新型冠状病毒肺炎重症、危重症恢复期患者的中医药治疗策略

本团队在多家新型冠状病毒肺炎定点医院开展了中医药救治工作,临床效果明显。虽然在经过正规、有效治疗后,大多数新冠肺炎患者可以康复出院,但是仍有约10%左右的出院患者存在临床不适症状,尤其是一些重症、危重症患者,因此,开展重症、危重症患者恢复期的中医药治疗具有重要意义。临床观察发现,肺纤维化是重症、危重症恢复期患者的重要病理改变及影像学特征,中医多表现为正虚邪恋的特点,以气虚为核心病机,或脾肺气虚,或气阴两虚,或气虚兼痰浊、血瘀而为病。针对肺纤维化这一重要病理改变和气虚这一核心病机,中医药治疗当扶正祛邪,随症加减,或益肺健脾佐以燥湿化痰,或益气养阴佐以清热生津,或益气活血兼化瘀通络等,并适当加用清解余毒的药物,以截断复发源头,提高患者生活质量。

Traditional Chinese Medicine Treatment Strategy for Convalescent Patients with Severe or Critical Cases of COVID-19

Our team has carried out the clinical treatment of traditional Chinese medicine(TCM)in many COVID-19 designated hospitals,and the clinical effect is remarkable.Although most patients with COVID-19 can be recovered and discharged after formal and effective treatment,but about 10%of discharged patients still have clinical symptoms of discomfort,especially some patients with severe or critical cases.Therefore,it is of great significance to carry out TCM treatment for convalescent patients with severe or critical cases.Clinical observation showed that pulmonary fibrosis is an important pathological change and imaging feature of patients in the convalescent period of severe or critical cases.In TCM,it is mainly manifested as the characteristics of healthy Qi deficiency with pathogen lingering,while Qi deficiency is the core pathogenesis,or spleen and lung Qi deficiency,or Qi and Yin deficiency,or Qi deficiency combined with phlegm turbid and blood stasis.For the important pathological change of pulmonary fibrosis and the core pathogenesis of Qi deficiency,TCM treatment should be used to strengthen body resistance,eliminate pathogen and modify according to symptoms.It is necessary to invigorate the lungs and spleen with drying dampness and resolving phlegm,or invigorate Qi and Yin with clearing heat and generating fluid,or invigorate Qi and blood circulation and resolving blood stasis and unblocking the collaterals.At the same time,appropriate addition of antitoxic drugs should be used to block the origin of recurrence and improve the quality life of patients.