基于“异病同治”理论探讨蒿芩清胆汤治疗病毒性肺炎的辨治思路及效应机制  

Thoughts of Syndrome Differentiation and Treatment and Effect Mechanism of Haoqin Qingdantang in Treating Viral Pneumonia Based on Theory of Treating Different Diseases with Same Therapy

作　　者：彭鑫 徐浩田 梁磊 栾哲宇 王晗笑 张益豪 杨坤[1] 封继宏[2] PENG Xin;XU Haotian;LIANG Lei;LUAN Zheyu;WANG Hanxiao;ZHANG Yihao;YANG Kun;FENG Jihong(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学第二附属医院,天津300250

出　　处：《中国实验方剂学杂志》2025年第8期209-217,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划项目(2022YFC3500803)。

摘　　要：异病同治是中医辨证论治的精髓,是指不同的疾病在发展过程中出现相同的病机变化或相同的证候表现时,可采用相同的原则和方法进行治疗。由于病毒致病类型的复杂性和高度变异性,不同类型病毒性肺炎(VP)的精准有效治疗一直是现代医学的研究重点和难题。VP属于中医学外感热病、温病、疫病等范畴,蒿芩清胆汤是温病学清热祛湿代表方,多种呼吸道病毒感染所致的VP使用该方干预疗效显著。该研究在异病同治理论指导下,将蒿芩清胆汤治疗不同类型VP的相关研究进行有机串联,发现流感病毒性肺炎(IVP)、严重急性呼吸综合征(SARS)及新型冠状病毒感染(COVID-19)在各自疾病发展的不同阶段均存在“湿热”共性病机,当上述疾病由湿热因素主导时,使用蒿芩清胆汤疗效斐然。现代药理研究证实蒿芩清胆汤可抑制病毒增殖、减轻发热反应、抑制炎症介质表达、调节免疫平衡,且该方君药具有极佳的抗病毒活性,组方蕴含着丰富的抗VP科学内涵。该文从异病同治视角出发,基于蒿芩清胆汤对不同类型VP的有效治疗实践及现代药理研究,挖掘其共治的中医理论基础,并在此基础上进一步探讨该方治疗不同类型VP的辨治思路及效应机制,分析其作用机制和特点,以期为蒿芩清胆汤治疗VP的临床应用及现代化研究提供依据与参考。The principle of treating different diseases with the same therapy is the essence of syndrome differentiation and treatment in traditional Chinese medicine(TCM).It means that when the same pathogenic changes or the same symptoms appear in the development of different diseases,the same principles or methods can be used for treatment.Due to the complexity and high variability of viral pathogenicity,the precise and effective treatment of different types of viral pneumonia(VP)has always been a research focus and difficulty in modern medicine.VP belongs to the category of external-contraction febrile disease,warm disease,and epidemic in TCM.Haoqin Qingdantang(HQQDD)is a representative formula for clearing heat and dispelling dampness in warm diseases,and its intervention in VP caused by various viral infections has significant effects.This study,guided by the theory of treating different diseases with the same therapy,links the related studies on using HQQDD to treat different types of VP and finds that influenza virus pneumonia(IVP),severe acute respiratory syndrome(SARS),and COVID-19 all have a common pathogenic mechanism of dampness-heat at different stages of respective diseases.When these diseases are dominated by damp-heat factors,the use of HQQDD yields remarkable therapeutic effects.Modern pharmacological studies have confirmed that HQQDD can inhibit virus replication,reduce fever reactions,inhibit the expression of inflammatory mediators,and regulate immune balance.Moreover,the sovereign medicine in this formula has excellent antiviral activity,and the formula reflects rich scientific connotations of treating VP.According to the theory of treating different diseases with the same therapy and based on the effective treatment practice and modern pharmacological research of HQQDD for different types of VP,this paper mines the underlying TCM theory of treatment with the same therapy,explores the syndrome differentiation and treatment strategy and effect mechanism of this formula for different types of VP,and anal

关 键 词：异病同治 蒿芩清胆汤 病毒性肺炎 辨治思路 效应机制 

分 类 号：R259[医药卫生—中西医结合] R563.1[医药卫生—中医内科学] R856.2[医药卫生—中医学]