从《温热论》考量新型冠状病毒肺炎的中医辨治

Consideration of traditional Chinese medicine differentiation and treatment of novel coronavirus pneumonia from Treatise on Epidemic Febrile Disease

2019年12月武汉发现新型冠状病毒肺炎(新冠肺炎),中医药治疗新冠肺炎疗效显著,且中医药抗击疫病自古有之,因此,中医药防治疫病经验丰富。此次新冠肺炎亦属于中医“瘟疫”范畴,且发现患者早期临床症状多见身热或不热,身热者多发热不甚伴呕恶、纳呆、腹泻、大便稀溏等湿毒困脾诸症,“湿毒”是其核心病邪已得到公认,病位主要累及肺脾,具有卫气营血传变规律而常逆传心包发为重症,疫气盛正气衰则易传变。故笔者从温病学大家叶天士所著《温热论》入手,以卫气营血辨证体系为纲考量新冠肺炎的辨证施治。

The novel coronavirus pneumonia(COVID-19)was out broke in Wuhan in December 2019.Traditional Chinese medicine(TCM)was effective in the treatment of COVID-19,and TCM had been combating epidemic diseases since ancient times.Therefore,TCM had rich experience in preventing and treating epidemic disease.The COVID-19 was also belonged to the category of"plague"in TCM,it was found that early clinical symptoms of the patients were febrile or no fever,most of the febrile patients with hiding fever were accompanied by vomiting,stupor,diarrhea,loose stool and other damp toxin trapped in the spleen."Dampness-Toxin"was the core pathogen which had been recognized,and the disease mainly involved the lung and the spleen,it was with wei-qi-ying-blood transmission law and perverse pericardium was often severe,hyperactivity of epidemic qi and decline of healthy qi caused inconstancy.The author considered the differentiation and treatment of COVID-19 from Treatise on Epidemic Febrile Disease written by master Ye Tian-shi with the outline of wei-qi-ying-blood.