新型冠状病毒肺炎重症患者临床辨治策略

Clinical Diagnosis and Treatment Strategies for Severe Cases of Coronavirus Disease 2019

新型冠状病毒肺炎(简称“新冠肺炎”)疫情发生以来,中医药全程参与防治工作,尤其在危急重症的诊治过程中彰显出独特优势。总结新冠肺炎临床辨治经验,提出新冠肺炎重症的核心病机为“疫毒留滞,正气不足”,临床以热盛不退、大便秘结、痰黏难咯、神昏不清、水肿难消等为主要症状特征,临床辨治当结合地域、季节、证候特征三因制宜,重视“清、通、托”三法,“一人一策、一人一方”,抓住主要症结,先症而治,截断传变,扭转病势,从而有效控制病情,降低病死率。

Since the outbreak of the coronavirus disease 2019(COVID-19),traditional Chinese medicine(TCM)has participated in the whole process from prevention to treatment,and has shown unique advantages especially in the diagnosis and treatment of severe cases.By summarizing the clinical experience,it is proposed that the core pathogenesis of severe COVID-19 cases is“retention of epidemic toxin and lack of healthy qi”.And the main symptoms are persistent excessive heat,constipation,difficult expectoration of sticking phlegm,confusion and edema.For syndrome differentiation and clinical treatment,there are three considerations of place,season and syndrome,and it is suggested to pay attention to the three methods of“clearing,unblocking and strengthening”,and take the principle of“one person,one strategy;one person,one formula”.The treatment should focus on the main symptoms,be taken before symptoms arising,cut off the transmission and reverse the trend of the disease,so as to control the disease effectively and reduce the mortality.