基于尸体解剖检验病理探讨新型冠状病毒肺炎危重型病因病机

Discussion About Etiology and Pathogenesis of COVID-19 of Severe Type Based on Autopsy Pathology

新型冠状病毒肺炎(corona virus disease 2019,COVID-19,简称新冠肺炎)死亡病例的尸体解剖检验(简称尸检)报告显示,新冠肺炎病变部位主要在肺脏,肺组织切面及气管内见大量黏稠分泌物及胶冻状黏液,提示大量痰阻塞。可见,新冠肺炎病位在肺,病因为疫毒,病性为湿邪。湿邪、痰饮均可阻滞气机、阻碍气血运行,使肺络痹阻成瘀。新冠肺炎患者的死亡病例中,大多为60岁以上患者,且有基础疾病如高血压、心血管疾病和糖尿病等。可知,新冠肺炎主要病机为痰饮阻肺、瘀血阻滞、正虚邪盛,治疗需注重泻肺涤痰、活血化瘀、扶助正气。

The autopsy report of the dead cases of corona virus disease 2019(COVID-19)shows that it mainly occurs in the lungs,and there are a lot of thick secretions and colloidal mucus in the lung tissue sections and trachea,,which indicates a large number of sputum obstruction.It can be seen that COVID-19 is located in the lung.The etiology is epidemic pathogenic factor and the nature is dampness pathogen.Dampness pathogen,epidemic pathogenic factor,phlegm retention all can block qi movement and disturb qi-blood circulation,which can block lung collaterals and form stasis.Most of COVID-19 death cases are over 60 years old,and have underlying diseases such as hypertension,cardiovascular disease and diabetes,etc.The main pathogenesis includes phlegm retention,blood stasis and deficient healthy qi.The treatment should focus on purging lung heat and resolving phlegm,promoting blood circulation to remove blood stasis,and strengthening body healthy qi based on syndrome differentiation.