中西医结合治疗慢性阻塞性肺疾病合并新型冠状病毒感染(重型)患者1例  

A case of chronic obstructive pulmonary disease combined with novel coronavirus infection(critical type)treated with integrated Chinese and western medicine

作　　者：周凌 田传玺 薛崇祥 李争[3] 王晶[3] 郭杏林 亢泽峥 董立硕 李修洋[1] 赵林华[1] 陈建 ZHOU Ling;TIAN Chuanxi;XUE Chongxiang;LI Zheng;WANG Jing;GUO Xinglin;KANG Zezheng;DONG Lishuo;LI Xiuyang;ZHAO Linhua;CHEN Jian(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China;Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi 830000,China;The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Medical Research Center for Acupuncture and Moxibustion,Tianjin 300000,China;Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029 [3]新疆医科大学附属中医医院,乌鲁木齐830000 [4]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津300000 [5]长春中医药大学附属医院,长春130021

出　　处：《吉林中医药》2023年第9期1088-1091,共4页Jilin Journal of Chinese Medicine

基　　金：国家重点研发计划(2022YFC0868300);新疆维吾尔自治区重大科技专项项目(2020A03004)。

摘　　要：慢性阻塞性肺疾病是一种常见的慢性肺部疾病,在此基础上合并新冠病毒感染者较一般新冠感染患者更易进展为重症肺炎。仝小林院士认为此类患者在治疗时应明确“寒湿疫”之“病-期-证”体系,依据“郁-闭-脱-虚”四期定位病程,并在此基础上调态打靶,综合论治。本案患者为高龄伴多发基础疾病新型冠状病毒感染患者,属“闭”证期,邪盛正虚,湿、热、痰、瘀、毒交织盘踞上焦,宜从分期分证及态靶结合角度探讨诊疗方案,选用子龙宣白承气汤,扶正益气,透邪外出,针对新型冠状病毒感染治疗有效,现析其病因并总结其经验,以期为临床诊治此类患者提供借鉴思路。Chronic obstructive pulmonary disease(COPD)is a common chronic lung condition that,when combined with a novel coronavirus infection,increases the risk of progressing to severe pneumonia compared to COVID-19 alone.According to Academician Tong Xiaolin,a clear understanding of the"disease-stage-syndrome"system of"cold-damp epidemic"is essential in the treatment of such patients.By determining the stages of"depression-obstruction-exhaustion-deficiency"and pinpointing its states and targets accordingly,a comprehensive approach can be employed.In this case,the patient is an elderly individual with multiple underlying conditions,falling into the"obstruction"stage,characterized by the healthy qi deficiency and pathogen excessiveness,with dampness,heat,phlegm,blood stasis and toxins intertwining in the upper respiratory tract.Therefore,it is advisable to explore its diagnosis and treatment plan from the perspectives of staging,differentiating syndrome and integrating states and targets,selecting the Zilong Xuanbai Chengqi Decoction with the aim of invigorating the vital energy,expelling pathogenic factors,which effectively treats the infection caused by the novel coronavirus.This paper examines its etiology and summarizes the experience in order to provide a guidance for the clinical management of similar patients.

关 键 词：新型冠状病毒感染 慢性阻塞性肺疾病 中西医结合 

分 类 号：R249[医药卫生—中医临床基础]