从宣、清、和、化角度探讨COVID-19的中医药防治策略  

Discussion on the Prevention and Treatment Strategy of COVID-19 in Chinese Medicine from the Perspective of Xuan,Qing,He and Hua

作　　者：周芳[1,2] 蔡威[1] 李旭成 张栋[1] 周勇[1] 张彩蝶[1] ZHOU Fang;CAI Wei;LI Xucheng;ZHANG Dong;ZHOU Yong;ZHANG Caidie(Wuhan Hospital of Chinese Medicine,Wuhan Hubei China 430014;Hubei University of Chinese Medicine,Hubei Wuhan China 430065)

机构地区：[1]武汉市中医医院,湖北武汉430014 [2]湖北中医药大学,湖北武汉430065

出　　处：《中医学报》2020年第7期1362-1366,共5页Acta Chinese Medicine

基　　金：国家科技应急攻关项目(2020YFC0841600);武汉市科技局新冠肺炎应急攻关项目(2020020201010017)。

摘　　要：新型冠状病毒肺炎(corona virus disease 2019,COVID-19)应归为肺系疫病中"湿毒疫"范畴。疫戾毒邪是COVID-19发病的主要原因,"湿邪"为发病的外在条件,正气不足是发病的内在因素。疫戾毒邪与六淫邪气挟杂形成湿毒邪气以致病,湿毒之邪致病初起以呼吸道症状为主,但尚无明显气血阴阳、寒热虚实之分。初期,湿毒困表,营卫失调,病位在表在卫气分;病至中后期,邪毒壅肺,肺失宣降,肾不纳气,湿毒困脾,脾失健运,病位在肺、脾、肾三脏。若遇素有伏邪,正气本虚,则易邪毒内陷,变生厥脱,并容易导致痰饮、瘀血等病理产物蓄积,病入营血分。对于COVID-19的防治,始终强调早期中医药干预,防止病情向危重症转化。宣清和化方主要用于COVID-19医学观察期和临床治疗期中的轻型、普通型发热患者,临床疗效评价主要从患者体温降低、咳嗽症状缓解、乏力症状减轻、胃肠道症状改善、病程缩短等几个方面综合评价。全方采用"宣透达表法""清热解毒法""表里和解法""辟秽化浊法"四法联用,扶正与祛邪相结合,使表里双解,患者病程缩短、发热及胃肠道症状明显改善,可有效预防患者向重型及危重型发展。The corona virus disease 2019(COVID-19)should be classified as the category of damp toxin pathogen in lung disease.The main cause of the disease of COVID-19 is the disease of toxin pathogen,the external condition of the disease is dampness,and the internal factor of the disease is lack of healthy qi.The pathogenic factors of dampness and toxin and the pathogenic factors of six pathogenic qi are mixed with each other to form the pathogenic factors of dampness and poison,thus causing diseases.At the beginning of the disease,respiratory symptoms are the main pathogenic factors,but there is no obvious difference between qi,blood,yin,yang,cold,heat,deficiency and excess.At the early stage of the disease,dampness and toxin are trapped in the surface,and yingfen and weifen are disharmonizing.The disease is located at the surface of weifen.In the middle and late stage of the disease,the pathogenic toxin blocked the lung,The lung fails both dispersing and decending,the kidney fails to promote inspiration,the dampness toxin is trapped the spleen,the spleen loses its function in transportation,and the disease is located in the lung,spleen and kidney.If there are always pathogenic factors and the vital qi is deficient,it is easy for the pathogenic toxin to sink in and become reversal desertion,and it is easy to cause the accumulation of pathological pathogens such as phlegm,blood stasis and so on,and the disease will enter the Xuefen.For the prevention and treatment of COVID-19,early intervention of Chinese medicine is always emphasized to prevent and treat the disease from turning into critical disease.Xuanqing Hehua Prescription is mainly used in the light and common fever patients in the observation period and clinical treatment period of COVID-19.The clinical efficacy evaluation mainly includes the comprehensive evaluation of the patients'hypothermia,the relief of cough symptoms,the relief of asthenia symptoms,the improvement of gastrointestinal symptoms,and the shortening of the course of disease.The four methods of"Xua

关 键 词：新型冠状病毒肺炎 宣清和化方 小柴胡汤 银翘散 宣透达表法 清热解毒法 表里和解法 辟秽化浊法 

分 类 号：R256.1[医药卫生—中医内科学]