基于五运六气理论的新型肺炎防治分析与探讨

Analysis and Discussion on the prevention and treatment of new pneumonia based on the theory of five movements and six Qi

五运六气理论对时令疫病的发生、发展及治疗防控具有系统阐述,强调天人气化、扶“正祛邪”是中医防治时令疫病的重要理论基础。新型冠状病毒(2019-nCoV)感染的肺炎属时令疫病范畴,2019年12月至2020年1月主体处于己亥年终之气,少阳相火内蕴,复被寒气阻遏,脾胃功能偏弱,适逢武汉本季气温偏高、湿度较大而诱发本病,为寒热错杂、脾虚湿困证之时令疫病。其防治原则需在清热透表、调畅枢机的同时兼顾脾胃、相火,重症者兼顾心阳。药物预防及轻症治疗推荐柴胡剂枢转气机、透热转气,日常调理首重饮食调控,避免食积助火、大剂苦寒重伤。大寒至立春前后进入庚子年五运六气格局,需关注时令转换与证候“拐点”的地域差异,适时调整防治策略。受金运太过、少阴君火司天及主客气影响,肺金肝木易失衡,脾胃功能渐趋恢复,疫情回落得益于时令转换及防控得力。2020年2~3月初春,春生之气被寒水客气郁遏,主症仍见外寒内热证,或由湿重渐转向燥症与燥湿相兼证,治宜泻肺宣气、疏散郁热、柔肝润燥,防控重点仍在青壮年人群,重症及年老体弱者仍需兼顾心阳、脾胃。初夏4~5月天气回暖,风火相扇,外感逐渐减少,防控重点应由呼吸道疾病转到心脑血管疾病;时有寒潮反复,届时高低年龄组人群仍需关注呼吸道疾病。基于五运六气理论分析,并相较于五运六气格局相似年份的中国疫病史料、近10年1~3月流行性感冒疫情及高病死月份的运气因素分析等,倾向于国富民安、时气小有异常、不具疫戾条件。

The theory of Five movements and six Qi has a systematic exposition on the occurrence,development,treatment and prevention and control of seasonal epidemics,emphasizing the popularity of nature,supporting the'Healthy Qi expelling pathogenic factors',which is an important theoretical basis for the prevention and treatment of seasonal epidemics in traditional Chinese medicine.COVID-19 is a seasonal epidemic disease,which occurred from December 2019 to January 2020.It belongs to the Qi of the end of the year of Yihai.The Shaoyang phase of fire is contained by the cold Qi,and the spleen and stomach function is weak.It happens that the high temperature and humidity in Wuhan for leading to the disease.The disease is characterized by mixed cold and heat,spleen deficiency and dampness.The prevention and treatment principle should be in clearing heat,expelling pathogenic factors from the exterior,and regulating Qi activity.Both the spleen and the stomach and the minister fire should be taken into account at the same time.In severe cases,the heart Yang is also taken into account.It is recommended to use Bupleurum to pivot the Qi activity and clearing heat of Yingfen to Qifen for drug prevention and light disease treatment.It is recommended to adjust the diet in daily life,so as to avoid the accumulation of food to help the fire and the severe injury caused by bitter and cold prescription.From the beginning of the Great Cold to the beginning of spring,the pattern of'five movements and six Qi'in the year of Gengzi needs to pay attention to the regional difference between seasonal change and syndrome'inflection point',and adjust the prevention and control strategies in time.Affected by Too excessive of Jinyun,minister fire of Shaoyin being the Celestial Manager and the influence of Zhuqi and Keqi,the lung and liver are easily out of balance,and the spleen and stomach functions are gradually recovering.The fall of the epidemic situation is due to the effective seasonal change and prevention and control.In the early spring of February and March,the spring Qi was restrained by cold water and Guest Qi depression,and the main symptom was still external cold and internal heat syndrome,or gradually turned to dryness syndrome and dryness and dampness syndrome,which was suitable for purging the lung and promoting Qi,evacuating the stagnant heat,softening the liver and moistening the dryness.The prevention and control focus was still on the young and middle-aged people,and the heart Yang,spleen and stomach were still needed for the severe and the old and the weak.From April to May,the weather gets warmer,the wind and the fire blow,and the external affection will gradually decrease.The prevention and control focus should be shifted from respiratory diseases to cardiovascular and cerebrovascular diseases;there are frequent cold waves,and the high and low age groups still need to pay attention to respiratory diseases.Based on the analysis of the theory of Five movements and six Qi,and compared with the historical data of Chinese epidemics in the similar years of Five movements and six Qi pattern,the analysis of the epidemic situation of influenza in January to March of the last decade and the Yun Qi factors in the month of high mortality,etc.It tends to be rich in the country and safe in the people,with little abnormal weather and no epidemic conditions.