| 刘春华,刘飞,陈福如,等.中医治疗老年重症新型冠状病毒肺炎案例分析[J].浙江中医药大学学报,2020,44(9):899-904. |
| 中医治疗老年重症新型冠状病毒肺炎案例分析 |
| Case Analysis of Treatment of Elderly Severe Corona Virus Disease 2019 with Traditional Chinese Medicine |
| DOI：10.16466/j.issn1005-5509.2020.09.015 |
| 中文关键词: 新型冠状病毒肺炎 重症 疫病 医案 湿毒 中医 辨证论治 |
| 英文关键词: COVID-19 severe case epidemic disease medical cases dampness toxin traditional Chinese medicine syndrome differentiation and treatment |
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| 中文摘要: |
| [目的]介绍中医药治疗老年重症新型冠状病毒肺炎(简称新冠肺炎)的治疗经验，突显因人制宜、祛邪与扶正兼施在“疫病”治疗中的重要性。[方法]通过整理两例老年重症新冠肺炎患者的住院资料，从中医病机、症、舌、药、效等方面进行全面分析，抓住疾病不同阶段病势转化的主要矛盾，灵活有针对性地对处方药味药量进行增减，观察治疗效果。[结果]新冠肺炎乃是因“寒湿(湿毒)”引起，但受个体差异的影响，疫病的发展转归也会出现“一元多岐”的现象。本文两例重症新冠肺炎患者所在的气候、水土以及感受的“疫毒”相同，但因体质、生活习性不同，导致病程中临床证型的变化也不尽相同。病例一兼有湿热之邪，后期伤阴，出现阴虚邪恋之证，治法祛邪同时养阴辅正；而病例二邪毒闭肺证，治法以宣肺化痰为主，温、宣、利、化同施，使病情迅即逆转。[结论]对于传变迅速的“疫病”，中医尤须坚持辨病、辨证与分期的有机结合，祛邪与扶正兼施，方可达到治愈疾病的目的。 |
| 英文摘要: |
| [Objective] To introduce the experience of traditional Chinese medicine(TCM) in the treatment of severe Corona Virus Disease 2019(COVID-19) in the elderly，and highlight the importance of adapting to human conditions， eliminating evils and strengthening the body resistance in the treatment of“epidemic diseases”.[Methods] In the process of clinical diagnosis and treatment of patients with COVID-19， the data of two cases of typical hospitalized elderly patients with severe COVID-19 were collected， and comprehensive analysis was conducted from the pathogenesis， symptoms， tongue， medicine delivery， and efficacy of TCM in seizing the main contradictions in different stages during the transformation of the disease， flexible and targeted increase and decrease of prescription drugs， and finally evaluated the patients' treatment effect.[Results] The epidemic was caused by “cold dampness(wet toxin)”， but due to the influence of individual differences， the development and prognosis of epidemic diseases would also appear the phenomenon of “same source， different development”. The two cases of COVID-19 patients have the same “epidemic” of climate， water and soil， and experience. However， due to different constitutions and living habits， the clinical syndromes in the course of the disease are also different. Case one had the evil of dampness and heat at the same time， in the later period， there was evidence of lingering pathogen due to Yin deficiency， and the treatment method was to eliminate evil and nourish Yin and supplement vital Qi.Case two， however， was diagnosed as the syndrome of invaded pathogenic toxin and depression in the lung. The therapy stressed ventilating the lung and resolving phlegm， with concurrent application of warming， ventilating， draining and resolving， so as to reverse the disease to betterment in a short time.[Conclusion] The TCM physicians， when faced with any “epidemic disease” of rapid variation and transmission， must stand fast to organic combinations of disease differentiation， syndrome differentiation and staging. It is only by a combined application of eliminating evil pathogens and strengthening the body resistance that such diseases will be cured. |
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