从伏邪试论新冠肺炎重症及危重症的机制与治疗

Discussion on Mechanism and Treatment of Severe and Critical COVID-19 Based on Latent Pathogen

[目的]总结新型冠状病毒肺炎(corona virus disease 2019,COVID-19)治疗经验,为COVID-19重症及危重症的研究提供新思路。[方法]通过查阅COVID-19相关文献,观察收治患者的临床表现等,结合伏邪发病隐匿、易从火化及致病严重等特点,探讨COVID-19(尤其是重症、危重症)的发病机制与治疗。[结果]COVID-19的隐匿性、潜伏性、易从火化、反复发作、发病较为严重等特点与伏邪致病特点基本一致。COVID-19重症及危重症的形成和发展与伏燥基础和感受湿毒时疫密切相关。伏燥基础是发病的重要条件,而细胞因子风暴的发生过程与伏邪从火而化的过程有相通之处。结合伏邪发病特点可预判病势,从而在发病前可进行有效干预,发病中可截断扭转病情。在COVID-19重症及危重症治疗中,重视伏燥基础、燥湿相兼的病机特点以及伏邪易从火化、致病严重的发病特点,选择合适的处方可取得较好疗效。[结论]COVID-19的发病特点符合伏邪致病特点,其重症及危重症的形成和发病机制与伏邪发病密切相关,运用伏邪理论可指导COVID-19重症及危重症的治疗。

[Objective]To summarize the treatment experience of corona virus disease 2019(COVID-19),and provide new ideas for the study of severe and critical COVID-19.[Methods]By reading COVID-19 related literature and observing the clinical manifestation of treated patients,combined with the characteristics of theory of latent pathogen in traditional Chinese medicine(TCM),based on the characteristics of occult,easy to convert into fire,and leading to severe disease of latent pathogen,the treatment and the pathogenesis of COVID-19(especially severe and critical)were explored.[Results]Combining with the characteristics of latent pathogens that can foresee the illness,which can carry out effective intervention prior to the onset,intercept and reverse condition in the onset.In the treatment of severe and critical COVID-19,the pathogenesis characteristics of the foundation of latent pathogens and the mixture of dryness and dampness,and pathogenic characteristics of latent pathogens easy to convert into fire and its severity should be paid attention to,and right prescription should be seleated,so as to achieve better results.[Conclusion]The pathogenesis characteristics of COVID-19 conforms to the pathogenesis characteristics of latent pathogen,and the formation and pathogenesis of severe and critical COVID-19 are closely related to the pathogenesis of latent pathogen.The theory of latent pathogen can be used to guide the treatment of severe and critical COVID-19.