基于《北京市新型冠状病毒感染中医药诊疗方案(试行第七版)》谈本病病因病机与辨治原则

Discussion on etiology,pathogenesis and principles of differentiation and treatment of COVID-19 based on the Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 of Beijing(the Seventh Trial Edition)

新型冠状病毒(简称“新冠”)感染严重威胁人民健康,影响社会经济的发展。中医药在防治该病中具有一定优势,本文旨在基于《北京市新型冠状病毒感染中医药诊疗方案(试行第七版)》详细论述该病病因病机与辨治原则。新冠感染属于中医“瘟疫”范畴,其病因具有综合性,新冠病毒是主要致病因素,而气候、季节等外界环境因素与个人体质是影响疾病发生的重要因素。新冠感染以湿毒郁阻为核心病机,受气候地域、个人体质、治疗等因素影响,不同人群感邪后疾病发生、传变与预后特点往往不同。在辨病机时,应从病性、病所、病势、病期、病理角度综合分析。新冠感染诊疗应坚持“一病一方”与“一人一方”结合的基本策略,以及早治疗、重祛邪、顾正气、防传变的4个基本原则。

COVID-19 has seriously threatened people’s health as well as social and economic development.Traditional Chinese medicine has certain advantages in the prevention and treatment of the disease.This article discusses the etiology,pathogenesis and principles of differentiation and treatment of COVID-19 in detail based on the Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 of Beijing(the seventh Trial Edition).According to traditional Chinese medicine(TCM),COVID-19 belongs to the category of“pestilence”.The etiology of COVID-19 infection is comprehensive.2019 novel coronavirus(SARS-CoV-2)is the main pathogenic factor.While climate,season and other external environmental factors and personal constitutions are important factors affecting the occurrence of the disease.The core pathogenesis of COVID-19 is dampness toxin stagnation.Influenced by climate,location,individual constitutions,treatment and other factors,the characteristics of disease transmission and prognosis are often different among various population groups.When identifying the pathogenesis,a comprehensive analysis should be made from the perspectives of disease nature,location,tendency,duration,and pathology.The diagnosis and treatment of COVID-19 should adhere to the basic strategy of combining“one formula for one disease”and“one formula for one person”.The four basic principles of treatment are early treatment,eliminating evil,replenishing healthy qi,and prevention of progress of disease.