| 黄琳,郦琳,杨辉,等.脾肺两虚型重症新型冠状病毒肺炎的机制与临证探讨[J].浙江中医药大学学报,2020,44(6):495-499, 506. |
| 脾肺两虚型重症新型冠状病毒肺炎的机制与临证探讨 |
| Discussion on the Mechanism and Clinical Symptoms of Severe COVID-19 with Spleen-lung Deficiency Syndrome |
| DOI：10.16466/j.issn1005-5509.2020.06.001 |
| 中文关键词: 新型冠状病毒肺炎 重症肺炎 机制 ACE2 脾肺两虚 培元宣化解毒方 验案 |
| 英文关键词: COVID-19 severe pneumonia mechanism ACE2 spleen-lung deficiency syndrome Peiyuan Xuanhua Jiedu formula consilias |
| 基金项目:浙江省自然科学基金项目“新型冠状病毒肺炎应急防治”专项(LEZ20H190001) |
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| 中文摘要: |
| [目的]从脾肺两虚证与血管紧张素转化酶Ⅱ(angiotensin-converting enzyme 2，ACE2)的角度探讨新型冠状病毒肺炎(Corona Virus Disease 2019，COVID-19)普通型转为重症的机制，并结合案例探讨培元宣化解毒方抑制COVID-19普通型转为重症的作用。[方法]通过临床观测与相关文献分析，总结ACE2与COVID-19肺脾两虚证的关系，阐明其对普通型转为重症的影响，并列举杭州市西溪医院确诊验案一则加以佐证。[结果]文献分析显示，脾肺两虚证患者感染后易转为重症的机制与ACE2相关。病毒可竞争性结合ACE2，引起消化道及其他脏器损伤，影响机体对病毒的免疫能力。杭州市西溪医院诊治的COVID-19确诊病例中50.7%属于脾肺两虚证。所举病案诊断为COVID-19(湿毒郁肺兼脾肺两虚证)，以培元宣化解毒方结合西医治疗，提高了患者免疫力和抗病毒能力，从而抑制了普通型向重症的转化。[结论]脾肺两虚型COVID-19患者转为重症的机制与ACE2密切相关，运用培元宣化解毒方抑制其转为重症具有良效。 |
| 英文摘要: |
| [Objective] To explore the mechanism of Corona Virus Disease 2019(COVID-19)'s conversion from common type to severe disease from the point of view of spleen-lung deficiency syndrome and angiotensin converting enzyme Ⅱ(ACE2)， and to explore the effect of Peiyuan Xuanhua Jiedu formula on inhibiting the conversion from common type to severe disease.[Methods]Through clinical observation and related literature analysis， the relationship between ACE2 and COVID-19 with spleen-lung deficiency syndrome was summarized， and its influence on the conversion of common type to severe disease was clarified， and a confirmed case from Hangzhou Xixi Hospital was given to prove it.[Results] Literature analysis showed that the mechanism of patients with spleen-lung deficiency syndrome turning to severe disease after infection was related to ACE2. Virus can competitively combine with ACE2， to cause damage to digestive tract and other organs， affecting the immune ability of the body to the virus. During the treatment of confirmed cases in Hangzhou Xixi Hospital， it was found that 50.7% of COVID-19 patients belonged to spleen-lung deficiency syndrome. The medical case was diagnosed as COVID-19(damp-toxin constraint in the lung pattern combined with deficiency of spleen and lung syndrome)， treated with Peiyuan Xuanhua Jiedu formula and western medicine， the immunity and antiviral ability of patient was improved， and the conversion from common type to severe disease was inhibited.[Conclusion]The mechanism that patients with deficiency of spleen and lung become severe after infection with COVID-19 virus are closely related to ACE2. It is effective to use Peiyuan Xuanhua Jiedu formula to prevent it from becoming more severe. |
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