关于新型冠状病毒肺炎中医病因病机的思考

Thinking on Etiology and Pathogenesis of Novel Coronavirus Pneumonia in Traditional Chinese Medicine

2019年底发现的新型冠状病毒肺炎(COVID-19)传染性强,病死率较高,目前尚无特效药物,中医药在辨治本病方面取得一定疗效。基于《黄帝内经》理论,结合温病学说,认为COVID-19病因在于湿毒,内外湿邪同气相感,聚而成毒,与疫疠毒邪相合,或从寒化,或从热化。根据COVID-19患者临床症状主要表现在肺系及脾胃,认为病位在肺与脾;主要病机为湿毒壅阻机体,气机不畅;病机特点为湿、热、毒、瘀、虚,病重患者热深厥亦深,瘀血阻络,肺失宣肃,久病及肾,热、瘀、虚特点更为鲜明。

Novel coronavirus pneumonia(COVID-19),first found at the end of 2019,is highly contagious and has a high mortality rate,with no specific drugs currently. Traditional Chinese medicine(TCM) has achieved certain results in identifying and treating this disease. Based on the theory in Inner Canon of Yellow Emperor(《黄帝内经》),combined with the theory of febrile disease,it is believed that the cause of COVID-19 is dampness toxin. The internal and external dampness pathogens have identical qi,affect each other,and assemble to become toxins. After combining with epidemic toxins,it can follow cold transformation or heat transformation. According to COVID-19 patients clinical symptoms mainly involving pulmonary system and spleen and stomach system,and combining theories such as five evolutive phases and six climatic factors,it is believed that the location of disease is lung and spleen. Main pathogenesis is dampness toxin obstructing the body and disorder of qi movement. Pathogenic characteristics are dampness,heat,toxin,stasis,and deficiency. In severely ill patients,the deeper the heat,the severer the reversal coldness. Static blood obstructs collateral,lung fails in dispersing and purifying,prolonged illness affects kidney,and the characteristics of heat,stasis and deficiency are more distinct.