从少阳论治新型冠状病毒感染后咳嗽  

Discussion on the Treatment of Cough Caused by SARS-CoV-2 Infection from Shaoyang Theory

作　　者：陈申达 张立山 洪波 张松 孙鸣欢 周晶晶 CHEN Shenda;ZHANG Lishan;HONG Bo(Ningbo TCM Hospital Affiliated to Zhejiang Chinese Medical University,Ningbo(315010),China;Dongzhimen Hospital,Beijing University of Chinese Medicin)

机构地区：[1]浙江中医药大学附属宁波中医院,宁波315010 [2]北京中医药大学东直门医院

出　　处：《浙江中医药大学学报》2024年第4期434-438,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科研基金项目(2022ZB315、2023ZL645)。

摘　　要：[目的]探索新型冠状病毒(简称新冠病毒)感染后咳嗽的中医诊疗思路。[方法]从少阳的生理病理入手,阐述少阳的病位特点,少阳与痰饮水湿的关系,分析新冠病毒感染后咳嗽的临床症候,将其与少阳证联系,并总结相应的治法,列举临床验案一则加以佐证。[结果]新冠病毒感染急性期解表不彻底,邪传少阳,是咳嗽迁延不愈的主要原因,而在咳嗽的亚急性期与慢性期又多兼有痰饮水湿等病邪。新冠病毒感染后咳嗽多伴有气道痒、咽干咽痒、口苦或口中乏味、嗅觉味觉减退、头晕,有的还伴有阳后焦虑,兼具少阳病的特点。因此新冠病毒感染后咳嗽可从少阳论治,其中少阳太阳合病、少阳夹饮、少阳湿热较为常见,还有部分表现为少阳少阴合病。所附医案辨证属于少阳太阳夹饮咳嗽,治以和解少阳、外散风寒、温化水饮之法,咳嗽明显改善。[结论]新冠病毒感染后咳嗽多为邪犯少阳所致,与痰饮水湿关系密切,治疗上需同时辨识少阳与他经合病以及病邪兼夹等情况,为临床提供思路。[Objective]To explore the idea of Chinese medicine treatment of cough caused by SARS-CoV-2 infection.[Methods]Starting with the physiology and pathology of Shaoyang,the location characteristics of Shaoyang,the relationship between Shaoyang and phlegm and fluid retention is explained,and the clinical symptoms of cough after SARS-CoV-2 infection,which can be linked with Shaoyang syndromes are also analyzed.Then,the corresponding treatment methods are summarized and a clinical case is cited for corroboration.[Results]Incomplete relief of symptoms during the acute phase and the transmission of evil to Shaoyang are the main reasons for the persistence of cough caused by SARS-CoV-2 infection.While in the subacute and chronic phases of cough,there is often a combination of phlegm,drink and dampness.Cough caused by SARS-CoV-2 infection is often accompanied by itchy airways,dry throat,bitterness or lack of taste in the mouth,loss of smell and taste,dizziness,and in some cases,post-infection anxiety,which is characteristic of Shaoyang disease.Therefore,this paper proposes that the cough after SARS-CoV-2 infection can be treated from Shaoyang,where Shaoyang-Taiyang syndromes,Shaoyang integrated drink and Shaoyang integrated damp-heat are more common,and some manifest as Shaoyang-Shaoyin syndromes.The attached clinical case described as“Shaoyang-Taiyang with phlegm drink”cough,was cured rapidly through harmonizing and dispelling Shaoyang,removing exogenous wind and cold,warming and transforming water-rheum.[Conclusion]Most coughs after SARS-CoV-2 infection are caused by evil offending Shaoyang and are closely related to phlegm,drink and dampness.The treatment needs to identify the combination of Shaoyang and other meridians as well as the combination of disease and evil to provide clinical ideas.

关 键 词：少阳 三焦 痰饮水湿 新型冠状病毒感染 咳嗽 六经辨证 

分 类 号：R254[医药卫生—中医内科学]