国医大师刘志明辨治新型冠状病毒肺炎经验与思路总结

Summary of TCM Master LIU Zhiming’s Experienceand Ideas on Differentiating and Treating Corona Virus Disease 2019(COVID-19)

国医大师刘志明虽已96岁高龄,仍心系新型冠状病毒肺炎(新冠肺炎)疫情防控,并且第一时间进行远程会诊。当前第一批患者已经全部出院,包括多例危重病人。刘老辨治新冠肺炎,鉴别中西医"肺炎",不妄用清热解毒,主要参考瘟疫、冬温、湿温的防治方法。既继承传统温病辨证体系,又注重表里同病,或表象滞后于疾病本质的情况。卫分证多用银翘散、桑菊饮加减。气分证,痰热阻肺常用《千金》苇茎汤、《金匮》茯苓杏仁甘草汤、黄芩半夏丸、贝母瓜蒌散加减;气热夹湿用白虎汤加治湿药;热盛府实用承气汤类方;营分证常用清营汤合猪苓汤;血分证,血热妄行证少见,余热未清用青蒿鳖甲汤加减。疫气辨证重视舌诊,选用达原饮或三消饮。脱证多见阴脱,以西洋参生脉散加黄芪为底方。

Although TCM master LIU Zhiming is 96 years old,he is still concerned about the prevention and control of the corona virus disease 2019(COVID-19)and he immediately conducts remote consultation.Currently,the first batch of patients have been cured and discharged,including several critically ill patients.When treating COVID-19,master LIU always identifies the concept of"pneumonia"in traditional Chinese and western medicine.Therefore,he does not abuse heat-clearing and detoxifying drugs.He mainly refers to the prevention and treatment methods of plague,plague in winter and plague due to dampness.He not only inherits the traditional syndrome differentiation system of epidemic febrile diseases,but also pays attention to the special situation of the patients,or the appearance lagging behind the nature of the disease.He often uses Yinqiao Powder and Sangju Drink to treat patients in the Wei stage.In the Qi stage,if patient has phlegm-heat obstructing lung,Qianjin Weijing Decoction,Jingui Fuling Xingren Gancao Decoction,Huangqin Banxia Pill and Beimu Gualou Powder are commonly used.If the patient is Qi-heat and dampness syndrome,Baihu Decoction is used.Chengqi Decoction is used to treat internal heat in Fu-organs.Qingying Decoction and Zhuling Decoction are commonly used in the Ying stage.For the Blood stage,blood-heat with bleeding syndrome is rare,and the remaining heat syndrome is treated with Qinghao Biejia Decoction.Epidemic diseases syndrome differentiation method attaches importance to tongue diagnosis.Dayuan Drink or Sanxiao Drink is selected according to the diagnosis.Yin collapse syndrome is more common.The basic formula is Shengmai Powder with Xiyangshen(American ginseng)adding Huangqi(astragalus).