中医对新型冠状病毒肺炎D-二聚体升高的认识及防治

Understanding and prevention of D-dimer elevation in coronavirus disease 2019 in traditional Chinese medicine

2019新型冠状病毒(2019-nCoV)感染引发世界大流行。从文献报道的病例来看,新型冠状病毒肺炎(简称新冠肺炎)患者D-二聚体水平与病情呈正相关,需引起临床工作者的关注。西医学认为,D-二聚体升高与患者的纤溶系统亢进和凝血酶原时间(PT)缩短造成血浆纤维蛋白生成及降解过多,血液出现高凝状态有关;而中医学则认为上述症候可归属于中医"血瘀"病机范畴。多年来,中医药对活血化瘀和改善微循环疗效显著。本文从2019-nCoV所致D-二聚体升高的机制、临床意义、中医的认识及常用活血化瘀方法等方面进行综述,以期为新冠肺炎患者凝血功能受损的防治提供思路。

2019 Novel coronavirus(2019-nCoV)infection caused a pandemic in the world.From the reported cases in the literatures,the level of D-dimer in patients with coronavirus disease 2019(COVID-19)is positively correlated with the severity of illness,which needs the attention of clinical workers.According to Western medicine,the increase of D-dimer is related to the hyperactivity of fibrinolytic system and the shortening of prothrombin time(PT),resulting in excessive production and degradation of plasma fibrin and hypercoagulable state of blood,while traditional Chinese medicine(TCM)believes that the above syndromes belong to the pathogenesis of"blood stasis"according to TCM theories.Over the years,TCM has a significant effect on promoting blood circulation,removing blood stasis and improving microcirculation.This article reviews the mechanism,clinical significance,understanding of TCM and common methods of promoting blood circulation and removing blood stasis caused by 2019-nCoV,in order to provide ideas for the prevention and treatment of impaired blood coagulation in patients with COVID-19.