基于古今文献和新冠皮肤病变探讨现代中医疫疹内涵

Discussion on the Connotation of Epidemic Eruption in Modern Chinese Medicine Based on Ancient and Modern Literature and COVID-19

[目的]探讨现代中医疫疹的内涵。[方法]研读古今疫疹相关文献,参考新型冠状病毒肺炎(以下简称新冠)皮肤病变的国内外临床报道,分析传统疫疹在概念认识上存在的争议与不足,提出现代中医疫疹的新定义;通过对传统疫疹和新冠疫疹的表征、病性进行比较,分析疫疹的皮损表现和疾病属性。[结果]现代中医疫疹已突破传统疫疹的概念范畴,系由疫疠毒邪所致,具有皮肤、黏膜损害表现的一类疫病的总称。疫疹之“疹”不仅限于“斑”和“疹”,应扩充包含疮、痘、痧、疱、疡、痂、浆、脓、溃烂等中医皮损,以及斑块、疱疹、结节、囊肿、鳞屑、色沉、苔藓样变等现代医学的皮损表现。新冠疫疹即包括假冻疮样、荨麻疹样、囊泡样、紫癜样皮损等复杂的皮肤病变,症状不拘于发热,印证了疫疹的病性并非绝对属热,尚有寒、湿、燥之性。[结论]疫疹的表征和病性在本质上是机体感受疠气的外象和表观反映。重新审视疫疹的内涵,借助多学科交叉融合研究,有助于建构富有中医特色的现代疫疹辨治体系,从而进一步指导临床和科研工作。

[Objective]To explore the connotation of epidemic eruption in modern Chinese medicine.[Methods]Based on the relevant literature concerning ancient and modern epidemic eruption,this paper analyzed the controversies and deficiencies in the traditional understanding of the concept of epidemic eruption while referring to the domestic and foreign clinical reports of skin lesions of Coronavirus Disease 2019(COVID-19),and proposed a relatively new definition of epidemic eruption in modern Chinese medicine.Meanwhile,this paper differentiated the characterization and nature of traditional epidemic eruption and COVID-19,and analyzed the skin lesions and disease attributions.[Results]Epidemic eruption has broken through the traditional concept clinically in modern Chinese medicine;Instead,it is a general term for a class of contagious diseases caused by the epidemic pathogen,which could damage skin and mucous membranes.The“eruption”of epidemic eruption is not limited to“spots”and“rashes”,but should be expanded to include sores,pox,sha,blisters,ulcers,scabs,pulp,pus,fester,and other Chinese medicine skin lesions,as well as modern medicine skin lesions such as plaques,herpes,nodules,cysts,scales,hyperpigmentation and lichenification.For instance,COVID-19 includes complex skin lesions such as pseudo-chilblain,urticaria,vesicles and purpura.What‘s more,the disease is not necessarily accompanied by fever,which indicates the nature of epidemic eruption are not absolutely hot,but also is cold,damp and dry.[Conclusion]The characterization and nature of epidemic eruption are essentially the external image and apparent reflection of the body‘s feeling of the epidemic pathogen.By means of re-examining the connotation of epidemic eruption and using the multi-disciplinary cross fusion research,it is helpful to construct a modern syndrome differentiation and treatment system full of traditional Chinese medicine characteristics,so as to further guide clinical and scientific research.