聚焦核心病机的新型冠状病毒感染中医证治研究与展望

Research and prospect of traditional Chinese medicine syndrome treatment of coronavirus disease infection focusing on core pathogenesis

新型冠状病毒(新冠病毒)感染属于中医学“疫病”或“瘟疫”范畴。尽管目前新冠病毒毒株不断变异,症状表现变化多端,但根据其临床特点,可聚焦“实性”“虚性”和“虚实夹杂”几种核心病机来认识新冠病毒感染。新冠病毒感染的实性病机包括热毒内盛、阳明热盛、湿浊酿毒等;虚性病机包括气血亏虚、肺脾素虚等;虚实夹杂病机包括津枯邪滞、邪热内盛兼津血内伤以及疫病虽愈,伏热内闭等。基于核心病机认识,新冠病毒感染的潜伏期可用连花清瘟胶囊、金花清感颗粒;轻型、普通型可选用清肺排毒汤、宣肺败毒方;重型、危重型选用血必净注射液、化湿败毒方、清肺排毒汤。近3年来的临床实践证明,中西医结合、优势互补是新冠病毒感染防治的最佳方案,中医中药在“疫病”的理论与实践中凸显出重要作用,中医药的分期辨证论治方案亦可为应对不断变异的新冠病毒感染的临床救治工作提供强有力的依据。

Coronavirus disease infection belongs to the range of"epidemic disease"or"plague"in traditional Chinese medicine.Although the current strain of coronavirus disease is constantly mutating and its symptoms are varied,according to its clinical characteristics,three core pathogenesis can be focused on"excess","deficiency"and"deficiency and excess"to recognize the disease.The excessive pathogenesis includes heat toxin,intense heat of Yang Ming,damp toxin,etc;while deficient pathogenesis includes deficiency of qi and blood,deficiency of lung and spleen,etc.Pathogenesis of deficiency complicated with excessive syndrome includes dryness of thin fluid and stagnation of heat toxin,internal injury of thin fluid and blood,and internal heat during phases of healing,etc.Based on the understanding of the core pathogenesis,Lianhua Qingwen capsules and Jinhua Qinggan granules can be used during the incubation period.Qingfei Paidu decoction and Xuanfei Baidu decoction can be used with mild and common types.Xuebijing injection,Huashi Baidu Formula,and Qingfei Paidu decoction can be used with severe and critical types.The clinical practice in the past 3 years has proved that the combination of traditional and western medicine and the complementary advantages are the best plan for the prevention and treatment of coronavirus disease infection.Traditional Chinese medicine has played an important role in the theory and practice of epidemic disease,and the treatment plan based on syndrome differentiation by stages of traditional Chinese medicine can also provide a strong basis for the clinical practice of the constantly mutating coronavirus disease infection.