从湿毒探讨新型冠状病毒感染后嗅觉障碍

Exploring Olfactory Disturbances after SARS-CoV-2 Infection from Damp-Toxin

严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染后常出现嗅觉障碍,是感染者早期临床表现之一,现已作为检测感染的首发症状,属于上呼吸道病毒感染后嗅觉障碍(PVOD)。从患病率、性别、地域、康复率、不同变异体等方面探讨SARS-CoV-2引起的PVOD发病特征,其发病机制主要为SARS-CoV-2直接损伤嗅上皮或鼻腔黏膜肿胀导致的传导性嗅觉障碍。中医认为SARS-CoV-2感染属“湿毒疫”范畴,SARS-CoV-2感染所致PVOD多因湿毒外袭,鼻窍不利;湿毒窜行,袭扰三焦;湿毒伤络,浊邪害清所致。治疗上外用芳香开窍避秽;内服化湿解毒,行气通窍为治则。从湿毒探讨SARS-CoV-2感染所致PVOD,旨在为患者提供中医诊疗思路。

Olfactory disturbance is often seen afterSARS-CoV-2 infection, as one of the early clinical manifestations in infected patients, and is now used as the first symptom to detect infection as part of infection of the upper respiratory tract with postviral olfactory disturbance(PVOD).The pathogenetic characteristics of PVOD caused by SARS-CoV-2 were explored in terms of prevalence, gender, geography, recovery rate and different variants. The pathogenesis is mainly due to conductive olfactory impairment caused by direct damage to the olfactory epithelium or swelling of the nasal mucosa by SARS-CoV-2.Traditional Chinese medicine considers SARS-CoV-2 infection to be a "damp-toxin epidemic". SARS-CoV-2 infection caused by PVOD is due to damp-toxin attacking andnasal obstructing, damp-toxindisturbing triple-Jiao, damp-toxin damaging collaterals and turbid evil invading the clear orifices.The treatment includes external use of aromatic drugs to avoid filth and opening the orifices, internal use of eliminating dampness and relieving toxin, promoting Qi movement and opening the orifices.It explored PVOD caused by SARS-CoV-2 infection from the perspective of damp-toxin, so as to provide the patients with TCM diagnosis and treatment ideas.