上焦宣痹汤治疗长新冠的临床应用体会

The clinical application of Shangjiao Xuanbi decoction in the treatment of symptoms after novel coronavirus infection

新型冠状病毒肆虐全球,据世界卫生组织(WHO)报道,截至2022年12月31日,全球累计报告确诊病例6.5亿例,自国务院应对新型冠状病毒感染疫情联防联控机制综合组发布《关于对新型冠状病毒感染实施“乙类乙管”的总体方案》以来,我国新型冠状病毒感染诊疗工作进入了新阶段。临床观察发现,许多人在感染后首先使用清热解毒药物治疗,而这样往往会导致部分邪气被寒凉药物冰伏于内,邪气透散不畅,阻滞气机,肺郁邪留,进而出现了许多不适症状,例如神疲、乏力、胸闷、咳嗽、心悸、头晕、失眠、健忘、焦虑等,这些症状统称为新型冠状病毒感染后症状,也称为“长新冠”。吴瑭(号鞠通)的上焦宣痹汤由枇杷叶、郁金、射干、白通草、香豆豉等药物组成。该方苦辛通润,清宣痹郁,原为治疗上焦清阳郁之呃逆而设,临床发现除呃逆外,凡属肺气痹郁所致诸症,用之治疗皆有疗效,尤其正对长新冠的病机。临床应用中,上焦宣痹汤在治疗新型冠状病毒感染后出现的喉痹、咳嗽、不寐、胃痞等症状中起到了很好的疗效,特此予以归纳整理,以期为临床同道诊疗长新冠提供一些思路。

According to the World Health Organization(WHO),a total of 650 million confirmed cases have been reported worldwide till December 31,2022.Since the Comprehensive Team of the Joint Prevention and Control Mechanism of the State Council issued the Overall Plan for the Implementation of Category B and B Management of Novel Coronavirus Infection,the diagnosis and treatment of novel coronavirus infection in China has entered a new stage.Clinical observation has found that many people first use heat-clearing and detoxification drugs after infection,which often leads to part of the evil Qi(气)being frozen by the cold drugs,the evil Qi blocks Qi,the lung is obstructed and the evil Qi lingers,and then there are many uncomfortable symptoms,such as fatigue,weakness,chest tightness,cough,palpitations,dizziness,insomnia,forgetfulness,anxiety,etc.,these symptoms are collectively referred to as the symptoms of the novel coronavirus infection,also known as“symptoms after novel coronavirus infection”.WU Jutong’s Shangjiao Xuanbi decoction(上焦宣痹汤)is composed of Pipaye(Loquat leaves),Yujin(Radix curcumae),Shegan(Rhizoma Belamcandae),Baitongcao(Tetrapanacis medulla),and Xiangdouchi(Tempeh).The prescription is bitter and moist,which can relieve obstructions.The prescription is originally used to treat hiccups,but clinical findings indicate that in addition to hiccups,it has curative effects on all diseases caused by lung Qi obstruction,especially in line with the pathogenesis of symptoms after novel coronavirus infection.According to the author’s clinical application experience,Shangjiao Xuanbi decoction has played a good role in the treatment of symptoms such as pharyngitis,cough,sleeplessness,and gastric fullness after novel coronavirus infection,and it is hereby summarized and sorted out,in order to provide some diagnosis and treatment ideas for clinical colleagues in the treatment of symptoms after novel coronavirus infection.