Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of <italic style="font-style: italic">Wenyilun</italic>

Meng-meng ZHANG; Qi WU; Xin-xue ZHANG; Zong-jiang ZHAO

doi:10.13422/j.cnki.syfjx.20201327

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Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of Wenyilun

Topic on Epidemic Resistance | 更新时间：2020-08-11

- Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of Wenyilun
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 13, Pages: 25-31(2020)
- 作者机构：
  
  北京中医药大学中医学院，北京 102488
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20201327
  CLC： R22;R242;R2-031;R287
- Published Online：20 March 2020，
  
  Published：05 July 2020
- 稿件说明：
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张萌萌,吴琪,张新雪等.基于《温疫论》理论探讨新冠肺炎的辨证施治方法[J].中国实验方剂学杂志,2020,26(13):25-31.

ZHANG Meng-meng,WU Qi,ZHANG Xin-xue,et al.Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of Wenyilun[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(13):25-31.
张萌萌,吴琪,张新雪等.基于《温疫论》理论探讨新冠肺炎的辨证施治方法[J].中国实验方剂学杂志,2020,26(13):25-31. DOI： 10.13422/j.cnki.syfjx.20201327.

ZHANG Meng-meng,WU Qi,ZHANG Xin-xue,et al.Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of Wenyilun[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(13):25-31. DOI： 10.13422/j.cnki.syfjx.20201327.

摘要

2019年12月我国武汉爆发新型冠状病毒肺炎（新冠肺炎），具有较强的传染性和流行性，属于中医学“瘟疫”范畴，严重威胁人类的生命健康。面对这一突发的公共卫生事件，该文基于《温疫论》理论，从临床实际出发，对新冠肺炎的发病特点、传变以及辨证论治进行了解析。根据此次疫情的特点，新冠肺炎的病因为感受“戾气”，病机为疫毒遏湿，其传变遵循《温疫论》“表里九传”规律，可分为顺传与逆传，病程具有一定的规律性与阶段性。初期邪伏膜原、疫毒遏湿，应开达膜原、祛湿化浊、宣透疏利；中期病邪可顺传于表，此时应当使用辛凉解表之剂，通过战汗透邪，使邪随汗出，若湿毒入里化热，致肺络受损，腑气不通，里实热结，当通腑泻热，攻下逐邪，给邪以出路；若失治、误治、病邪太过，可致病邪内陷心包，造成神昏谵语、躁扰不宁、四肢厥逆、脉微欲绝等内闭外脱的危重表现，治疗上注意攻补兼施，开闭固脱；恢复期，由于余邪未尽，且热病易伤阴耗气，治疗上不仅要预防余邪反复，更要滋阴补血，恢复正气。在疾病治疗过程中，吴又可提出“祛邪为第一要义、忌妄汗下法、顾护脾胃”三大法则。《温疫论》对“瘟疫”的病因病机、传变和辨证施治有着系统的认识，为后代战胜历次瘟疫提供了宝贵经验，这对于此次新冠肺炎的防治同样具有重要的指导意义。

Abstract

The outbreak of corona virus disease-2019 (COVID-19) in Wuhan

China

in December 2019

is highly contagious and epidemic

and belongs to the category of "plague" in traditional Chinese medicine

which seriously threatens human life and health. In the face of this sudden public health event

based on the theory of

Wenyilun

this paper analyzes the onset characteristics

transmission

and syndrome differentiation-based treatment of COVID-19 in clinical practice. According to the characteristics of this epidemic

the pathogeny of COVID-19 is "epidemic pathogenic factors"

and the pathogenesis is that the epidemic suppresses the dampness. Its transmission follows the regularity of "nine transmissions between exterior and interior" recorded in

Wenyilun

which can be divided into sequential transmission and reverse transmission. The course of the disease has certain regularity and stages. In the early stage

the pathogen hides in the pleurodiaphragmatic interspace

and the epidemic suppresses the dampness， the treatment shall reach the pleurodiaphragmatic interspace

clear the dampness and turbidness

diffuse the lungs and dredging the lung meridian. In the middle stage

the pathogen can be transmitted to the exterior， the treatment shall be pungent in flavor and cool in property and could relieve the exterior syndrome

so as to remove the pathogen by shivering and sweating. If the dampness toxin enters the interior and be transmitted into the heat

and caused damage to the lung meridian

obstruction of Qi in the lungs

interior excess and heat accumulation

the treatment shall dredge bowel and purge heat

and expel the pathogen out. Any delay in treatment

mistreatment or excessive pathogen can lead to pathogenic invasion into the pericardium

and cause delirium

dysphoria

reversal cold of limbs

barely palpable pulse and other critical manifestations of internal blocking causing external depletion. The treatment shall focus on both attack and supplement

open blocking and relieve depletion. In the recovery period

due to the residual pathogen and the Yin and Qi impairment caused by fever

the treatment shall prevent the recurrence of the residual pathogen

nourish Yin and blood

and restore the vital energy. During the treatment

WU You-ke put forward three principles of "removing the pathogen as the priority

and then avoiding false sweating

and caring for the spleen and stomach". The theory of

Wenyilun

has a systematic understanding of the pathogeny

pathogenesis

and syndrome differentiation-based treatment of "the epidemic"

and provides valuable experience for fight against plagues in later generations

which is also of great significance for the prevention and treatment of COVID-19.

关键词

Keywords

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Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of Wenyilun

DOI：10.13422/j.cnki.syfjx.20201327

摘要

Abstract

关键词

Keywords

references