加味小承气汤治疗新型冠状病毒肺炎个案报道

Case Report of Modified Xiaochengqi Decoction(加味小承气汤) in Treatment of COVID-19

中医药治疗新型冠状病毒肺炎疗效明显。结合案例介绍了加味小承气汤治疗新型冠状病毒肺炎,获得满意效果,并进一步指出:1.《伤寒论》治疗温病发热时,以承气汤类方为主方,吴有性所推崇的“疫病下不厌早”的观点更是与承气法一脉相承。2.阳明胃经为疫邪盘桓之所,初始阶段与伤寒皆凛凛恶寒,随后即发热而不恶寒,是为疫邪转入阳明。治疗新冠病毒肺炎,应从阳明入手,逐邪外出,安未受邪之地。3.疫病的预后和转归分为病“从外解者”或病“从内陷者”两种途径,新冠肺炎病毒也遵循这一规律,感受疫邪轻浅、症状较轻的新冠肺炎患者常可以从外解而易愈;而感受疫邪较深、发热重、并伴有多种兼症的患者,常常出现疫邪内陷,需以承气汤祛邪外出。4.结合本地自然气候环境及生活饮食习惯,采用祛湿泄热之法,加入适合患者个人体质特点的药物进行治疗。5.新冠病毒肺炎的主要病机是邪实正虚,临床紧紧抓住祛邪这一根本治法,兼顾正气,则新冠病毒终不能久居人体,提升免疫力是防护新冠肺炎的有效手段。6.新冠肺炎患者兼有旧病时,应抓住新冠肺炎(疫邪)这个主病(证),只要“疫邪”这个主要矛盾还在,就应以治疫为主,治疗兼证和旧病为辅。

Traditional Chinese medicine has obvious curative effect on COVID-19.This article introduces the effect of Modified Xiaochengqi Decoction(加味小承气汤)in the treatment of COVID-19 with a case study,and further points out the followings.1.In Treatise On Febrile Diseases,the treatment of febrile diseases is mainly based on Chengqi Decoction(承气汤).WU Youxing’s highly praised idea of“purging early for epidemic diseases”is the same as that of Chengqi method.2.Yangming stomach meridian is the place where epidemic evil lingers.In the initial stage,both epidemic diseases and febrile diseases are aversion to cold,and then fever instead of cold is the reason why epidemic evil turns into Yangming.To treat COVID-19,we should start with Yangming and let the evils go out.3.The transformation law of the febrile diseases can be divided into two ways:“treatment from the external”or“evils trapping internally”.COVID-19 also follows this rule.Patients with COVID-19who feel mild pathogenic factors and mild symptoms can often be easily cured from the external.The patients who feel the deep pathogenic factors,have severe fever and are accompanied by many concurrent diseases often have the depression of pathogenic factors,need Chengqi Decoction.4.Combined with the local natural climate environment and living and eating habits,the method of removing dampness and heat is adopted,and drugs suitable for the patients’physical characteristics are added for treatment.5.The main pathogenesis of COVID-19 is the vital Qi deficiency and excess evils.The clinical treatment of the disease is based on the basic treatment of dispelling evils,giving consideration to the vital Qi.And then the virus can not be in the body for long.It is an effective way to treat COVID-19 by improving immunity.The main reason for the disease is COVID-19.6.COVID-19 Patients who have other old diseases,the treatment should grasp the main disease(syndrome)which is COVID-19.If the main contradiction of“epidemic evil”is still in existence,the main treatment is to treat the epidemic evil,assisted by the treatment of the old diseases.