新型冠状病毒肺炎重症病理生理机制及中医药防治切入点  

Pathophysiological mechanism of severe COVID-19 and the entry point of traditional Chinese medicine prevention and treatment

作　　者：冯颖[1] 王宪波[1] 高方媛[1] 侯艺鑫[1] 时克 FENG Ying;WANG Xianbo;GAO Fangyuan;HOU Yixin;SHI ke(Center of Integrative Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院中西医结合中心,北京100015

出　　处：《北京中医药大学学报》2022年第4期382-386,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：首都卫生发展科研专项项目(No.2018-1-2172);北京市科学技术委员会资助项目(No.Z191100006619033)。

摘　　要：新型冠状病毒肺炎(COVID-19)重症发生发展符合瘟疫“温邪上受,首先犯肺,逆传心包”发病特点和传变规律,属于“变证、坏证”范畴,病情进展迅速,初见疫毒犯肺,继则疫毒闭肺,甚则出现内闭外脱的危重阶段。西医学认为重症涉及病毒损伤、免疫炎症反应、内皮细胞损伤、血栓形成和肾素-血管紧张素-醛固酮系统失调等一系列病理生理变化。关于COVID-19重症治疗,首先是阻抑重症的发生,必要时不拘卫气营血,可以“先证而治”;凝练总结了解毒凉血法、通腑泻肺法和健脾化湿法在COVID-19重症治疗中的作用,并结合西医学研究分析了上述3种治法可能的作用机制。The occurrence and development of severe novel coronavirus pneumonia(COVID-19) follows the pathogenesis characteristics and transmission law of the pestilential diseases, “pathogenic warm attacks the lungs first, and goes to the pericardium reversely”, which belongs to the category of “wrongly-treated pattern” or “unfavorable pattern”. The disease progressed rapidly. At first, the epidemic virus invaded the lungs, then blocked the lungs, leading to the critical stage of inner blocking causing collapse. Modern medicine believes that severe disease involves a series of pathophysiological changes, such as viral damage, immune inflammatory response, endothelial cell damage, thrombosis, and renin-angiotensin-aldosterone system(RAAS) disorders. Regarding the treatment of severe COVID-19, the first proposal is to prevent the occurrence of severe disease, When necessary, it is not limited to wei(defense), qi, ying(nutrient) and blood levels. and prior treatment should be given before development of patterns;This article summarizes the role and value of the methods of detoxification and cooling blood, purging the lungs and opening the bowels, and strengthening spleen and eliminating dampness in the treatment of severe COVID-19. In combination with modern medical research, the possible mechanism of action of the above three treatments was also analyzed.

关 键 词：新型冠状病毒肺炎 重症 病理生理 中医药 

分 类 号：R254.3[医药卫生—中医内科学]