从“正邪不争”角度探讨新冠肺炎患者核酸检测持续阳性机理及治疗

Discussion on the mechanism and treatment of persistent positive nucleic acid test results in patients with COVID-19 from the perspective of "no struggles between vital qi and pathogenic qi"

长春中医药大学附属医院COVID-19救治专家组针对2022年春吉林省新一轮疫情制定了防控方案,并首次提出部分新冠肺炎患者核酸检测持续阳性问题的治疗策略。本次吉林省疫情属“寒湿疫”范畴,“正邪不争”为患者核酸久不转阴的关键,虚处藏奸,正邪缠绵、相持,导致寒湿疫邪留连不去。具体表现根据感染个体情况发生从化,热化者多为发热过后,气阴两伤,络气不和,寒化者多见脾肾虚冷,疫毒伤络。治疗上扶正与祛邪并举,攻补兼施,寒温并用,借正邪相争之机祛邪外出。

The COVID-19 treatment expert group of the Affiliated Hospital of Changchun University of Chinese Medicine formulated a prevention and control plan for the new round of epidemic in Jilin Province in the spring of 2022, and put forward a treatment strategy for the persistent positive nucleic acid test results in some patients with COVID-19. It is believed that this wave of epidemic in Jilin Province belongs to the category of "cold-damp pestilence" in traditional Chinese medicine, and "no struggles between vital qi and pathogenic qi" is the key to the patients’ nucleic acid test results not turning negative for a long time. Specific manifestations of affected patients differ as a result of various transformations in accord with their individual constitutions. A syndrome of heat transformation mostly occurs in patients after a fever, manifested as an injury of both qi and yin, and a disharmony of collateral qi, while those with a syndrome of cold transformation are mostly manifested as deficient cold in the spleen and kidney, and pestilent toxins impairing collaterals. As for its treatment, it is advised that strengthening the body resistance should be combined with expelling the pathogenic qi, adopting a strategy of practicing reinforcement and elimination in combination by using both cold-and warm-natured herbs, taking advantage of the conflicts between the healthy qi and pathogenic qi to dispel the pathogens.