新型冠状病毒肺炎验案用药规律探析

Analysis and Study of Drug Use Patterns in COVID-19 Treatment Cases

目的探究中医治疗新型冠状病毒肺炎临证的用药特点及组方特征,以期为临床用药提供理论参考,更好地发挥中医药的防治优势。方法检索并整理中医药治疗新型冠状病毒肺炎相关临证经验、验案等文献,采用Excel2016建立数据表,运用医案大数据分析系统,对症状、辨证、单味药、剂量区间、药物组合等进行频次及关联分析,并对结果进行分析讨论。结果共收集到中医治疗新型冠状病毒肺炎的验案77则,涉及中药121味;高频药物有黄芩、甘草、柴胡、法半夏、麻黄等;核心药物组合有法半夏-柴胡-黄芩、白芍-柴胡-黄芩、枳实-生姜-黄芩、金银花-黄芩-甘草等。结论中医治疗新型冠状病毒肺炎的核心药物组合为麻杏石甘汤、达原饮以及藿朴夏苓汤的加减,治则上以扶正透邪、疏肝健脾、宣肺祛湿等法为主,重祛邪、防传变;但临证中还需兼顾其可能伤气、伤阴、结瘀等病机特点,适当佐以温阳补气、滋阴润燥之品,以防伤阴损阳、疫毒入血的重症转变。

Objective To explore the characteristics of TCM in the treatment of COVID-19 clinical symptoms and prescription formulation,so as to provide theoretical reference for clinical medication and give better play to the prevention and treatment advantages of TCM.Methods Clinical experience and cases related to the treatment of covid-19 with traditional Chinese medicine were searched and sorted out.Excel2016 was used to establish a data table,and the medical case big data analysis system was used to analyze the frequency and correlation of symptoms,syndrome differentiation,single drug,dose interval and drug combination,and the results were analyzed and discussed.Results A total of 77 cases of COVID-19 treatment with traditional Chinese medicine were collected,involving 121 Chinese herbs.High frequency herbs included Radix Scutellariae,Radix Glycyrrhizae,Radix Bupleuri,Rhizoma Pinelliae Preparatum,etc.The core herb combinations include Rhizoma Pinelliae Preparatum-Radix Bupleuri-Radix Scutellariae,Radix Paeoniae Alba-Radix Bupleuri-Radix.Scutellariae,Fructus Aurantii Immaturus-Rhizoma Zingiberis Recens-Radix Scutellariae,Jinyinhua-Radix Scutellariae-Radix Glycyrrhizae,etc.Conclusion The core herb combination of TCM for COVID-19 treatment is the modified Maxing Shigan Decoction,Dayuan Decoction and Huopu Xialing Decoction.The treatment is mainly based on the methods of strengthening the right to dispel pathogenic factors,soothing the liver and strengthening the spleen,and propagating clearing damp for the lungs.