发现新冠肺炎与疮疡在中医病因病机、西医病因病理、临床症状、传变规律方面存在互通之处,提示基于“疮疡理论”,以“透、清、补”三法分期辨治新冠肺炎,具有一定的合理性,值得临床借鉴。

Objective 2019(COVID-19)based on“sore and ulcer theory”by combining the tongue manifestation and clinical features.Methods The tongue manifestation and clinical features of 58 cases of COVID-19 patients in Huizhou area were summarized,and the similarity of the clinical manifestations between COVID-19 and the sore and ulcer was analyzed.And then the specific syndrome treatment rules for COVID-19 based on the“sore and ulcer theory”were proposed.Results The tongue manifestation in the 58 confirmed COVID-19 patients in Huizhou area was predominated by red or dull-red tongue[53.45%(31/58)]with greasy coating[86.21%(50/58)],mostly accompanied by tooth-marked tongue[55.17%(32/58)],cracked tongue[43.10%(25/58)]or enlarged tongue[24.14%(14/58)].The initial symptom of COVID-19 patients in Huizhou area was usually shown as fever[62.07%(36/58)].After admission,cough[55.17%(32/58)],dry mouth and bitter mouth[55.17%(32/58)]and loose stool[55.17%(32/58)]were the common symptoms.The chest imaging suggested that the foci with exudation in the lungs were presented in 94.83%of the cases(55/58).Conclusion According to the tongue manifestation and clinical features,the etiology of COVID-19 can be considered as the predominant dampness,and the tendency of dampness and toxicity turning into heat is usually presented.Further research revealed that COVID-19 and sore and ulcer have the commonality of traditional Chinese medicine etiology and pathogenesis,western medicine etiology and pathology,clinical symptoms,and clinical transmission patterns.The results indicated that staging differentiation and treatment of COVID-19 following the methods of expelling,clearing and tonifying based on“sore and ulcer theory”has certain rationality,which has definite clinical significance.