基于五运六气理论从寒湿郁虚火之厥阴病论治新型冠状病毒肺炎

Treatment of COVID-19 from the perspective of Jue-Yin Disease caused by cold-damp enveloping constrained fire based on Five-yun Six-qi theory

目的探讨新型冠状病毒肺炎(COVID-19)的中医病因病机和治法方药,评价中西医结合治疗COVID-19的疗效。方法依据中医五运六气理论、地域气候特点及症状、实验室检查及影像学特点,分析出病因病机证治方案,并据此对2019年12月-2020年1月湖北省黄冈市中心医院30例COVID-19患者实施临床治疗。结果 COVID-19属中医瘟疫范畴,为寒湿直中三阴内郁虚火之厥阴病,病名以寒湿瘟(疫)为宜,故治以乌梅丸合麻黄升麻汤合达原饮,随证加减。30例COVID-19患者中,1例纯中药治疗,29例在西医对症治疗基础上加用中药。25例患者在服用中药1剂后症状即出现好转。服中药后7~10 d,30例患者全部有效,其中18例患者症状完全消失,6例重型患者5例转为普通型、1例转为轻型,症状总消失率达60.0%(18/30),病毒核酸检测转阴并达到出院标准13例(包括1例纯中药治疗)。结论 COVID-19病机为寒湿直中三阴,内郁虚火,形成厥阴病,属寒湿瘟(疫)范畴,中西医结合治疗可迅速改善症状且临床疗效满意。

Objective To explore the etiology,pathogenesis and prescription of treatment methods of COVID-19 in traditional Chinese medicine(TCM),and to evaluate the value of integrated Chinese and western medicine for the treatment of the disease.Methods According to the theory of five Yun and six Qi,regional climate characteristics and clinical evidence,the etiology and pathogenesis of COVID-19 were analyzed,and TCM treatment was established for clinical practices for 30 patients with COVID-19 in Huanggang Central hospital,during December 2019 and Janual 2020.Results It is considered that COVID-19 belongs to the range of Plague in TCM theory,the etiology and pathogenesis are cold and dampness directly attacking the three yin channels,and internal constraint of deficient fire,so the disease name is called by cold-dampness pestilence.The prescription was Wumeiwan(Mume Pill)combined with Mahuang-Shengma Decoction(Ephedra and Cimicifuga Decoction)and Dayuanyin(Dayuan Beverage),and the treatment was modified according to pattern differentiation.A total of 30 patients were treated with pattern differentiation and treatment of TCM.Among which,one patient was treated only with herbal medicine,and the other 29 were treated based on the routine treatment of Western medicine.After treatment,25 of the 30 patients had improved symptoms after taking 1 dose of TCM.After taking 7-10 doses,all patients had major symptoms ranging from improvement(8+4 cases)to complete disappearance(18 cases),13 cases met the discharge criteria,including the one who was treated only with herbal medicine.Among all the patients,5 of the 6 severe turned to moderate and 1 turned to mild.Conclusions The pathogenesis of COVID-19 is cold and dampness directly attacking the three yin channels,and internal constraint of deficient fire,and then Jue-Yin Disease,which belongs to the category of cold-damp pestilence.The method of integrated Chinese and Western medicine can rapidly improve the symptoms and the clinical effect is satisfactory.