黄连解毒汤治疗新型冠状病毒肺炎(COVID-19)重型气营两燔证的中医方证关系及药理研究进展

Prescription-syndrome relationship in traditional Chinese medicine and pharmacology research progress of Huanglian Jiedu Decoction in treatment of COVID-19 with severe syndrome of dual blaze of qi and nutrient

自新型冠状病毒肺炎(COVID-19)疫情暴发以来,国家卫生健康委员会及各地相关单位陆续发布多个诊疗方案,其中重症期治疗推荐方剂中黄连解毒汤的中医证侯与《新型冠状病毒肺炎诊疗方案(试运行第七版)》中重型气营两燔证相应,可用于治疗气营两燔证。气营两燔证津液营阴耗损、正不敌邪,气营热毒炽盛,黄连解毒汤清热解毒,可通过祛邪达到扶正护阴的治疗目的。现代药理研究表明黄连解毒汤在治疗COVID-19重型气营两燔证中具有潜在的抗炎解热、抗病毒、抗氧化、调节机体免疫力、保护脏器组织等作用。通过对COVID-19重型气营两燔证的病机演变、黄连解毒汤的方证关系及现代药理作用进行梳理,分析黄连解毒汤治疗重型气营两燔证的中医方证关系及现代药理学基础,以期为黄连解毒汤用于COVID-19重型气营两燔证的有效治疗提供依据。

Since the coronavirus disease 2019(COVID-19) outbreak, National Health Commission of the People’s Republic of China and local departments have released a number of diagnosis and treatment plans for COVID-19. One of the recommended prescriptions for severe stage treatment is Huanglian Jiedu Decoction, whose TCM syndrome is corresponding to the severe syndrome of dual blaze of qi and nutrient in the COVID-19 protocol of Diagnosis and Treatment of Novel Coronavirus Pneumonia(trial version 7). Huanglian Jiedu Decoction can be used in the treatment of syndrome of dual blaze of qi and nutrient. Syndrome of dual blaze of qi and nutrient is with consumption of nutrient yin of body fluid, pathogenic qi always triumphing over healthy qi, excessive noxious heat from qi and nutrient, Huanglian Jiedu Decoction has the efficacy of clearing heat and detoxicating. It can achieve the therapeutic purpose of nourishing yin and protecting yin by removing evil spirits. Modern pharmacological studies have shown that Huanglian Jiedu Decoction has potential effects of anti-inflammatory and antipyretic, antiviral, antioxidant, regulating immunity and protecting viscera and tissues in the treatment of COVID-19 with severe syndrome of dual blaze of qi and nutrient. In this paper, the pathogenesis evolution of COVID-19 with severe syndrome of dual blaze of qi and nutrient, the relationship between prescriptions and syndromes of Huanglian Jiedu Decoction and its modern pharmacological effects was analyzed, so as to provide a basis for the effective treatment of Huanglian Jiedu Decoction in COVID-19 with severe syndrome of dual blaze of qi and nutrient.