薛伯寿教授对新型冠状病毒肺炎探讨及验案分析

Professor XUE Bo-shou's Exploration on Coronavirus Disease-2019 and Analysis of Cases

国医大师薛伯寿教授认为,新型冠状病毒肺炎为中医“寒疫”或“寒湿疫”,寒湿闭肺是发病初期之关键病机;寒湿之邪化热入里,病情进一步发展,气机升降失调、正气损耗,气阴两伤,甚者出现内闭阳脱。薛伯寿教授认为,临床辨证论治时当以六经辨证为主,参考历代瘟疫之名方综合组方可提高疗效。强调治该病初起以宣肺开闭、透邪外出为第一要务。提倡要善用麻黄。麻黄能开肺闭,宣肺透邪,消散肺间质郁饮邪毒。故认为麻黄为宣散肺邪之圣药,又是利小便祛湿圣药,宣通寒闭寒凝血脉瘀滞之圣药。同时,疾病之所以发生,正气衰弱是根本原因,正气的盛衰存亡对疾病的发展转归与疗效起决定性作用,薛老特别重视整体调治,强调“病因为本”“正气为本”“胃气为本”,在去除病因同时,顾护正气、胃气。该文总结了薛老新型冠状病毒肺炎的诊疗思路,列举并分析了薛老对临沂、新疆及北京等定点医院新冠肺炎的会诊病例,以期为中药抗疫提供更多的思路。

Professor XUE Bo-shou,a master of traditional Chinese medicine(TCM),believes that coronavirus disease-2019(COVID-19)belongs to the category of"cold epidemic"or"cold-dampness epidemic"in TCM theory.Cold-dampness obstructing the lungs is the key pathogenesis in the early stage of the disease.Exogenous pathogenic factors of cold and dampness are converted into heat in the interior.Over time,the pathogenesis is the disturbance in ascending and descending of Qi movement,loss of vital Qi,deficiency of both Qi and Yin,and even the occurrence of inner blocking causing Yang collapse.Professor XUE believes that the clinical syndrome differentiation and treatment shall be based on six meridians,and the efficacy could be improved by reference to classical prescriptions of plague in the past dynasties.To treat the disease in the early stage,the prescriptions emphasize on diffusing the lungs,inducing resuscitation and expelling pathogenic factors.He advocates the proper use of Ephedrae Herba,which can induce resuscitation of the lungs,diffuse the lungs and expel pathogenic factors,dissipate the interstitial depression and pathogenic factors in the lung interstitium.Therefore,it is considered that Ephedrae Herba is an effective medicine for diffusing the lungs,expelling pathogenic factors,inducing diuresis,eliminating dampness,promoting blood circulation and removing stasis due to cold coagulation.At the same time,the weakness of vital Qi is the root cause of the disease.The prosperity and decline of vital Qi plays a decisive role in the development,prognosis and efficacy of the disease.Professor XUE attaches importance to overall treatment,and emphasize the basis of pathogenesis,vital Qi,and stomach Qi.We shall expel pathogenic factors of disease,while protecting the vital Qi and stomach Qi.This article summarizes Professor XUE's diagnosis and treatment of COVID-19,enumerates and analyzes professor XUE's consultation cases of COVID-19 in designated hospitals in Linyi,Xinjiang and Beijing,in order to provide more ideas for the anti-epidemic effect of TCM.