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1. 中国中医科学院 西苑医院,北京 100091
2. 武汉市金银潭医院,武汉 430022
李斌,硕士,副主任医师,从事中医治疗风湿免疫病的研究,E-mail:libinabcdef@163.com
苗青,博士,主任医师,从事中医治疗呼吸病的研究,E-mail:miaoqing55@sina.com
纸质出版日期:2020-07-20,
网络出版日期:2020-03-18,
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李斌,丛晓东,苗青等.应用蒿芩清胆汤治疗新型冠状病毒肺炎医案分析[J].中国实验方剂学杂志,2020,26(14):1-6.
LI Bin,CONG Xiao-dong,MIAO Qing,et al.Analysis of Medical Cases of Coronavirus Disease-2019 Treated with Haoqin Qingdantang[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(14):1-6.
李斌,丛晓东,苗青等.应用蒿芩清胆汤治疗新型冠状病毒肺炎医案分析[J].中国实验方剂学杂志,2020,26(14):1-6. DOI: 10.13422/j.cnki.syfjx.20201324.
LI Bin,CONG Xiao-dong,MIAO Qing,et al.Analysis of Medical Cases of Coronavirus Disease-2019 Treated with Haoqin Qingdantang[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(14):1-6. DOI: 10.13422/j.cnki.syfjx.20201324.
新型冠状病毒肺炎(COVID-19)传染性较强,在疾病早期常表现为寒湿郁肺的证候,可出现发热乏力、身体酸痛、干咳、纳差、舌苔白腻等症状;在病情发展过程中湿毒疫邪常入里化热,湿热疫毒裹挟阻于膜原、三焦、肺脏,表现为胸闷气短,活动后加重,或发热不解,食欲差、口苦、倦怠乏力、腹泻、便溏,舌苔黄厚腻,此时邪气既可外解而向愈,又能内陷入于里,导致病情危重甚至死亡,故此时是该病治疗的关键环节。该研究以蒿芩清胆汤清利湿热、和解少阳、畅达三焦、分消湿热疫毒,截断疫毒入于里,取得了很好的疗效。该方重在调畅少阳胆和三焦,重视脾胃为后天之本,方中二陈汤调和脾胃、升清降浊,且加用北柴胡增其疏解之功,加赤芍活血行瘀,以防邪气入血。当病情改善常去青蒿、滑石,加党参以补益脾胃,扶正以祛邪。该文结合在武汉金银潭医院治疗COVID-19案例,总结应用蒿芩清胆汤的一些体会。
Coronavirus disease-2019 (COVID-19) is highly contagious. In the early stages of the disease
the symptoms of coldness
dampness and depression in the lungs often appear
including fever
fatigue
soreness
dry cough
poor appetite
and white greasy tongue coating. During the development of the disease
the damp toxin epidemic often enters the inner and generates heat
and the damp heat epidemic toxin blocks pleurodiaphragmatic sites
the triple energizer and lungs
with manifestations of chest tightness
shortness of breath
exacerbation after exercise
or high fever without bringing down
poor appetite
bitterness in mouth
fatigue
diarrhea
loose stools
and yellow and thick tongue fur. As the pathogen can go outward or enter more deeply inside to cause death at the moment
it is the crucial time to treat the disease. In this study
Haoqin Qingdantang was used to clear dampness and heat
reconcile Shaoyang channel and recover the triple energizer
detoxify the dampness fever epidemic toxin
and block the toxin inside
with a good efficacy. This prescription focuses on smoothing the Shaoyang gallbladder channel and the triple energizer
and regards the spleen and stomach as the acquired essence. In the prescription
Erchentang reconciles the spleen and stomach
elevates clear Qi and lower turbid Qi. Bupleuri Radix is added to increase its detoxification function
and Paeoniae Rubra Radix is added to circulate the blood and prevent pathogen from the blood. When the condition improves
Sweet Wormwood Herb and talc are often withdrawn
and
Codonopsis
is added to nourish the spleen and stomach
to strengthening vital qi to eliminate pathogenic factor. Based on the cases of COVID-19 treated in Wuhan Jinyintan Hospital
this paper summarized some experience of applying Haoqin Qingdantang.
蒿芩清胆汤新型冠状病毒肺炎湿毒疫验案
Haoqin Qingdantangcoronavirus disease 2019case
苗青,丛晓东,王冰,等 .新型冠状病毒感染的肺炎的中医认识与思考[J].中医杂志,2020,doi:11.2166.R.2020020 5.1606.002http://dx.doi.org/11.2166.R.2020020 5.1606.002 .
王玉光,齐文升,马家驹,等 .新型冠状病毒(2019nCoV)肺炎中医临床特征与辨证治疗初探[J].中医杂志,2020,doi:11.2166.R.20200129.1258.002http://dx.doi.org/11.2166.R.20200129.1258.002 .
连建伟 .三订通俗伤寒论[M].北京:中医古籍出版社,2002:62.
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