从同气相求谈新型冠状病毒肺炎症状不明显阶段的治疗策略  

Treatment Strategy of COVID-19 in Non-obvious Symptom Stage from Perspective of Tong Qi Xiang Qiu

作　　者：王丽娜 WANG Lina(Department of Traditional Chinese Medicine,Naval Medical University,Shanghai China 200433)

机构地区：[1]海军军医大学中医系,上海200433

出　　处：《中医学报》2022年第11期2302-2306,共5页Acta Chinese Medicine

基　　金：上海市卫生计划生育委员会杏林新星项目(ZY3-RCPY-2-2026)。

摘　　要：新型冠状病毒肺炎起源于“外湿”,病位在肺脾,初起湿毒困脾闭肺,气机升降失司。在疾病发展过程中出现不同的症状表现。因此湿毒化热,传入阳明,形成阳明腑实,湿毒瘀热内闭,热深厥深者有之;湿毒寒化,传入太阴,进一步伤阳,寒湿瘀滞,寒深厥深者有之。在治疗上始终从“脾虚”和“湿盛”两个方面将健脾祛湿作为总的治疗原则。对于无症状感染者,健脾选择党参、茯苓、陈皮、制半夏等二陈汤为底方,健脾理气和胃兼燥湿之品;祛湿选择藿香、佩兰、白扁豆、厚朴、薏苡仁等芳香化湿健脾祛湿之品;舌质红、脉数热象明显者,加金银花、连翘、贯众等辛凉透邪、清热泻火之品。后期症状消失、核酸长期不转阴的常阳患者,或是复阳患者,可选择四君子汤、六君子汤、补中益气汤为底方益气健脾、祛湿化痰。COVID-19 is originated from "external Dampness",and the disease site was in the Lung and Spleen.At the beginning, Dampness toxin traps the Spleen and closes the Lung Qi, and the qi movement is injured.Different symptoms appear during the development of the disease.Therefore, when the Damp toxin transforms into Heat, which enters into Yangming and causes Yangming Fu excessiveness.All of the above would lead to strong Heat and serious faint.In treatment, strengthening the Spleen and eliminating Dampness is always the general treatment principle based on "Spleen deficiency" and "Dampness".For those with asymptomatic infection, the Spleen-invigorating herbs such as Dangshen(codonopsis),Fuling(poria),Chenpi(dried tangerine peel) and processed Banxia(pinellia),which are used as the basic hurbs in Erchen Recipe, to invigorate the Spleen, regulate Qi, harmonize the Stomach and dry Dampness;Huoxiang(patchouli),Peilan(herba eupatorii),Baibiandou(white lentil),Houpo(magnolia officinalis),Yiyiren(coix seed) and other aromatic products are used for dispelling Dampness and invigorating the Spleen;for those with a red tongue and a rapid pulse, Jinyinhua(honeysuckle),Lianqiao(forsythia) and Guanzhong(cyrtomium fortunei),etc can be added in medication.For patients with disappeard symptoms in the later stage but positive in nucleic acid test for a long time, or patients whose nucleic acid test outcome turn to positive again, Sijunzi Decoction, Liujunzi Decoction and Buzhong Yiqi Decoction can be used as the base recipes to replenish Qi, invigorate the Spleen, dispel Dampness and resolve Phlegm.

关 键 词：新型冠状病毒肺炎 症状 同气相求 健脾祛湿 治疗策略 

分 类 号：R256.1[医药卫生—中医内科学]