李赛美基于六经辨证治疗长新冠综合征患者自汗症经验  

Li Saimei's Experience in Treating Spontaneous Sweating Syndrome in Patients with Long COVID Based on Six-Meridian Syndrome Differentiation

作　　者：刘欣怡 曾纪斌 李赛美(指导)[3] LIU Xinyi;ZENG Jibin;LI Saimei(Advisor)(The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518101 Guangdong,China;Bao'an Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Shenzhen 518101 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第七临床医学院,广东深圳518101 [2]广州中医药大学附属宝安中医院,广东深圳518101 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2025年第3期741-745,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：感染新型冠状病毒后遗留的不同程度的感染后症状称之为长新冠综合征。部分长新冠综合征患者存在自汗不止、疲倦乏力、心悸气短等症状。李赛美教授根据六经辨证理论体系,遵循方证对应的辨治思路,总结长新冠综合征患者自汗症的四大证型为太阳营卫不和自汗证、阳明湿热自汗证、太阴寒湿自汗证及厥阴血虚自汗证,可分别予桂枝汤、葛根芩连汤、附子理中汤、当归四逆汤合二至丸。认为长新冠综合征患者自汗症的发病机制或因营卫不和,或因湿热,或因寒湿,或因气血亏虚,治疗除需调和营卫、燥湿祛邪、温经养血外,还需顾护心之阴阳,临证可选通阳益阴、宁心定悸之品。Various degrees of post-infection symptoms after novel coronavirus infection are called long COVID or post COVID-19 syndrome.Some of the patients with long COVID syndrome exhibit the symptoms of spontaneous sweating,fatigue and weakness,palpitation and shortness of breath.Following the theory of six-meridian syndrome differentiation and the clinical principle of prescriptions corresponding to syndromes,Professor Li Saimei differentiated the spontaneous sweating of patients with long COVID into four main types,namely spontaneous sweating due to disharmony between taiyang nutritive qi and defensive qi,spontaneous sweating due to Yangming damp-heat,spontaneous sweating due to taiyin cold-damp,and spontaneous sweating due to jueyin blood deficiency,which can be treated with Guizhi Decoction,Gegen Qinlian Decoction,Fuzi Lizhong Decoction,and Danggui Sini Decoction plus Erzhi Pills,respectively.In the view of Professor Li Saimei,spontaneous sweating in patients with long COVID may result from disharmony between nutritive qi and defensive qi,or from damp-heat pathogen,or from cold-damp pathogen,or from deficiency of qi and blood.Therefore,the therapies for spontaneous sweating should be focused on harmonizing nutritive qi and defensive qi,drying dampness and eliminating pathogens,warming meridians and nourishing blood.Moreover,protecting the heart-yin and heart-yang should be taken into account,and herbal medicines with the actions of activating heart-yang and replenishing heart-yin and herbs for tranquilizing and alleviating palpitation can be selected in clinic.

关 键 词：长新冠综合征 自汗 六经辨证 太阳营卫不和 阳明湿热 太阴寒湿 厥阴血虚 李赛美 

分 类 号：R249.2[医药卫生—中医临床基础]