从《温疫论》探析新型冠状病毒肺炎  

Analysis of COVID-19 from the Theory of Wenyi Lun

作　　者：王宇亮[1] 马利节 钤培国 郭淑云[2] 李墨航[2] WANG Yuliang;MA Lijie;QIAN Peiguo;GUO Shuyun;LI Mohang(The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Hospital of Chinese Medicine,Zhengzhou Henan China 450002;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第二附属医院/河南省中医院,河南郑州450002 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2020年第3期487-489,共3页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(2017JDZX009)。

摘　　要：明代吴又可《温疫论》认为"疫病"是感染杂气所致,首次提出杂气是有别于六淫而具有强烈传染性的、流行时间捉摸不定的外感病邪。强调杂气发病类型为"伏而后发",即杂气为病具有一定的潜伏期。与伤寒六经传变、温病卫气营血及三焦传变不同,吴又可提出杂气为"邪伏膜原,表里分传",即以膜原为中心,而后出表、入里。故治疗疫病既要扶助正气,亦要祛除邪气。祛除杂气以宣通疏利为本,用药上善用走而不守之大黄,而慎用守而不走之黄连等寒凉药物。《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》中医药治疗方案遵循了《温疫论》"邪自窍而入,未有不由窍而出"之治则。Wu Youke′s Wenyi Lun in the Ming Dynasty believed that"epidemic disease"was caused by the infection of miscellaneous qi.It was first proposed that miscellaneous qi was an exogenous disease pathogen with strong infectivity and uncertain epidemic time,which was different from six climatic exopathogens.It emphasized that the pathogenic type of miscellaneous qi was"recumbent and then occur",that is,miscellaneous qi had a certain incubation period.Different from the six meridians transmission of typhoid fever,the Wei Qi Ying Xue and the Sanjiao transmission of febrile diseases,Wu Youke put forward that miscellaneous qi was the"pathogen hidden in Moyuan,respective infection of superficies and interior",that is,taking the Moyuan as the center,and then going out of the surface and into the internal.Therefore,in the treatment of epidemic diseases,we should not only support the healthy qi,but also eliminate the pathogenic qi.To eliminate miscellaneous qi is based on Xuantong Shuli,medication is best to use Dahuang(Radix et Rhizoma Rhei)that penetrates without detention,and cautious to use cold medicine such as Huanglian(Rhizoma Coptidis)that detents without penetrating.Diagnosis and Treatment Plan for corona virus disease 2019(COVID-19)(the Fifth Trial Version)has been followed by the Chinese medicine treatment plan,which is based on the treatment principle of"pathogenic qi coming from the orifices,and also going out of the orifices"in Wenyi Lun.

关 键 词：新型冠状病毒肺炎 《温疫论》 杂气 邪伏膜原 表里分传 

分 类 号：R256.1[医药卫生—中医内科学]