发皇“伤寒”微旨,探究新冠论治

Extracting the Connotation of Cold Damage to Explore Differentiation and Treatment of Corona Virus Disease 2019 (COVID-19)

[目的]通过发掘《伤寒杂病论》中对新型冠状病毒(以下简称新冠病毒)感染治疗有借鉴意义的治则治法、方药等,探究新型冠状病毒肺炎(以下简称新冠肺炎)的论治。[方法]通过古今文献考证、查阅近期新冠病毒相关的研究,比较“伤寒病”与此次新冠肺炎流行时的气候条件、地域特点、传染性强弱,以及两者具体证候特点、症候体征、传变规律等相似之处,进行合理分析,明确《伤寒杂病论》对新冠肺炎防治的指导意义,并列举验案一则加以佐证。[结果]《伤寒杂病论》成书年代的气候与此次新冠肺炎起病时相似,疫情发生的地域相近,两者的传染性相仿,新冠肺炎在三阴三阳时不同的证候特点、症候体征在《伤寒杂病论》中有迹可循,六经传变也提示疾病的发生发展规律。根据临床总结和实践,筛选出有明显抗疫疗效的“三药三方”,三药为金花清感颗粒、连花清瘟胶囊、血必净注射液,三方为清肺排毒汤、化湿败毒方、宣肺败毒方。“三药三方”均由经方化裁而成,其中清肺排毒汤实践证明其总有效率达90%以上,该系列方药的成功应用印证了经方抗疫的有效性。本文医案辨病为疫毒闭肺之重型新冠肺炎,治以宣肺止咳、清热解毒,并贯穿病程始终,方用麻杏石甘汤合小陷胸汤、苇茎汤加减,患者乏力、咳嗽咳痰等症状明显好转,取得成效。[结论]本次新冠肺炎疫情与“伤寒病”有着高度的一致性,《伤寒杂病论》可以指导新冠肺炎的防治。深入发掘《伤寒杂病论》中治疗疫病的治法方药等,对中医药防治传染病具有重大意义。

[Objective]To explore the treatment of Corona Virus Disease 2019(COVID-19),through excavating the therapeutic principles and prescription which have referential significance to novel Corona Virusinfection from“Treatise on Febrile and Miscellaneous Diseases”.[Methods]Through textual research of ancient and modern literatures,checking out the recent study on COVID-19,comparing the outbreak epidemic with climate conditions,regional characteristics,infectious strength,and syndrome characteristics,signs and symptoms,and the transmission rules in the epidemic period of COVID-19 with“cold damage”,this paper made a reasonable analysis to clarify the guiding significance of“Treatise on Febrile and Miscellaneous Diseases”to prophylaxis and treatment of COVID-19,and one case was presented as proof.[Results]The climate of eastern HAN Dynasty was similar to that of the outbreak of COVID-19,the epidemic area was similar,and the infectivity of the two diseases was similar.COVID-19 manifested in different syndromes and signs with three Yin and three Yang,which could be traced in“Treatise on Febrile and Miscellaneous Diseases”.The six classical conversions also indicated the occurrence and development of COVID-19.According to the clinical summary and practice,“three drugs and three prescriptions”with obvious anti-epidemic effect were selected.The three drugs were Jinhua Qinggan granule,Lianhua Qingwen capsule and Xuebijing injection,the three prescriptions were Qingfei Paidu decoction,Huashi Baidu formula and Xuanfei Baidu formula.Three drugs and three prescriptions were made up of the classical prescriptions,and the total effective rate of Qingfei Paidu decoction was more than 90%.The successful application of this series of prescriptions effectively proved the effectiveness of classical prescriptions in anti-epidemic.In this study,the case was identified as severe COVID-19 of epidemic toxin blocking the lung syndrome,and was treated with modified Maxing Shigan decoction combined with Xiaoxianxiong decoction and Weijing decoction to promote the dispersing function of the lung and relieve cough,clear heat and detoxification throughout the course of the disease.Symptoms such as fatigue,cough and expectoration were significantly relieved,and good results were achieved.[Conclusion]The COVID-19 epidemic is highly consistent with typhoid fever,and“Treatise on Febrile and Miscellaneous Diseases”can guide the prevention and treatment of COVID-19.It is of great significance for the prevention and treatment of infectious diseases with traditional Chinese medicine to explore the therapeutic methods and prescriptions for epidemic diseases in“Treatise on Febrile and Miscellaneous Diseases”.