新型冠状病毒肺炎中医临床特征与辨证治疗初探

Clinical Features and Syndrome Differentiation of Novel Coronavirus Pneumonia in Traditional Chinese Medicine

新型冠状病毒(2019-nCoV)肺炎大部分患者以身热不扬、咳嗽、乏力、纳差、舌苔厚腻为主要症状,根据采集的四诊信息,审症求因,研判核心病机,认为2019-nCoV肺炎属于瘟疫范畴,主要病性为湿毒,可称之为湿毒疫。病位在肺脾,基本病机特点为"湿、毒、瘀、闭"。本病需要与当令的时行感冒、风温、冬温等病证相鉴别。根据疾病传变规律,可分四个阶段辨治:早期、进展期、极期(危重期)、恢复期。大部分病例以早期、进展期为主,为本病的顺传(正局),极度乏力、喘憋、咯血等症状提示病情将逆传加重,肺之化源绝而喘脱,为本病的逆传和变局。治则治法拟为辟秽化浊,以祛邪为第一要义,以分消湿热、宣畅气机为主,抓住早期、进展期治疗是减少危重症、降低病死率的关键。

Most patients with novel coronavirus pneumonia(NCP) in Wuhan have the main symptoms of unsurfaced fever, cough, fatigue, poor appetite, and thick tongue coating. According to the examinations collected, pathogenesis is considered that NCP belongs to the pestilence, and the main nature of disease is dampness toxin, which can be called dampness toxin epidemic. The disease was located in the lung and spleen. The basic pathogenesis was "dampness, toxin, stasis, and closed". This disease needs to be distinguished from seasonal symptoms such as seasonal colds, wind-warmth and winter warmth. According to the law of disease transmission and change, treatment can be differentiated in four stages: early stage, advanced stage, extreme stage(critical stage), and recovery stage. Most cases are mainly in the early and advanced stages, and the disease is sequential transmission. Severe fatigue, panting;expectoration of blood, and other symptoms suggest that the disease will be worsened, which is the reverse transmission change of the disease. Governing the rule is to eliminate filth and turbidity, and to dispel pathogen is the first priority. The treatment is mainly based on dispelling damp-heat and activating qi movement. Grasping early and advanced treatment is the key to reducing critical illness and mortality.