| 曹灵勇,刘建廷,朱崇瑞,等.从经方天行病治法探讨新型冠状病毒肺炎辨治思路[J].浙江中医药大学学报,2021,45(7):685-690, 725. |
| 从经方天行病治法探讨新型冠状病毒肺炎辨治思路 |
| Exploration of Syndrome Differentiation on Novel Corona Virus Pneumonia Based on the Treatment Method of Classical Formulas on Tianxing Disease |
| DOI：10.16466/j.issn1005-5509.2021.07.001 |
| 中文关键词: 新型冠状病毒肺炎 经方 涌泄法 六经辨证 分期治疗 天行病 |
| 英文关键词: Corona Virus Disease 2019 classical formulas expelling from interior method syndrome differentiation of six meridians staged treatment Tianxing disease |
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| 中文摘要: |
| [目的]总结经方治疗天行病的治法，探讨经方分期辨治新型冠状病毒肺炎(以下简称新冠肺炎)的思路。[方法]通过文献研究，总结《伤寒论》《金匮要略》及《备急千金要方》《外台秘要》等诸家经方论著之相关方药，提炼新冠肺炎经方四期辨治思路，并结合临床案例进行分析。[结果]经方辨治天行病以“解肌-涌泄”二法为主线。结合新冠肺炎“湿疫”的病证特点、寒湿蕴热的病机特点及经方治疗湿病的六经辨治规律，提出新冠肺炎“涌泄为主，兼及六经”的治疗原则及分期辨治规律。新冠肺炎分期治法规律及代表方:初期(太阳层面)应以散寒解肌、涌泄湿毒为法；典型期(阳明层面)应以酸苦涌泄、泻火解毒为法；重症期(少阳层面、厥阴层面)应分别以疏利三焦、涌泄通腑及凉血解毒、涌泄开窍为法；恢复期余邪未净、津亏胃弱，以甘凉养益、兼透余邪为法。所附两则典型期(阳明层面)医案经治疗转入恢复期(湿热未净)，分别使用百痛壮热方和增损栀子豉汤，另一则为恢复期(余热未清)医案，使用竹叶石膏加生姜汤，都取得了良好疗效，验证了新冠肺炎的证候特点、治法及转归符合前述规律。[结论]经方对天行病的认识和治疗方药，可为新冠肺炎的防治研究提供文献与理论支持。 |
| 英文摘要: |
| [Objective] To summarize the treatment method of Tianxing disease by classical formulas and explore the idea of using classical formulas in syndrome differentiation and treatment of Corona Virus Disease 2019(COVID-19) by stages.[Methods]Through literature research， this paper summarized the formulas and herbs in“Treatise on Febrile Diseases”“Synopsis of the Golden Chamber”“Invaluable Prescriptions for Ready Reference”“Medical Secrets of Official” and other renowned classical texts， and refined ideas of four stages syndrome differentiation and treatment with classical formulas on COVID-19， and combined with clinical cases for analysis. [Results]It is suggested that the mainline of syndrome differentiation of Tianxing disease was the method of “expelling from the muscles-expelling from interior”. Combined with the syndrome characteristics of COVID-19“epidemic disease of dampness”， the pathogenesis characteristics of cold-dampness accumulating heat pathogens and the pattern of six-meridian differential diagnosis of dampness disease using classical formulas， therefore， the treatment principle for syndrome differentiation by stages for treating COVID-19 was put forward， which included “expelling from interior method and taking six-meridian differentiation into consideration”. And the treatment pattern by stages and representative formulas were put forward: In initial stage(Taiyang aspect)，the method should be based on dispersing the cold and expelling from the muscles， drainage dampness pathogen using expelling from interior; typical stage(Yangming aspect) should use the expelling from interior method with bitter or sour herbs and purging fire and detoxifying; critical stage(Shaoyang and Jueyin aspect) should adopt the methods of dredging and smoothing tri-Jiao and expelling from interior by draining Fu-organ， or cooling blood with detoxification and expelling from interior by opening orifices， respectively; during recovery stage， the residual pathogens are not all cleaned， body fluids deficient and the stomach is weak， sweet and cooling herbs should be adopted to regenerate while relieving the residual pathogens. The two medical cases of typical stage(Yangming aspect) transformed into recovery stage(with residual damp-heat) after treatment，Baitong Zhuangre Decoction and Revised Zhizichi Decoction were used respectively; another case was in recovery stage(with residual heat) was treated with Zhuye Shigao Plus Shengjiang Decoction， all the patients got good results. The syndrome characteristics， treatment and prognosis of this disease were verified to be in accordance with the above pattern.[Conclusion] Understanding of the knowledge and treatment of Tianxing disease with classical formulas could provide literature and theoretical support for the further research on COVID-19. |
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