新型冠状病毒肺炎“肺络郁闭”病机阐微  

The Pathogenesis of COVID-19"Lung Collaterals Stagnation"

作　　者：张明远 许二平[1] 李亚南[1] 高鹏[1] ZHANG Mingyuan;XU Erping;LI Yanan;GAO Peng(Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046

出　　处：《中医学报》2020年第9期1826-1830,共5页Acta Chinese Medicine

基　　金：教育部人文社会科学研究规划项目(12YJAZH171);河南省中医药科学研究专项课题项目(2019ZY1019);河南中医药大学科研创新项目(2018CXCY01,2019SHDY001)。

摘　　要：新型冠状病毒肺炎在病理演变过程中,普遍存在“肺络郁闭”的病理变化。也正是由于病邪及其病理产物郁闭肺络,严重影响“肺主气司呼吸”的功能,从而出现呼吸困难或低氧血症,甚则发展为急性呼吸窘迫综合征,导致多脏器功能受损而危及患者生命。在新型冠状病毒肺炎发展的不同阶段,导致“肺络郁闭”的病因和机理各有不同。病变初期处于标实阶段,多为寒湿夹热损伤肺络;后期进入传变阶段,主要为疫毒陷肺;恢复期病机本质为本虚,主要为气阴亏虚所致。“肺络郁闭”的治疗可以“通”为用,内外同治。内治法以解毒通络为纲,用药包括辛味通络、虫藤通络、祛邪通络和补益通络四大特点;外治法主要对内治法起辅助作用,提高协同功效,主要包括针灸、推拿、艾灸、穴位敷贴、功法等。During the pathological evolution of corona virus diseasa(COVID-19),pathological changes of"lung collaterals stagnation"are common.It is because of pathogens and their pathological products that block the lung collaterals,which seriously affects the functionof"lungs governing qi and breathing",resulting in dyspnea or hypoxemia,and even acute respiratory distress syndrome,leading to the damage of multiple organs and endangering the life of the patient.At different stages of the development of COVID-19,the causes and mechanisms of"lung collaterals stagnation"are different.In the early stage,the pathogenesis is in excess,which is mainly cold-dampness together with heat damaging the lungs;in the later stage,it changes into the transformation stage,and the main pathogenesis is the epidemic trapped in lungs;during the recovery stage of the disease,the essence of the patho-genesis is deficiency,mainly caused by deficiency of qi and yin.The method of"removing obstruction"can be used in the treatment of"lung collaterals stagnation".The internal treatment method and external treatment method can be used at the same time.The in-ternal treatment method is based on detoxification and dredging collaterals,and the medication includes four characteristics:pungent flavour medicine to dredge collaterals,insect and vine medicine to dredge collaterals,dispelling pathogen medicine to dredge collater-als and tonifying medicine to dredge collaterals.The external treatment method mainly assists the internal treatment method and im-proves the synergistic effect.It mainly includes acupuncture,massage,moxibustion,acupoint application,and exercises.

关 键 词：新型冠状病毒肺炎 肺络郁闭 病机 通络法 寒湿夹燥 疫毒陷肺 气阴亏虚 

分 类 号：R256.1[医药卫生—中医内科学]