络病理论指导新型冠状病毒肺炎证治探讨

笔者应用络病理论指导新型冠状病毒肺炎证治研究,指出肺络包括气络与血络,是肺主气、司呼吸、朝百脉功能发挥的基础,气道与气络概念不同,但其功能与肺络密切相关。新型冠状病毒肺炎属中医"瘟疫"范畴,疫毒之邪由口鼻而入发病。疫毒袭肺、气道壅滞、邪盛正退、气络虚滞是该病早期特点,毒热内生、气道壅阻、"换气转血"功能失常是该病发展加重的关键环节,气病及血、血伤入络、耗血动血是该病后期转归。汲取历代医家瘟疫的治疗用药经验,提出早中期积极干预的治疗原则--首重病因、驱逐毒邪;先证用药、积极干预;整体调节、多靶治疗。以络病理论为指导研制的连花清瘟可以体外抑制新型冠状病毒活性,改善发热、咳嗽、乏力、气促等临床症状,减少疾病向重症发展的比率;连花清咳宣肺泄热、止咳化痰,可用于改善新型冠状病毒肺炎患者咳嗽咳痰症状,佐证了络病理论及通络药物在疫情防控中的重要科学价值。

Discussion About Guidance of Diagnosis and Treatment of COVID-19 by Luobing Theory

This paper uses the Luobing theory to guide the diagnosis and treatment of coronavirus disease-2019 (COVID-19), and states that lung collateral includes Qi collateral and blood collateral, and is the basis for playing the function of lung of dominating Qi, controlling breathing and connecting all vessels. The concept of Qi channel is different from that of Qi collateral, but its function is closely related to lung collateral. COVID-19 belongs to "pestilence" in traditional Chinese medicine. The epidemic pathogenic factor enters from mouth and nose and then causes the disease. The early characteristics of this disease include the invasion of the lung by the epidemic pathogenic factor, the obstruction of Qi channels, the prevailing of the evil and the retreat of the good, and the deficiency and stagnation of Qi collateral. Generation of toxic heat from inside, obstruction of Qi channels and dysfunction of "breathing and blood transfer" are the key links to the development and aggravation of this disease. Qi disease involves blood, blood wound intrudes into collateral, and blood consumption and hemorrhage are the late outcome of this disease. Based on the experience of doctors of all dynasties in the treatment and medication of pestilence, the treatment principle of active intervention in the early and middle stage is proposed, including focusing on pathogenesis and expelling of toxin, drug use before syndrome onset and active intervention, and the whole regulation and multi-target treatment. Lianhua Qingwen developed under the guidance of Luobing theory can inhibit the activity of novel coronavirus in vitro, relieve clinical symptoms (such as fever, cough, weakness, shortness of breath and so on) and reduce the rate of disease progression to severity. Lianhua Qingke can diffuse the lung, clear the lung heat, relieve cough and reduce sputum. It can be used to relieve the symptoms of cough and sputum in patients with COVID-19, which proves the important scientific value of Luobing theory and collateral-dredging drugs in epidemic prevention and control.