从“逆传心包”角度认识新型冠状病毒肺炎相关心脏并发症

新型冠状病毒肺炎(COVID-19)属广义温病的范畴,遵循温病卫气营血传变规律,除了典型的呼吸系统症状外,还可出现心脏并发症。本文从逆传心包角度分析了肺炎相关心脏并发症的可能原因,并根据目前的诊疗指南总结其证候及治疗。原因可能与体质因素、疫毒致病力、失治误治相关,根据疫毒扰神、邪闭心包、心阳虚脱、气虚络阻证等不同的证候采取相应的针药治疗,并针对心脏轻症提出了治疗建议。中医药应发挥在救治传染病和危重症方面的优势,尽早干预,全程参与。

To Understand the Novel Coronavirus Pneumonia Related Cardiac Complications from the Perspective of Reversed Transmission to Pericardium

he Coronavirus Disease 2019(COVID-19) belongs to the category of general warm disease, follows the transmission rule of Wei, Qi, Ying and Xue, it brings about cardiac complications besides the typical respiratory symptoms. In this paper, the possible causes of the cardiac complications were analyzed from the perspective of reversed transmission to pericardium, the TCM symptoms and treatment were summarized according to the current guidelines. The possible causes may relate to constitution, virulence of COVID-19, missed diagnosis and mistreatment. Herb or acupuncture should be given according to the four syndromes which are epidemic virus disturbing mind, pathogen blocking the pericardium, heart Yang desertion, Qi deficiency obstructing the collaterals. The treatment suggestions for mild heart disease were put forward. TCM should take advantages in treating infectious diseases and critical illness, intervene as early as possible and participate in the whole process.