冠状病毒疾病临床证据与中医论治理论

探讨新型冠状病毒疾病(COVID-19)的中医病因特征、病邪属性、病机特点,为临床辨证论治提供思路.检索中国知网(CNKI)与万方数据库中与COVID-19中医药相关的临床研究,理论探讨,国家及各省市、自治区、直辖市发布的中医诊疗方案等相关文献,对其中的病因病机、理论认识、临床症状体征、辨证分型、用药规律等,进行归纳、...

Clinical Evidence and Theory of COVID-19 by Traditional Chinese Medicine

This study aims to investigate the etiology, pathogenic properties and pathogenic characteristics of corona virus disease-2019(COVID-19)in traditional Chinese medicine(TCM),so as to provide ideas for clinical treatment based on syndrome differentiation. Efforts were made to retrive relevant literature concerning clinical studies,theoretical discussions and TCM diagnosis and treatment schemes issued by the state and various provinces,municipalities,autonomous regions and municipalities directly under the central government in relation to TCM from China Knowledge Network(CNKI)and Wanfang Database,and to analyze and summarize the etiology,pathology,theoretical viewpoints,clinical symptoms and signs,syndrome differentiation and medication rules. Currently,the common understanding of the etiology of COVID-19 in the field of TCM is the infection of pestilential pathogen. However,there is a dispute over cold and heat or mixed understanding of cold and heat in terms of pathogenic attributes. The pathogenic factors are different from each other in dampness,toxin,dryness,fire(heat),wind,filth,depression,etc. There are various understandings on the pathogenesis including dampness,cold,heat,toxin,stasis,phlegm,stagnation,knot,dryness,filth,deficiency,blocking,collapse and asthma,etc. The etiology and pathogenesis are often mixed up. Integration of cold and heat,dryness and dampness,and other contradictory pathogens or pathogenesis is widely seen,which lacks the logicality of theoretical systems,and does not in line with the thinking characteristics of TCM on the etiology,pathogenesis,and syndrome differentiation of exogenous diseases. The main idea of medication in treatment is to diffuse the lung,clear away heat,eliminate dampness,resolve phlegm and repel foulness with aromatics. Maxing Shigantang is used as the core prescription. Chosen warm acrid drugs are mainly the ones with the effect of fragrance,removing dampness,resolving phlegm,and invigorating spleen. They are not the ones with the effects of warming yang and dissipating cold,but the combination of cold and heat,suggesting the complexity of etiology and pathogenesis. COVID-19 is categorized as plaque in TCM,and its etiology is pestilential pathogen. This pestilential pathogen possesses not only the basic properties of toxin and filth,but also the characteristics of dampness,heat and wind. Throughout the course of the disease,phlegm,stasis,stagnation and other secondary pathogenic factors also occur. The evolution of pathogenesis is characterized by depression,blocking,and deficiency. There are more evidences that the pestilential pathogen of COVID-19 belongs to heat property no matter in the aspects of clinical manifestation, transmission law(syndrome differentiation at different stages),or in compatibility of medication.