“顾护阳气”思想在新型冠状病毒肺炎证治中的应用探析

结合杭州市西溪医院所收治的新型冠状病毒肺炎(以下简称"新冠肺炎")的临床实践,笔者认为新冠肺炎以寒湿证为主,寒湿伤阳,且阳气是正气的重要组成部分,故治疗宜始终"顾护阳气",既重视阳气量之充足,又注重阳气运行之宣通。本病早、中、危重及恢复期4个阶段皆需顾护阳气:早期宜辅助阳气、透邪外出,温补卫阳或宣通阳气解表之凝滞。中期正邪交争剧烈,既要顾护阳气以防邪气内陷,又要祛除邪气以使正气来复:寒湿重者宜温阳散寒、利水渗湿;热势弥漫者宜清热泻火止汗,以截阳气外泄之势;热结成实者阳气功能异常,宜通降腑气,使阳气功能来复;同时邪正交争之证,需顾护胃气以滋卫阳、抵御疠气。危重期真阳厥脱,需回阳救逆、求得生机。恢复期注重瘥后防护,滋补阳气、阳复则阴生、清除余邪。

Application of the Theory of Protecting Yang Qi on the Treatment of COVID-19

Combined with the clinical practice of COVID-19 treated in Hangzhou Xixi Hospital,the authors believe that COVID-19 is mainly characterized by cold-damp syndrome.Cold and damp wound Yang,and Yang qi is an important component of vital qi,so the treatment of COVID-19 should always protect Yang qi.Not only should we pay attention to the plenty of Yang qi,but also to the normal operation of Yang qi.COVID-19 is divided into four stages:early,advanced,critical,and recovery.In the early stage,it is advisable to assist Yang qi,pass through the evil qi to go out,and warm up or make smooth Yang qi to relieve the stagnation of the surface.In the advanced stage,there is a fierce dispute between righteousness and evil qi.We should protect Yang qi to prevent evil qi invasion and dispel evil qi to restore vital qi.Those who are severely cold or wet should warm yang and disperse cold,remove dampness by promoting diuresis.The patient of excess syndrome caused by accumulation of heat can clear heat and drain fire to antiperspirant,in order to prevent the leakage of Yang qi.And it is appropriate to attack the heat knot,to restore the function of Yang qi.Then,syndrome of fighting between healthy qi and evil qi needs to take care of the stomach qi,in order to replenish Yang qi and resist epidemic disease.In the critical stage,Yang qi is Jue-Tuo,so we need to revive the yang for resuscitation and seek to live on.In the recovery stage,we need to pay attention to protection,including nourishing Yang qi,balancing Yin and Yang,as well as removing residual evil.