基于温病理论的新型冠状病毒感染实践与再认识  

Practice and Reunderstanding of COVID-19 Based on Theory of Febrile Diseases

作　　者：张思超[1] ZHANG Sichao(Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学,山东济南250355

出　　处：《山东中医杂志》2023年第10期1021-1028,1061,共9页Shandong Journal of Traditional Chinese Medicine

基　　金：齐鲁医派中医学术流派传承项目(批文号:鲁卫函〔2022〕9号);山东省研究生优质教育资源项目(编号:SDYAL2022047)。

摘　　要：从温病学理论出发,基于新型冠状病毒感染治疗的临床实践,系统探讨该病的中医病名、发病类型、病因属性、病机变化、辨证方法、治则治法、方药运用等。认为该病属于温病中的温疫病,其病因属性为湿热疫戾之气。邪气从口鼻或皮毛而入,在人体正气亏虚时,伏藏于肺脾,可按伏气温病认识和治疗。湿热疫戾之气可自发于里,也可由外邪引动,并长期停留气分,形成湿重于热、湿热并重、热重于湿证。湿热弥漫,可出现心、脑、舌、鼻、耳等上窍被蒙表现。病变过程或后期,根据湿与热的程度,既可伤阴亦可伤阳。涉及脏腑主要是肺、脾、心、肾。病理因素主要为湿、热、虚、瘀。基本治则是祛邪扶正、透邪外出,并根据湿热轻重及外邪性质确立不同治法和选方用药。例举本病不同阶段常见的发热、咳嗽、疲劳、失眠验案,并分析证治思路及体会以佐前述。From the perspective of the theory of febrile diseases and based on the clinical practice of the treatment of COVID-19,this paper systematically discusses the name of the disease in traditional Chinese medicine,the types of disease,the attributes of etiology,the changes of pathogenesis,the methods of syndrome differentiation,the treatment principles and methods,and the application of prescriptions.It is considered that COVID-19 belongs to the infectious febrile disease of febrile diseases,and its etiological attribute is the qi of dampness-heat pestilence.Pathogenic factor enters from the mouth and nose or fur,and it is latent in the lung and spleen when the healthy qi is in deficiency,and it can be recognized and treated as a latent febrile disase.The qi of dampness-heat pestilence can be spontaneous in the interior,or induced by external evil,and stay in the qi aspect for a long time,forming the syndrome of dampness superior to heat,both dampness and heat,heat superior to dampness.The dampness and heat pestilence may permeate the heart,brain,tongue,nose,ears and other upper orificums.During or after the pathological process,according to the degree of dampness and heat,both yin and yang can be damaged.It mainly involves the lungs,spleen,heart and kidneys.The main pathological factors are dampness,heat,deficiency and blood stasis.The basic treatment principle is strengthening the body resistance to eliminate pathogenic factors and driving away pathogenic factors,and different treatments and prescription drugs are given according to the severity of dampness-heat and the nature of the pathogenic factors.The common cases of fever,cough,fatigue and insomnia in different stages of the disease are cited,and the ideas of diagnosis and treatment are analyzed.

关 键 词：新型冠状病毒感染 温病理论 湿热疫 伏气温病 卫气营血辨证 祛邪扶正 透邪外出 

分 类 号：R254.3[医药卫生—中医内科学]