《温疫论》对新型冠状病毒肺炎传变与治法的启示  

Enlightenment of Wenyi Lun on the Transmission and Treatment of COVID-19

作　　者：李亚飞 LI Yafei(School of Chinese Classics,Beijing University of Chinese Medicine,Beijing China 102488)

机构地区：[1]北京中医药大学国学院,北京102488

出　　处：《中医学报》2020年第9期1812-1816,共5页Acta Chinese Medicine

基　　金：中国博士后科学基金面上资助项目(2019M660577)。

摘　　要：《温疫论》认为瘟疫以疫气化热为主,热邪与正气交争于内,使身体出现一片热象。疫气虽有半表半里、传表或传里、表里分传等传变,但治法皆以驱邪外出为本,分别用疏利法、散法、吐法、泻下法、表中里三消等法,邪去则诸兼症自然平复。针对虚实夹杂者,灵活采用攻补兼施法,鼓舞正气祛邪。达原饮、白虎汤、托里举斑汤、大承气汤、三消饮是最常用的方剂。新型冠状病毒肺炎患者既有表证发热、浑身酸痛,又有里证腹胀便秘、胸闷、恶心呕吐等症状,重症则“化热、变燥、伤阴、致瘀、闭脱”,这符合《温疫论》中疫邪多表里分传,邪气郁结化热、伤阴、致瘀、表里之气阻隔的进程。汗法、下法作为“导引其邪打门户而出”的治本法也被一线普遍使用。《温疫论》强调忌用大剂量的黄芩、黄连、黄柏、栀子等寒凉药,一则妄伐脾胃之生气,二则犹“扬汤止沸”。故治疗新型冠状病毒肺炎也不可过用苦寒性滞之药。The plague discussed in Wenyi Lun is mainly about the transformation of heat from the epidemic qi.The heat pathogen and the vital qi contend inside,causing a heat phenomenon in the body.Although the epidemic qi has the nature of half-surface and half-internal transmission,transmission of external or internal transmission,external and internal transmission,etc.,the treatment methods are all based on expelling the epidemic qi out of the body.Respectively use the method of Shuli,dispersing,vomiting,purging,three elimination of surface,middle and inner,etc.,and all the combined symptoms will be eliminated naturally.For those who are mixed with the excess and deficiency,it also flexibly adopts the attacking and supplementing method to invigorate the vital qi and eliminate epidemic qi.Dayuan Yin,Baihu Decoction,Tuoli Juban Decoction,Dachengqi Decoction and Sanxiao Yin are the most commonly used prescriptions.Patients with corona virus diseasa(COVID-19)have symptoms such as fever and body aches,as well as abdominal distension,chest tightness,nausea and vomiting and other symptoms of the internal syndrome.In severe cases,they have the syndromes of"reducing heat,becoming dry,damaging yin,causing stasis,and collapse."This is in line with the process that Wenyi Lun discusses,that is,the epidemic pathogens are transmitted from the outside to the inside,and the pathogenic qi is stagnant to reduce heat,damage yin,cause blood stasis,and block qi between the outside and the inside.Sweeting method and purging method are also commonly used as the fundamental method of"leading th epathogenic qi out of the body through Menhu".Wenyi Lun emphasizes avoiding the use of large doses of cold medicines such as Huanglian(Radix Scutellariae),Huangqin(Rhizoma Coptidis),Huanbo(Phellodendron chinense),Zhizi(Gardenia jasminoides)etc.,one is to avoid damaging the spleen and stomach qi,and the other is to avoid the inability to fundamentally cure the disease.Therefore,the treatment of COVID-19 should not be treated with medicine with the mature of

关 键 词：新型冠状病毒肺炎 《温疫论》 瘟疫传变 疏利法 散法 泻下法 

分 类 号：R256.1[医药卫生—中医内科学]