65例非典型肺炎中医证候及病因病机探讨

Discussion on Symptoms, Pathogens and Pathogenesis of 65 SARS Cases by TCM Theory

在观察 6 5例非典型肺炎 (SARS)患者症状基础上 ,对该病的病因病机进行了探讨分析。将SARS命名为肺瘟疫 ;疫疠之气、湿热之邪为致病之因 ;肺气郁闭为病变关键 ;首发气分 ,易入营血 ,逆传心包 ;湿浊瘀阻、气阴亏虚为病变结果。高热期邪热炽盛突出 ,喘憋期湿浊闭肺突出 ,后期气阴亏虚突出 ,标本虚实中各有侧重。由于西医使用大量激素治疗该病 ,所以即使在该病的恢复期 ,许多患者也表现出热盛湿阻的证候 ,故治疗时应强调在固护气阴的基础上注意清热宣肺、化浊通络。

The paper had discussed and analyzed the pathogens and pathogenesis of SARS on the observation of 65 cases. SARS was named lung pestilence by TCM theory. The pathogens of SARS were plague and damp-heat evil. The key of SARS pathogenesis was closure of lung-qi. The disease attacked the qi phase at first, then nutrient and blood phases and finally transmitted to the pericardium reversely. The stagnation of damp turgidity and insufficiency of qi and ying were the results of the disease. In the high fever stage of SARS evil-heat was exuberant; the asthma stage, the lung was stagnated by damp turbidity; and the later stage, the insufficiency of qi and ying was the most important symptom. Because of the large dose of hormones were applied at the treatment of SARS by western medical physicians, many cases had the symptoms of exuberant heat and obstructive damp even in their convalescences. So the treatment of SARS with TCM should be stressed on clearing away heat and dispersing lung, resolving dampness and dredging collaterals on the basis of reinforcing qi and ying.