27,445 | 833 | 23 |
下载次数 | 被引频次 | 阅读次数 |
新型冠状病毒(2019-nCoV)肺炎大部分患者以身热不扬、咳嗽、乏力、纳差、舌苔厚腻为主要症状,根据采集的四诊信息,审症求因,研判核心病机,认为2019-nCoV肺炎属于瘟疫范畴,主要病性为湿毒,可称之为湿毒疫。病位在肺脾,基本病机特点为"湿、毒、瘀、闭"。本病需要与当令的时行感冒、风温、冬温等病证相鉴别。根据疾病传变规律,可分四个阶段辨治:早期、进展期、极期(危重期)、恢复期。大部分病例以早期、进展期为主,为本病的顺传(正局),极度乏力、喘憋、咯血等症状提示病情将逆传加重,肺之化源绝而喘脱,为本病的逆传和变局。治则治法拟为辟秽化浊,以祛邪为第一要义,以分消湿热、宣畅气机为主,抓住早期、进展期治疗是减少危重症、降低病死率的关键。
Abstract:Most patients with novel coronavirus pneumonia(NCP) in Wuhan have the main symptoms of unsurfaced fever, cough, fatigue, poor appetite, and thick tongue coating. According to the examinations collected, pathogenesis is considered that NCP belongs to the pestilence, and the main nature of disease is dampness toxin, which can be called dampness toxin epidemic. The disease was located in the lung and spleen. The basic pathogenesis was "dampness, toxin, stasis, and closed". This disease needs to be distinguished from seasonal symptoms such as seasonal colds, wind-warmth and winter warmth. According to the law of disease transmission and change, treatment can be differentiated in four stages: early stage, advanced stage, extreme stage(critical stage), and recovery stage. Most cases are mainly in the early and advanced stages, and the disease is sequential transmission. Severe fatigue, panting; expectoration of blood, and other symptoms suggest that the disease will be worsened, which is the reverse transmission change of the disease. Governing the rule is to eliminate filth and turbidity, and to dispel pathogen is the first priority. The treatment is mainly based on dispelling damp-heat and activating qi movement. Grasping early and advanced treatment is the key to reducing critical illness and mortality.
[1]国家卫生健康委员会.截至1月26日24时新型冠状病毒感染的肺炎疫情最新情况[EB/OL].(2020-01-27)[2020-01-27].http://www.nhc.gov.cn/xcs/yqfkdt/202001/3882fdcdbfdc4b4fa4e3a829b62d518e.shtml
[2]国家卫生健康委办公厅,国家中医药管理局办公室.新型冠状病毒感染的肺炎诊疗方案(试行第三版)[EB/OL].(2020-01-23)[2020-01-27].http://www.nhc.gov.cn/xcs/zhengcwj/202001/f492c9153ea9437bb 587ce2ffcbee1fa/files/39e7578d85964 dbe81117736dd789 d8f.pdf
[3]HUANG C,WANG Y,LI X,et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan,China[J /OL].Lancet,(2020-01-24)[2020-01-27].https://www.sciencedirect.com/science/article/pii/S0140673620301835#!
[4]何权灜.必须继续严密关注各种呼吸系统传染病流行趋势[J].中国呼吸与危重监护杂志,2005,4(5):332-333.
基本信息:
DOI:10.13288/j.11-2166/r.2020.04.002
中图分类号:R259
引用信息:
[1]王玉光,齐文升,马家驹等.新型冠状病毒肺炎中医临床特征与辨证治疗初探[J].中医杂志,2020,61(04):281-285.DOI:10.13288/j.11-2166/r.2020.04.002.
基金信息:
国家科技重大专项(2017ZX10305501)