辨治新型冠状病毒感染验案八则

Eight cases of diagnosis and treatment of novel coronavirus infection

新型冠状病毒感染具有强烈的传染性和流行性,属于中医“疫病”范畴。几千年来,中医通过不断的临床实践,对“疫病”的认识逐渐系统化,并积累了丰富的诊治经验。文献记载显示,在我国历史上多次发生过较大规模的“疫病”,中医在历次疫病防治中均发挥了重要的作用,为中华民族的繁衍作出了不可磨灭的贡献。新型冠状病毒感染虽然是近年出现的新病种,但中医通过辨证论治可以达到“以不变应万变”的效果。笔者回顾了自己采用互联网诊治的新型冠状病毒感染病例,提出感染初期多为风寒束表,治疗应祛风散寒、发汗解表;若治疗不当,余邪未尽可入里化热伤津,应疏风透邪,清热利咽,养阴生津;进一步发展可出现肺热壅盛,痰热内蕴,燥热伤阴,应采用清肺化痰,降气止咳,养阴利咽之法;热退后患者多见气阴两虚,脾胃虚弱,痰湿内停诸证,应根据患者具体情况采用益气养阴,健脾和胃,化痰利湿等法,随证治之。笔者列举了8则新型冠状病毒感染的典型病例,简要分析了各病例的诊治过程,进一步佐证了笔者前面提出的诊疗思路,并强调中医药治疗新型冠状病毒感染可有效缓解患者症状,减少高危人群发生重症的概率,取效的关键在于辨清各期的病因、病位、病性辨证施治。

COVID-19 is highly infectious and epidemic,which belongs to the category of epidemic disease in traditional Chinese medicine(TCM).For several thousand years,through continuous clinical practice,TCM has gradually systematized its understanding of“epidemic diseases”and accumulated rich experience in the diagnosis and treatment.Literature records show that there have been several episodes of large-scale“pandemic”in the history of our country.TCM has played an important role in the prevention and control of these epidemics and made indelible contributions to the prosperity of the Chinese nation.Although novel coronavirus infection is a new disease in recent years,but TCM is able to deal with change through differential diagnosis and treatment.The author reviews the cases of COVID-19 treated in traditional Chinese medicine,notes that the syndrome is superficies tightened by wind-cold in the early stage of infection,sweating therapy should be given to dispel the wind-cold.If it is not properly treated,the residual pathogens will enter the body and generate heat and damage body fluid,and the treatment should be adopted for dispelling wind to relieve superficies syndrome,clearing heat for relieving sore throat,nourishing Yin(阴)and promoting fluid production.If the condition progresses,the lungs may be backpacked heavily with heat,phlegm-heat blocking internally,and Yin will be injured by dryness-heat.The treatment consists of clearing lung-heat for removing phlegm,lowering adverse Qi(气)for arresting cough,nourishing Yin for relieving sore throat.After the remission of fever,patients often have deficiencies of Qi and Yin,deficiencies of spleen Qi and stomach Qi,and internal stagnation of phlegm-dampness,and differentiation treatment should be adopted according to the patient’s specific conditions,such as methods of benefiting Qi and nourishing Yin,strengthening spleen and harmonizing stomach,removing phlegm and promoting diuresis.The author cites eight typical cases of novel coronavirus infection,gives a brief analysis of the diagnostic and therapeutic procedures for each case,and further supports the author’s previous diagnostic and therapeutic approaches.The author emphasizes that TCM treatment of COVID-19 is effective on relieving symptoms and reducing the incidence of severe disease in high-risk populations,and the key to success lies in identifying the etiology,location and pathogenesis of each period and giving treatment based on syndrome differentiation.