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1. 中国医学科学院 北京协和医学院 生物医学工程研究所,天津 300072
2. 中国中医科学院 中药 研究所,北京 100700
3. 江西中医药大学,南昌 330004
4. 广东省中医院,广州 510120
5. 广东省中医院 广东省中医证候临床研究重点实验室,广州 510120
岳萍,硕士,从事中医药临床应用研究,E-mail:joy20371@126.com
郭新峰,博士,研究员,从事中医循证医学研究,E-mail:guoxinfeng@gzucm.edu.cn
网络出版日期:2020-03-04,
纸质出版日期:2020-07-20
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岳萍,唐仕欢,于欢等.新型冠状病毒肺炎中医防治方案的病机与组方规律分析[J].中国实验方剂学杂志,2020,26(14):13-19.
YUE Ping,TANG Shi-huan,YU Huan,et al.Analysis of Pathogenesis and Prescription Formulating Principle of Traditional Chinese Medicine Prevention and Treatment Plan for COVID-19[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(14):13-19.
岳萍,唐仕欢,于欢等.新型冠状病毒肺炎中医防治方案的病机与组方规律分析[J].中国实验方剂学杂志,2020,26(14):13-19. DOI: 10.13422/j.cnki.syfjx.20200842.
YUE Ping,TANG Shi-huan,YU Huan,et al.Analysis of Pathogenesis and Prescription Formulating Principle of Traditional Chinese Medicine Prevention and Treatment Plan for COVID-19[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(14):13-19. DOI: 10.13422/j.cnki.syfjx.20200842.
新型冠状病毒肺炎(COVID-19)疫情发生以来,各地卫生主管部门以中医专家共识性的病因病机分析为依据,制定了一批中医诊疗方案,对预防、治疗、恢复等3个阶段不同证型推荐了指导性处方。为有效总结各方案对病机的认识以及各类处方的组方规律,本研究以全国地级市及以上卫生管理部门发布的49种中医防治方案为依据,对其中308种中药处方进行了分期整理(治疗期处方151种、预防期处方118种、恢复期处方39种)。进一步采用中医传承辅助平台对各阶段处方进行处理,总结出常见证型频次、常用中药用药频次,提炼各阶段常用药对及组合,分析其关联规则,初步总结了COVID-19中药处方用药规律。治疗期主要证型为内闭外脱、疫毒闭肺、寒湿郁肺、邪热壅肺,共涉及187味药材,单味频次>20次的共29种,使用频次最高的为苦杏仁,药对出现频次最高者为石膏-苦杏仁,核心组方为麻杏石甘汤,主要病机为寒、湿、热。预防期无统一证型,共涉及119味药材,单味频次>20次的共13种,使用频次最高的为黄芪,药对出现频次最高者为黄芪-防风,核心组方为玉屏风散,主要病机为气虚。恢复期主要证型为肺脾气虚、气阴两虚,共涉及113味药材,单味频次>10次的共12种,使用频次最高的为茯苓,药对出现频次最高者为陈皮-茯苓,核心组方为二陈汤、生脉饮,主要病机为脾气虚、阴虚。本研究初步探索了中医药参与疫情救治思路的共性,旨在为加强临床精准施治、提高中医救治效果、推进中药防控资源管理提供多方面参考。
Since the outbreak of coronavirus disease 2019 (COVID-19)
the health authorities in various regions have formulated a group of traditional Chinese medicine (TCM) diagnosis and treatment programs based on the consensus analysis of etiology and pathogenesis of TCM experts
and recommended the guiding prescriptions for different syndromes in three stages of prevention
treatment and recovery. In order to effectively summarize the understanding of the pathogenesis of each scheme and the rules of the formulation of various prescriptions
based on 49 TCM prevention and treatment plans issued by the health administration departments
308 TCM prescriptions were sorted by stages (151 prescriptions in the treatment period
118 prescriptions in the prevention period and 39 prescriptions in the recovery period). The 2019-nCoV pneumonia prescriptions was further processed by using TCM inheritance platform system. The common syndromes and the frequency of commonly used Chinese medicines were summed up. The commonly used drug pairs and combinations in different stages were extracted
and their association rules were analyzed. The rules of the Chinese herbal prescription for COVID-19 were preliminarily summarized. During the treatment period
the main syndrome types are inner blocking causing collapse
epidemic toxin in the lung
cold dampness in the lung and toxic heat in the lung
involving 187 kinds of herbs
29 kinds of herbs with single taste frequency more than 20 times.Armeniacae Semen Amarum is the most frequently used
Gypsum Fibrosum-Armeniacae Semen Amarum is the most frequently used drug-pair
the core formula is Maxing Shigan Tang
and the main pathogenesis is cold
wet and heat. There is no unified syndrome type in the prevention period
involving 119 herbs in total. There are 13 kinds of herbs with single taste frequency more than 20 times. The most frequently used is Astragali Radix. The most frequently used medicine pair is Astragali Radix-Saposhnikoviae Radix. The core formula is Yupingfeng San
and the main pathogenesis is Qi deficiency. During the recovery period
the main syndromes are deficiency of lung and spleen Qi deficiency and Qi and Yin deficiency
involving 113 herbs
12 kinds of herbs with single taste frequency more than 10 times
Poria with the highest frequency of use
Citri Reticulatae Pericarpium-Poria with the highest frequency of drug pairing
Erchentang and Shengmaiyin with the main pathogenesis of deficiency of spleen Qi and Yin. The purpose of this study is to provide multiple references for strengthening clinical precise treatment
improving the effect of TCM treatment and promoting the management of TCM prevention and control resources.
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郑文科 , 张俊华 , 杨丰文 , 等 . 中医药防治新型冠状病毒感染的肺炎各地诊疗方案综合分析 [J]. 中医杂志 , 2020 , doi: 11.2166.r.20200206.1113.002 http://doi.org//11.2166.r.20200206.1113.002 .
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