新型冠状病毒肺炎中医药防治研究述评

Review of Corona Virus Disease 2019 in Traditional Chinese Medicine

目的为了全面系统研析新型冠状病毒肺炎(简称新冠肺炎)的防治,对新冠肺炎预防及诊疗方案和知名中医专家观点进行归纳分析。方法通过对数据库进行文献检索,查阅各级卫生健康委员会官方网站发布的诊疗方案,知名中医院士及专家临床等公开发表的观点,整合归纳总结,进行述评。结果该病属于中医"温疫""瘟病""疫疠"的范畴,疾病早期的患者多为轻型,多为素体脾虚患者,以感受湿邪疫毒之气为主,常多见湿重,对于寒湿还是湿热为患,有一定的分歧。治疗上以调理肺脾,健脾祛湿为主。疾病中期的患者,多考虑为素体内热或者湿郁化热,湿毒热充斥肺脏,损伤肺络,治疗以清化湿热为主。如果病情进展,内陷心包,出现坏病,内闭外脱。需要中医"三宝"(安宫牛黄丸、紫雪丹、至宝丹)急救。治疗后的恢复期患者常表现为脾虚湿盛,气阴两伤,需要益气养阴,健脾利湿。结论新型冠状病毒肺炎的病因以"湿"邪为主,感受疫戾之气为其病机,而脾肺是主要病位。治疗上,化湿是贯穿治疗始终,全程都要固护脾胃阳气,勿伤中气。

Objective The corona virus disease 2019( COVID-19) prevention and treatment plan,and the famous TCM experts’ viewpoints were summarized and analyzed to provide a systematic and comprehensive reference for the prevention and treatment of the disease. Methods The literature was searched in the database,the diagnosis and treatment plan published on the official website of health committee at all levels were consulted,and the public opinions of famous academicians and experts of traditional Chinese medicine were summarized and commented. Results The disease belongs to the category of"pestilence","plague"and "epidemic disease"in traditional Chinese medicine. In the early stage of the disease,most of the patients were mild,with spleen deficiency in peacetime. They were mainly affected by Qi of pathogenic damp in epidemic disease. There were some divergences on whether damp-cold or damp-heat. The main treatment was to regulate the lung and spleen,invigorate the spleen and remove dampness. The patients in the middle stage of the disease were mostly considered to have internal heat or damp-heat stagnation. Dampness,toxin and heat filled the lungs and damaged lung collateral. The treatment was mainly to clear awayand transform damp-heat. If the disease progressed,the pericardium was invaginated,and internal closure and external detachment occurred. The first aid of "three treasures"( Angong Niuhuang Pill,Zixue Dan and Zhibao Dan) was administrated in traditional Chinese medicine. After treatment,the patients in the recovery period showed spleen deficiency and dampness,with the deficiency of both Qi and Yin. The treatment was mainly to replenish Qi and Yin,and invigorate spleen and dampness. Conclusion COVID-19 is mainly caused by "damp"evil,and patients are affected by Qi of pestilence. Spleen and lung are the main involved parts.Dissipating dampness,protecting spleen and stomach Yang Qi,and not hurting the middle Qi therapy is throughout the treatment.