芳香类中药防治新型冠状病毒感染思路探微

Discussion on aromatic TCM medicines in the prevention and treatment of COVID-19

新型冠状病毒感染(Corona Virus Disease 2019,COVID-19)当属中医学“疫病”范畴,病位主要在肺脾,正气不足为内在因素,“湿毒秽浊”为外在病因,病机特点为“湿、热、毒、瘀、虚”。中医药防治COVID-19有独特的优势,其中芳香类中药显示出了较大的应用潜力。芳香类中药因其气味芳香的特性,具有避秽扶正、解表行气、祛湿和胃、开窍醒神、透络活血等多方面的功效,因而在COVID-19的预防及治疗阶段得以广泛应用。内服及外用芳香类中药具有突出且确实的疗效,其作用的多环节、多因素、多途径既显示了中医辨证论治的特点,又体现了“治未病”及“内病外治”的思想。文章以温病理论为指导,提出芳香类中药防治COVID-19的作用机制及理论依据,研究临证应用思路及策略。诊疗过程中要重视“祛湿、透邪”,明辨湿邪寒热性质,恰当使用芳香类药物;辨明湿与温之孰轻孰重,重视因势利导,透邪外出;辨病位,即邪在上中下三焦所属的部位,注重脏腑功能和三焦气机;最后还要辨卫气营血浅深层次,采用芳香类中药干预COVID-19的发生发展。总之,文章旨在通过探讨COVID-19的证候及传变规律,继承发挥古人运用芳香药的治病理论,筛选防治疫病的芳香方药,灵活应用防疫剂型,为临床治疗COVID-19等感染性疾病提供新的思路和方法。

COVID-19 belongs to the category of“epidemic”in TCM,the disease location is mainly in the lungs and spleen,the lack of healthy Qi(气)is an internal factor,“wet poison and turbid pathogen”is the external cause,and the disease mechanism is characterized by“dampness,heat,toxic,blood stasis,deficiency”.Traditional Chinese medicine has unique advantages in the prevention and treatment of COVID-19,among which aromatic TCM medicine has shown great application potential.Because of its aromatic properties,aromatic TCM medicine has many effects such as eliminating turbid pathogen and strengthening vital Qi,resolving exterior and activating Qi,removing dampness for regulating stomach,resuscitation with aromatics,dredging channels and promoting blood circulation and etc.So it has been widely used in the prevention and treatment stage of COVID-19.It can be applied for internal and external use,which has outstanding and definite curative effects,and the multi-link,multi-factor and multi-channel effects not only show the characteristics of TCM differentiation and treatment,but also embody the ideas of“treating diseases before they occur”and“treating internal diseases externally”.Guided by the theory of epidemic febrile disease,the paper proposes the mechanism and theoretical basis of aromatic TCM medicine in the prevention and treatment of COVID-19,and studies the application ideas and strategies of clinical evidence.It is proposed that in the process of diagnosis and treatment,attention should be paid to“removing dampness and penetrating evil spirits”.It is necessary to distinguish the nature of dampness,evil cold and heat,and use aromatic drugs appropriately.Distinguishing dampness and warmth is of importance,importance is attached to the treatment based on the actual condition and the pathogens are driven away.Differentiation is made to distinguish the disease position,that is,the part where the evil belongs in the triple energizer,and pay attention to the function of the internal organs and Qi movement of triple energizer;Finally,it is necessary to identify the shallow and deep levels of Wei-Qi-Ying-Xue(卫气营血),and use aromatic TCM medicine to intervene in the occurrence and development of COVID-19.In a word,the paper aims to explore the symptoms and transmission laws of COVID-19,inherit the ancient theories of using aromatic TCM medicines,screen aromatic prescriptions for epidemic prevention and control,and flexibly apply epidemic prevention dosage forms,so as to provide new ideas and methods for the clinical treatment of infectious diseases such as COVID-19.