| 摘要: |
| 从壬寅岁末我省新型冠状病毒流行的季节气候及其发病时比较普遍多见的证候分析，认为此次疫病多属“寒湿疫”类。按《伤寒论》六病分类，多以太阳少阳合病为主。其病因病机为疫毒挟寒、湿之淫邪外侵，痹阻太阳，闭塞肺气，困扰胃肠，郁结少阳，乃至化热生毒，酿痰成瘀，殃及心、脾、肝、肾等。其发病急剧，传变迅速，往往诡异缠绵，吉凶难料。故治疗贵早贵快，初起就需表里同治，寒温并用，即外解表邪以驱毒，内清里热以解毒，尽快分消表邪疫毒，截断病势，方以自拟柴胡羌蒲汤加减；若病情发展，形成感染性肺炎，则宜根据辨证，分清寒热，分别采取清肺解毒、化痰止咳，或温肺化饮的法则治之，以自拟清肺化痰解毒汤或经方小青龙汤加减。恢复期，则以扶正气、祛余邪并施为大法，需因人而异，辨证分析，随机调治。附验案6则，分析病机及疗效机制，以供同道参考。 |
| 关键词: 新型冠状病毒感染 病毒性肺炎 寒湿疫 柴胡羌蒲汤 清肺化痰解毒汤 小青龙汤 |
| DOI： |
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| Syndrome differentiation and treatment of coronavirus disease 2019 and analysis of proven cases:Discussion at the end of Renyin Year |
| YUAN Changjin |
| (The Second Affiliated Hospital of Hunan University of Chinese Medicine，Changsha 410005，Hunan，China) |
| Abstract: |
| Based on the analysis of the seasonal climate of the epidemic of severe acute respiratory syndrome coronavirus 2 in Hunan Province at the end of Renyin Year and the relatively common syndromes at the time of onset，it is believed that the epidemic is mostly a “cold and wet epidemic”.According to the classification of six diseases in Treatise on Febrile Diseases，the combination of Greater Yang and Lesser Yang is the main disease.The etiology and pathogenesis are that the epidemic toxin invades the outside with cold and damp pathogens，paralyzes the sun，occludes lung Qi，troubles the stomach and intestines，leads to stagnation and Lesser Yang，and even transforms heat to produce toxins，causing phlegm to become stasis and affecting the heart，spleen，liver，kidney，etc.Coronavirus disease 2019 occurs and spreads rapidly，and it is often strange and lingering，with unpredictable good or bad outcome.Therefore，early treatment is advisable.From the beginning，it is necessary to treat both the outside and the inside，using both cold and warm means，that is，to eliminate the external evils for expelling the toxin and to clear the internal heat for detoxifying the body.The external evils and epidemic toxins should be dispelled as soon as possible to cut off the disease，with the use of self-made modified Chaihu Qiangpu decoction.If the disease progresses to pneumonia，it is advisable to distinguish between cold and heat according to syndrome differentiation and adopt lung-clearing/detoxifying and phlegm-resolving/cough-relieving therapies or lung-warming and retained fluid-resolving therapies，with the use of self-made lung-clearing，phlegm-resolving，and detoxifying decoction or modified classical prescription Xiaoqinglong decoction.In the recovery period，the methods of strengthening the vital energy and dispelling the remaining evils are used in combination on an individual basis，with syndrome differentiation and random adjustment.Six proven cases are attached to analyze the pathogenesis as well as treatment outcome and mechanism for peer reference. |
| Key words: severe acute respiratory syndrome coronavirus 2 infection viral pneumonia cold and wet epidemic Chaihu Qiangpu decoction lung-clearing,phlegm-resolving,and detoxifying decoction Xiaoqinglong decoction |
