从国医大师邓铁涛治“非典”经验探讨新型冠状病毒肺炎中医诊疗思路  

Discussion on TCM Diagnosis and Treatment of COVID-19 Based on the Experience of Chinese Medicine Master Deng Tietao in Treating SARS

作　　者：张巍岚 王相东[1] 王郁金[1] 谭从娥[1] ZHANG Weilan;WANG Xiangdong;WANG Yujin;TAN Cong’e(Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712046)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《中医学报》2020年第3期483-486,共4页Acta Chinese Medicine

基　　金：陕西中医药大学科技创新团队项目(2019-QN06)。

摘　　要：新型冠状病毒肺炎的疾病属性为瘟疫毒邪,病因为疠气、邪盛、正虚,病机为寒湿袭肺,郁热化毒,致病因素为寒、湿、热、毒、瘀、虚。治疗当根据具体阶段合理辨证,扶正祛邪,使邪有出路。早期:病机主要为湿邪遏肺、卫气同病,治疗上当以化湿解表退热为主,方选藿香正气散合柴葛解肌汤加减;中期:病机主要为表邪入里化热、邪伏膜原,治疗当以清除里热、邪透膜原,方选三消饮合小柴胡汤加减。极期:病机为邪毒闭肺、内闭外脱,治疗当以解热解毒,宣肺开闭。内闭外脱者应清心开窍、回阳救脱。邪毒闭肺选五虎汤合葶苈大枣泻肺汤;内闭外脱选生脉饮、参附汤配合安宫牛黄丸,结合西医急救治疗效果更佳。恢复期:病机主要为邪去正虚、湿退未尽,治疗当益气扶正、健脾祛湿,方选沙参麦冬汤合参苓白术散加减。The disease attribute of corona virus disease 2019(COVID-19)is plague and toxin.The disease is caused by pestilential qi,excess of pathogenic qi and deficiency of vital qi.The pathogenesis is cold and dampness attacking the lung,and stagnated heat transforming into toxin.The pathogenesis are cold,dampness,heat,poison,stasis and deficiency.The treatment should be based on the reasonable differentiation of symptoms and signs according to the specific stage,strengthening the healthy qi and removing pathogenic factors,so that there is a way out for them.At the early stage of the disease:the pathogenesis of the disease is mainly dampness suppressing the lung and disease involving weifen and qifen.The treatment should be based on eliminating dampness,resolving superficial heat and reducing fever.The prescription of modified Huoxiang Zhengqi Powder combined with Chaige jieji Decoction can be chosen.At the middle stage of the disease:the pathogenesis is mainly the superficies pathogens involving interior and heat-transmission,pathogen hidden in Moyuan.The treatment should be based on removing the internal heat and pathogen removing from Moyuan,and the prescription of Sanxiaoyin and Xiaochaihu Decoction can be chosen.At the critical stage of disease:the pathogenesis of the disease is to close lung blocked by pathogenic toxin,internal blockade and external collapse.The treatment should be clearing heat and removing toxicity,ventilating lung qi and clearing blockade.The patients of internal blockade and external collapse should clear their mind,open their orifices and return yang for rescue.Patients with the lung blocked by pathogenic toxin can be treated by Wuhu Decoction combined with Dingli Dazao Xiefeng Decoction.The patients of internal blockade and external collapse can be treated by Shengmai Yin,Shenfu Decoction combined with Angong Niuhuang Pill.Combining with western medicine,the effect of emergency treatment is better.At the recovery stage of the disease:the main pathogenesis of the disease is that the pathogenic

关 键 词：新型冠状病毒肺炎 非典型性肺炎 邓铁涛 辨证论治 

分 类 号：R256.1[医药卫生—中医内科学]