文章摘要
王宇皓,俞操,姚心怡,等.基于薛雪湿热三焦辨证对新型冠状病毒肺炎传变规律的探讨[J].浙江中医药大学学报,2020,44(7):599-604.
基于薛雪湿热三焦辨证对新型冠状病毒肺炎传变规律的探讨
Discussion on the Transmission Rule of COVID-19 Based on Damp-heat Tri-Jiao Syndrome Differentiation by XUE Xue
DOI:10.16466/j.issn1005-5509.2020.07.001
中文关键词: 湿热条辨  新冠肺炎  湿热病  传变规律  三焦辨证  六经  卫气营血
英文关键词: Dampness and Heat Dissection  COVID-19  damp-heat disease  transmission rule  syndrome differentiation of tri-Jiao  six meridians  Weiqi, Ying and Xue
基金项目:
作者单位E-mail
王宇皓 浙江中医药大学 杭州 310053  
俞操 浙江中医药大学 杭州 310053  
姚心怡 浙江中医药大学 杭州 310053  
韩楚轩 浙江中医药大学 杭州 310053  
王俊祺 温州医科大学  
谭增迪 浙江中医药大学 杭州 310053  
王娟 杭州市儿童医院  
沈祥峰 浙江中医药大学 杭州 310053 49472033@qq.com 
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中文摘要:
      [目的]研究外感湿热病的传变体系与治则治法,为新型冠状病毒肺炎(下称新冠肺炎)的防治提供思路。[方法]研究薛雪《湿热条辨》的内容,总结湿热病的传变规律,结合湿热疫的相关研究文献和指南,以及临床上新冠肺炎的典型症状,提出其可能的传变途径、分期证型和治则治法。[结果]新冠肺炎具有湿热病的性质,而湿热病的传变以三焦为主线,可以三焦为主体进行分期分治。邪始在上焦,则有犯太阴阳明之分,犯太阴之经则当辛温宣透、芳香化湿,犯阳明之经则当辛温宣透、渗湿泄热。进而在中焦,则有湿重于热、热重于湿之别,湿重于热则法当芳香开郁、苦温燥湿,热重于湿则主以甘寒清热、苦温燥湿。邪踞下焦,则又可见湿阻下焦、热邪下陷等证型,湿阻下焦则当清热淡渗利水,热邪下陷则当清热开窍、活血散瘀。又可以六经、卫气营血变证为支线,产生多种坏病。[结论]新冠肺炎的传变具有湿热病特点,故研究分析湿热三焦传变可以为诊疗新冠肺炎提供新的思路。
英文摘要:
      [Objective] To study the transmission system and therapeutic principle and method of exogenous damp-heat disease, and provide ideas for the prevention and treatment of coronavirus disease 2019(COVID-19).[Methods] Through studying the content of XUE Xue’s "Dampness and Heat Dissection", summarizing the transmission rule of damp-heat disease, combined with the relevant research literature of damp-heat disease, guidelines and typical symptoms of clinical novel coronavirus pneumonia, the possible transmission path of COVID-19, staging certificate type, governance rules were proposed.[Results] The nature of COVID-19 is damp-heat disease, and the transmission of damp-heat disease is mainly based on Tri-Jiao, which can be divided into three stages. If the evil attack starts at upper Jiao, it might be different between violating the Taiyin meridian or Yangming meridian, if the evil attacks the Taiyin meridian, treatment should be dispersing with pungent and warm drugs, resolving dampness with aromatics; if the evil attacks the Yangming meridian, treatment should be dispersing with pungent and warm drugs, promoting diuresis and releasing heat. If evil attacks middle-Jiao, there are different types of wet weightier than heat, or heat weightier than wet. If wet more than heat, treatment should be expelling depression with aromatics, dispelling dampness with bitter and warm drugs; if heat more than wet, treatment should be clearing away heat with sweet and cold drugs, dispelling dampness with bitter and warm drugs. If evil attacks lower-Jiao, the syndrome types of dampness blocking lower-Jiao and heat pathogen subsidence can be seen. For the syndrome type of dampness blocking lower-Jiao, the treatment should be clearing away heat, reducing infiltration and promoting diuresis; for the syndrome type of subsidence of heat pathogen, the treatment should be clearing away heat and inducing resuscitation;promoting blood circulation and removing blood stasis. COVID-19 can also take deterioration of six meridians and Weiqi,Ying and Xue as branch lines to produce a variety of deteriorated disease. The transmission rule has reference significance for clinical diagnosis and treatment of COVID-19.[Conclusion] The transmission of COVID-19 has the characteristics of damp-heat disease. Therefore, the research and analysis of the damp-heat tri-Jiao transmission can provide new ideas for the diagnosis and treatment of COVID-19.
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