166例新型冠状病毒肺炎临床症状特点及治疗研究  

Study on the Clinical Symptoms and Treatment of 166 Cases of COVID-19

作　　者：周芳[1,2] 李智杰[2] 李旭成[2] 张栋[2] 周勇[2] 张彩蝶[2] Zhou Fang;Cai Wei;Li Xucheng;Zhang Dong;Zhou Yong;Zhang Caidie(Wuhan Hospital of Traditional Chinese Medicine,Hubei,Wu-han 430014,China)

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

出　　处：《中国中医急症》2021年第8期1407-1411,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家科技应急攻关项目(2020YFC0841600);国家重点研发计划中医药现代化研究重点专项2018年度(2018YFC1075602);武汉市科技局新冠肺炎应急攻关项目(2020020201010017)。

摘　　要：本文通过分析166例新型冠状病毒肺炎(COVID-19)患者的临床症状及病机,认为COVID-19为肺系疫病中湿毒疫范畴。从病机病机而言,发病的主要原因为疫戾毒邪,发病的外在条件为气候伏邪“湿邪”,发病的内在因素为正气不足。初期:湿毒困表,营卫失调;中后期:邪毒壅肺,湿毒困脾,肾不纳气,若遇素有伏邪,正气本虚,则易邪毒内陷,变生厥脱。从疾病临床症状而言,COVID-19发病变得更加隐蔽。发热、咳嗽等症状仍是疾病主要症状。消化道及其他系统症状常常兼有,疾病临床证候变得多样化。合并多系统疾病的患者,特别是合并高血压、糖尿病的患者更容易转化为危重病例。危重病例中胸闷、心慌、乏力、喘息、气促等临床表现早期更容易出现,而畏寒、咽痛、咽干、咽痒、呼吸困难、烦躁、食欲减退或厌食、腹痛、呕吐、影像学改变等症状早期并未出现。COVID-19产生的这些变化,可能会增加防疫的难度,这值得我们警惕和重视。对于疾病的防治,始终强调早期中医药干预。本院使用自制药“宣清和化方”治疗COVID-19医学观察期和临床治疗期中的轻型、普通型发热患者,全方采用“宣透达表法”“清热解毒法”“表里和解法”“辟秽化浊法”4法联用,扶正与祛邪相结合,以期表里双解,从而明显改善患者呼吸道及胃肠道症状,缩短病程,有效预防病情向重型及危重型转化。This article analyzes the clinical symptoms and pathogenesis of 166 patients with coronavirus disease 2019(COVID-19),and considers that COVID-19 belongs to the category of pulmonary disease.In terms of pathogenesis and pathogenesis,the main cause of the disease is epidemic and poisonous evil,the external condition of the disease is the climate and the“wet evil”,and the internal factor of the disease is the lack of righteousness.In the early stage,the damp toxin is obstructed,and yingfen and weifen are out of balance;in the middle and late stages,the evil toxin constricts the lungs,the damp toxin traps the spleen,and the kidneys are unable to absorb qi,resulting in syncope.In terms of clinical symptoms of the disease,the onset of COVID-19 has become more insidious.Symptoms such as fever and cough are still the main symptoms of the disease.Symptoms of the digestive tract and other systems are often combined,and the clinical symptoms of the disease become diversified.Patients with multiple system diseases,especially those with hypertension and diabetes,are more likely to be transformed into critical cases.In critical cases,clinical manifestations such as chest tightness,palpitation,fatigue,wheezing,and shortness of breath are more likely to occur in the early stage,while chills,sore throat,dry throat,itchy throat,dyspnea,irritability,loss of appetite or anorexia,abdominal pain,vomiting,imaging changes did not appear in the early stage.These changes caused by COVID-19 may increase the difficulty of epidemic prevention,which deserves our vigilance and attention.For the prevention and treatment of diseases,early intervention of traditional Chinese medicine has always been emphasized.Our hospital uses the self-designed Xuanqing Hehua Decoction for COVID-19 patients with light and ordinary fever during the medical observation period and clinical treatment period.It is a combination of four TCM treatment methods:outthrust and resolving exterior,clearing heat and removing toxin,reconciling exterior and interior,and eli

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

分 类 号：R285.5[医药卫生—中药学]