中西医结合治疗长期生存心脏移植患者合并新型冠状病毒感染(重型)1例

Traditional Chinese Medicine Combined with Conventional Medicine Treatment for a Long-Term Survivor of Heart Transplant with Severe COVID-19:A Case Report

报告1例长期生存心脏移植患者合并新型冠状病毒感染(重型)的中西医结合治疗过程。患者治疗中始终予西医积极对症治疗,中医药治疗历经益气补中、健脾化痰,通阳散结、祛湿化痰、活血化瘀,最终以回阳救逆、化痰利水、活血通络为主要治则,予破格子龙宣白承气汤加减收功。总结治疗经验,免疫抗排斥方案的及时调整、以抗新型冠状病毒为主导的多种抗感染药物联合运用、心肾功能保护以及中医药的联合使用,在整个治疗过程中发挥了重要作用。因病例罕见,其中医辨证诊治及中医药使用、免疫抑制剂的启动时机及后续监测思路值得借鉴。

We report a case of a long-term survivor of heart transplant who developed severe coronavirus disease 2019(COVID-19)and was treated with a traditional Chinese medicine combined with conventional medicine.Throughout the treatment,the patient received active conventional medical treatment,and traditional Chinese medi?cine interventions included tonifying qi,invigorating the spleen and transforming phlegm,promoting yang and elimi?nating stagnation,resolving dampness and dissipating phlegm,and promoting blood circulation and eliminating stasis.The main therapeutic principles adopted were to recuperating depleted yang and rescuing the patient from collapse and to resolve phlegm and promote water.Pogezilong Xuanbai Chengqi Decoction(破格子龙宣白承气汤)with modifications was administered.In summary,it is crucial to the timely adjust the immunosuppressive regimen,combine use of various anti-infective agents with a focus on COVID-19,to protect of cardiac and renal function,and to integrate traditional Chinese medicine in the entire treatment process.As this case is rare,the diagnostic and therapeutic methods in traditional Chinese medicine,the use of immunosuppressive agents,and follow-up monitoring strategies can be a valuable reference.