基于防治方案探讨儿童新型冠状病毒肺炎中医药防治策略

Discussion on TCM Prevention and Treatment Strategies in Children with Pediatric COVID-19 Based on Prevention and Treatment Scheme

新型冠状病毒肺炎以"湿毒疫气"为主要致病因素,病位在肺,与脾胃相关,预防策略以"调体防病"为主。治疗方案以"分期论治"为主。医学观察期主要临床表现为乏力,清热化湿为治,用药如小儿清热利肺口服液、藿香正气口服液、清热化湿口服液等;早期患儿初感外邪,病在肺卫,临床症状较轻,治疗当宣肺解表透邪,予金不换正气散、银翘散合霍朴夏苓汤或连朴饮加减;中期湿毒之邪入里化热,肺气郁闭,气机失调,辨证属湿热蕴肺,治以清肺开闭,解毒化湿,方用麻杏石甘汤合三仁汤加减;重症期,因小儿稚阴稚阳之体,御邪能力较弱,湿毒疫疠之气侵袭极易传变,易出现内闭外脱之证,表现为呼吸困难,神昏,烦躁,汗出肢冷,舌质紫暗,苔厚腻或燥,脉浮大无根,指纹青紫可达命关,方用参附汤合安宫牛黄丸、苏合香丸加减;疾病后期,余邪留恋,正气未复,易伤气伤阴,故临床以气虚证和阴虚证为主,治疗当益气养阴,方用六君子汤、玉屏风散加减。

The corona virus disease 2019(COVID-19)takes"Dampness Toxin and Epidemic Qi"as the main pathogenic factors.The disease is located in the lungs and is related to the spleen and stomach.The prevention strategy is mainly"to regulate body and prevent disease".The treatment plan is mainly based on"treatment by stages".During the medical observation period,the main clinical manifestations are fatigue,and clearing away Heat and removing Dampness are used in treatment.Prescriptions like Xiaoer Qingre Lifei Oral Liquid,Huoxiang Zhengqi Oral Liquid and Qingre Huashi Oral Liquid are usually used in clinics.In the early stage,the children were firstly exposed to external pathogens,and the disease was in the lung,with mild clinical symptoms.The treatment should be to clarify the lungs to relieve the pathogens,and modified Jinbuhuan Zhengqi Powder,Yinqiao Powder,Huopo Xialing Decoction or Lianpo Drink can be used.In the middle stage,the Dampness Toxin enters the interior to dissipate Heat,the lung Qi is stagnated,which leads to the Qi imbalance.The syndrome is Damp-heat accumulating in the lung.The treatment is to clear the lung and encourage sweat,so as to detoxify and dissipate Dampness.In this occasion,Maxing Shigan Decoction and Sanren Decoction can be used.In the severe stage,because the child is immature in both yin and yang aspect,the inner strength to defend against evil factor is not strong enough.Besides,when the Damp Toxin invades and injures the body,it is easy to show signs of internal closure and external loss of yang Qi,which are manifested as breathing difficulties,dizziness,and irritability,sweating with cold limbs,dark purple tongue,thick and greasy or dry tougue moss,floating pulse without root,and bruising fingerprints that reaches Mingguan.The prescriptions used are modified Shenfu Decoction,Angong Niuhuang Pills and Suhexiang Pills.In the later stage of the disease,with certain evil factors left and being short of Zheng Qi,it is easy to hurt Qi and Yin.Therefore,the clinical treatment is mainly based on Qi deficiency and Yin deficiency.The treatment is to benefit Qi and nourish yin,and modified Liujunzi Decoction and Yupingfeng Powder are often used.