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1.中国中医科学院 中医基础理论研究所,北京 100700
2.中国中医科学院 医学实验中心,北京 100700
3.中华中医药学会,北京 100029
申力,博士,副研究员,从事中医基础理论和临床疗效研究,E-mail:shenli1116@126.com
曹洪欣,博士,教授,从事中医对生命和疾病认知方法研究,E-mail:caohx898@163.com
收稿日期:2020-05-23,
网络出版日期:2020-07-23,
纸质出版日期:2020-10-05
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申力,唐丹丽,曹洪欣.中医药治疗新型冠状病毒肺炎心肌损伤[J].中国实验方剂学杂志,2020,26(19):80-83.
SHEN Li,TANG Dan-li,CAO Hong-xin.Treatment of Myocardial Injury from Coronavirus Disease-2019 by Chinese Medicine[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(19):80-83.
申力,唐丹丽,曹洪欣.中医药治疗新型冠状病毒肺炎心肌损伤[J].中国实验方剂学杂志,2020,26(19):80-83. DOI: 10.13422/j.cnki.syfjx.20201926.
SHEN Li,TANG Dan-li,CAO Hong-xin.Treatment of Myocardial Injury from Coronavirus Disease-2019 by Chinese Medicine[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(19):80-83. DOI: 10.13422/j.cnki.syfjx.20201926.
新型冠状病毒肺炎(COVID-19)心肌损伤是新型冠状病毒感染后出现的一种临床征象,伴随着罹患COVID-19后出现,或见于急性发病期的普通型与重症,或于COVID-19临床痊愈后发病,概由疫毒邪气由口、鼻而入,客于肺卫,肺朝百脉、心主血脉,肺脏受邪,累及于心,气血不畅而发为心肌损伤。通过治疗100余例确诊COVID-19与出院康复患者,发现部分新型冠状病毒感染患者出现心悸、气短、胸痛、胸憋闷、乏力等症状,检查所见心电图心肌缺血损伤、心肌酶升高等,表现温邪上受,首先犯肺、逆传于心的病理变化。新型冠状病毒感染引起心肌损伤,一方面COVID-19患者痊愈出院后,仍有体弱乏力、病情缠绵难愈,另一方面重症患者出现心肌损伤,极易加重病情,甚则危及生命。临床根据发病不同阶段、病情轻重程度及康复期与患者体质采用不同的证治方法。急性重型COVID-19病患心肌损伤,可用生脉饮、急救回阳汤等加减,毒热扰乱心神可酌情使用安宫牛黄丸、至宝丹等;对普通型COVID-19出现心肌损伤,可用竹叶石膏汤与升陷汤加减;对COVID-19临床痊愈后以心肌损伤为主的病理变化用升陷汤、养心汤和柴陷汤等化裁,运用解毒益气养阴、益气升陷、活血化痰等方法治疗COVID-19心肌损伤,能有效改善临床症状,使心肌酶与心电图恢复正常范围,疗效满意,体现中医药治疗COVID-19心肌损伤的整体优势。
Myocardial injury from coronavirus disease-2019 (COVID-19) is a clinical sign after the novel coronavirus infection
which can be seen in common type and severe type in acute stage
or after recovery of COVID-19. From the mouth and nose
the epidemic and pathogenic factors enter the lung
involving the heart
so that Qi and blood are blocked and developed into myocardial injury. More than 100 patients with COVID-19 and rehabilitation were treated
and we found that some patients infected with novel coronavirus had palpitation
shortness of breath
chest pain
chest oppression
fatigue and other symptoms. Electrocardiogram(ECG) showed myocardial ischemia injury and increased myocardial enzymes
due to the pathological changes of warm pathogen
first invading the lung and reversely spreading to the heart. Myocardial injury due to infection of novel coronavirus
on the one hand
made the patients weak and conditions lingering and hard to heal after COVID-19 was recovered in discharged patients. On the other hand
myocardial injury in severe cases could easily aggravate the disease and even threaten life. According to the different stages of the disease
the severity of the disease
and the patients' physique in the recovery period
different treatment methods were adopted. For the myocardial injury in patients with acute severe COVID-19
Shengmaiyin and Emergency Huiyangtang can be taken, if the poisonous heat disturbs the mind
we can use Angong Niuhuangwan and Zhibaodan as appropriate. For myocardial injury occurred in common type of COVID-19
Zhuye Shigaotang and Shenxiantang can be used. For the pathological changes mainly including myocardial injury after clinical recovery of COVID-19
we can use Shengxiantang
Yangxintang
Chaixiantang and so on. Methods of detoxification
tonifying Qi and Yin
invigorating Qi and ascending Qi collapse
blood circulation and phlegm resolving were used for treatment of myocardial injury from COVID-19
which can not only effectively improve clinical symptoms
but also restore creatine kinase isoenzyme-MB(CPK-MB) and ECG levels to obtain satisfactory results. All of these could reflect that TCM has a notable advantage in the prevention and treatment of this disease.
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