猴痘中医古籍与8例猴痘患者中医治疗及用药研究  

Ancient Chinese Medical Texts and Treatment of 8 Cases of Monkeypox with TCM

作　　者：赵蕊[1] 辛晓丽[1] 肖婷月 石晓琳 王妍[1] 田霞[2] 张伟 ZHAO Rui;XIN Xiaoli;XIAO Tingyue;SHI Xiaolin;WANG Yan;TIAN Xia;ZHANG Wei(Department of Infection,Shenyang Sixth People’s Hospital,Shenyang Liaoning 110006,China;Department of Traditional Chinese Medicine Rehabilitation,Shenyang Sixth People’s Hospital,Shenyang Liaoning 110006,China;National Key Laboratory of Source Tracing,Early Warning and Intelligent Tracking and Forecasting for Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;National Medical Center for Infectious Diseases(Beijing),Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Center of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]沈阳市第六人民医院感染科,辽宁沈阳110006 [2]沈阳市第六人民医院中医康复科,辽宁沈阳110006 [3]传染病溯源预警与智能决策全国重点实验室,首都医科大学附属北京地坛医院,北京100015 [4]国家传染病医学中心(北京),首都医科大学附属北京地坛医院,北京100015 [5]首都医科大学附属北京地坛医院感染性疾病中心,北京100015

出　　处：《中国药物警戒》2024年第12期1343-1349,1356,共8页Chinese Journal of Pharmacovigilance

基　　金：国家重点研发计划(2022YFF1203201);国家中医药治疗艾滋病试点项目;北京市高层次公共卫生技术人才建设项目培养计划(学科骨干-02-31)。

摘　　要：目的复习“猴痘”中医古籍文献,认识并讨论猴痘中医病名、病因和病机及疾病辨证论治,以期为猴痘中医临床治疗及用药提供参考。方法针对猴痘病症,系统梳理中医古籍相关文献,并对沈阳市第六人民医院2023年6月29日至2024年2月5日收治的8例猴痘患者病因病机、治则治法、分阶段辨证论治、药理分析、中医外治进行分析。结果在对猴痘病症的中医临床研究中,发现猴痘病理机制与临床表现与中医传统理论中的“疫病”“痘疹”范畴高度契合,且病症类似天花,进一步总结出猴痘的病因病机为外感时行疫毒,湿热蕴于肺脾两经。根据猴痘病程,将猴痘分为初期、出疹7 d左右、出疹14 d以上。根据不同病程阶段提出治宜疏风清热,解表透疹,健脾祛湿,扶正祛邪。分别采用芍药桂枝甘草汤合参苓白术散加减治疗、四君子汤和柴葛解肌汤加减治疗、八珍汤合防风通圣散加减治疗。此外,同时配合雷火灸和中药溻渍等中医外治法,表里兼治,既调和内在病机,同时又祛邪,改变正气与邪气之间的变化趋势,达到干预病情治疗疾病的目的。结论根据猴痘不同时期的疾病特点提出解表透疹、健脾祛湿、扶正祛邪的中医药治疗思维,并给予中医药治疗,取得一定临床效果,为今后猴痘的防治工作提供参考。Objective To review ancient Chinese medical literature on monkeypox in terms of the disease name,etiology,pathogenesis,syndrome differentiation and treatments.Methods Literature on monkeypox from ancient Chinese medical texts was reviewed.Analysis was conducted of the clinical data on the etiology pathogenesis,principles and methods of treatment,syndrome differentiation and treatment by stages,pharmacology,and external treatment with TCM related to 8 cases of monkeypox admitted to Shenyang Sixth People’s Hospital between June 29,2023 and February 5,2024.Results During clinical research on monkeypox using TCM,it was found that the pathological mechanism and clinical manifestations of monkeypox were highly consistent with the category of“epidemic diseases”"variola"in traditional theories of TCM,and that the disease resembled smallpox.The etiology and pathogenesis of monkeypox were believed to be due to external contraction of epidemic toxins prevalent at the time,and with damp-heat accumulations in lungs and spleens.Based on the course of disease,monkeypox was divided into three stages:the initial stage,around 7 days after rash onset,and more than 14 days after rash onset.According to different stages of the disease,treatments involved dispersing wind and clearing heat,relieving the exterior and promoting the eruption of rashes,strengthening the spleen and eliminating dampness,and enhancing the body’s resistance to eliminate pathogens.A modified prescription of Shaoyao Guizhi Gancao Tang(Paeoniae Radix,Cassiae Twig,and Glycyrrhizae Radix Decoction)was used in combination with Shenling Baishu San(Poria,Atractylodes,and Coicis Semen Powder),Sijunzi Tang(Astragalus,Atractylodes,Ginseng,and Poria Decoction)along with Chaige Jieji Tang(Bupleurum,Pueraria,and other herbal decoction),Bazhen Tang(Eight-Treasure Decoction)combined with Fangfeng Tongsheng San(Saposhnikoviae and other herbal powder).External treatments with TCM such as thunder-fire moxibustion and Chinese herbal decoction soaking were also adopted.Con

关 键 词：痘疹 天花 猴痘 病因病机 证治 男男性行为者 人类免疫缺陷病毒 获得性免疫缺陷综合征(艾滋病) 

分 类 号：R183.9[医药卫生—流行病学] R994.11[医药卫生—公共卫生与预防医学]