从湿毒疫论治新型冠状病毒肺炎

Treatment of Coronavirus Disease 2019(COVID-19)from Perspective of Dampness-toxicity Plagues

通过梳理中医对疫病的认识,对比分析我国近20年经历的较大疫病,认为2019年12月暴发的新型冠状病毒肺炎当以"湿毒疫"论治。随着疫情的蔓延,病例数逐渐增多,病患临床表现及发病规律逐渐清晰,发现此次疫病早期临床表现为发热或不发热,发热者多身热不扬、干咳、乏力,伴恶心、呕吐、便溏、腹泻等消化系统症状,舌苔普遍腻,具有明显的湿毒裹挟之症,病位在肺与脾。多数患者发病缓慢,潜伏期长,症状相对温和,少数患者可迅速发展为痰瘀壅肺、邪毒闭肺、内闭外脱等证,此期重症转危重症呈现黏腻胶着、缠绵难愈的典型湿毒特点,病毒转阴后的恢复期多呈现邪气留恋、余热未清的特点,尤其是重症患者免疫功能和组织损伤的修复需要很长时间。比较分析了传染性非典型性肺炎、甲型H1N1流感及新型冠状病毒肺炎,认为近代流行疫病多湿,此次疫情尤为明显。因此,在防治过程中应充分发挥中医药作用,注意在化湿解毒、辟秽化浊的基础上因证施治。

By reviewing the understanding of epidemic diseases in traditional Chinese medicine(TCM),comparing and analyzing the major epidemic diseases experienced in China in the past 20 years,it is believed that the coronavirus disease 2019(COVID-19)outbreak in December 2019 should be treated as"dampness-toxicity plagues".With the spread of the epidemic,the number of cases gradually increasing,and the clinical manifestations and onset regularity of the patients gradually becoming clear,it was found that early clinical manifestations of the disease were fever or no fever and fever often being accompanied by multiple symptoms of hiding fever,dry cough,fatigue,vomiting,loose stools,diarrhea and other digestive symptoms.The tongue coating is generally greasy,and has obvious dampness-toxicity into the disease,and the disease is located in the lung and the spleen.The majority of patients were with slow onset,long incubation period,and relatively mild symptoms,while a few patients could rapidly develop into syndromes such as phlegm and blood stasis obstructing the lung,pathogen and poison blocking the lung,and inner blocking causing collapse etc.,among whom severe to critical illness cases presented characteristics of the typical dampness-toxicity such as being sticky,difficult to cure.The convalescence period after the virus turns negative presented the characteristics of repeated pathogenic qi and lingering heat,and in particular,the repair of immune functions and tissue damage in severe patients needed to take a long time.SARS,2009 H1 N1 Flu and COVID-19 were compared and analysed,and it was believed that the epidemic diseases in modern times were mostly dampness,especially the current one.Therefore,the role of TCM should be brought into full play in the process of prevention and treatment,and we should pay attention to the treatment according to the syndrome based on eliminating dampness,detoxication,eliminating dirt and resolving turbidity.