埃博拉病毒病中医临床诊疗思路探析

Way of Thinking about Chinese Medical Diagnosis and Treatment for Ebola Virus Disease

采集塞拉利昂首都弗里敦市塞中友好医院住院的102例埃博拉病毒病患者中医四诊信息,分析临床症状特征。认为埃博拉病毒病符合中医学＂暑瘟＂＂湿毒＂范畴,初期起病急,常见高热、乏力、头身痛、咽痛,同时伴发恶心、呕吐、腹痛、腹泻等;第5~7天后部分患者进入极期,瘟毒迫血妄行,高热持续,出现皮疹和瘀斑以及鼻衄、呕血、咯血、便血、血尿等多部位出血;逐渐出现意识障碍、少尿和厥脱等征象;大部分患者在发病2周内死于出血、多脏器功能衰竭。中医学认为,本病内因是素体虚弱,正气不足,不耐时邪,导致暑瘟、湿毒从肌肤腠理侵入,逐渐按卫、气、营、血规律传变加重,危重者可并发厥证、脱证导致死亡。

Chinese medical four-diagnosis information of 102 patients with Ebola virus disease in Sierra Leone- China Friendship Hospital in Freetown, the capital of Sierra Leone, was collected, and the characteristics of clinical symptoms were analyzed. It is considered that Ebola virus disease is accorded with the category of ＂febrile diseases in summer＂ and ＂damp toxin＂ in Chinese medicine. This disease breaks out abruptly in initial stage and its common symptoms include high fever, fatigue, head and bodily pain, sore throat, and accompanying with nausea, vomiting, abdominal pain and diarrhea. After the fifth to seventh day, some patients go into fastigium when the pestilential poison forces blood to flow, continuous high fever, rash, ecchymosis and multiple-site bleeding, including epistaxis, hematemesis, hemoptysis, hemafecia and hematuria. Gradually, disturbance of consciousness, oliguria, faint and prostration appear. Most patients died of bleeding and multi-organ failure within two weeks of attacking. Chinese medi- cine holds that the internal cause of the disease is debility, and healthy Qi insufficient to withstand seasonal evil-Q/, leading to febrile diseases in summer and damp toxin intruding from the texture and interspace of the skin. Then the disease gradually becomes exacerbated according to the order of Wei-Qi-Ying-Xue. The critical illness can present with faint and prostration syndrome, probably causing to death.