主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2020, Vol. 43 ›› Issue (5): 357-362.doi: 10.3969/j.issn.1006-2157.2020.05.001

• 新冠肺炎专题 •    下一篇

基于“肺—三焦膜原—肾”理论对新型冠状病毒肺炎肺肾同损的认识与思考*

董斐1, 柳红良2, 谷晓红1#   

  1. 1.北京中医药大学中医学院 北京 100029;
    2.中国中医科学院广安门医院
  • 收稿日期:2020-02-13 发布日期:2020-06-08
  • 通讯作者: #谷晓红,女,硕士,教授,主任医师,博士生导师,主要研究方向:温病学理论、临床及基础研究,E-mail:guxh1003@126.com
  • 作者简介:董斐,女,博士,助理研究员
  • 基金资助:
    *国家重点研发计划项目(No.2018YFC1704100,No.2018YFC1704101)

Exploring the mechanism and treatment of lung-kidney impairment in novel coronavirus pneumonia by using the “lung-sanjiao moyuan-kidney” model theory*

Dong Fei1, Liu Hongliang2, Gu Xiaohong1#   

  1. 1. School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029,China;
    2. Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053,China
  • Received:2020-02-13 Published:2020-06-08
  • Contact: Gu Xiaohong, Chief Physician, Doctoral Supervisor. Beijing University of Chinese Medicine. No.11, Beisanhuan Donglu Road, Chaoyang District, Beijing 100029,China. E-mail:guxh1003@126.com
  • Supported by:
    National Key Research and Development Project, Ministry of Science and Technology (No.2018YFC1704100, No.2018YFC1704101)

摘要: 新型冠状病毒肺炎的肺部病变主要累及肺间质,部分患者新冠病毒在肾脏中存在高水平表达,发病初起即出现肺肾同损的表现;部分高龄、基础疾病多的患者在发病后期出现肺肾同损的表现,甚至出现多器官功能衰竭综合征(MOFS)。从中医三焦膜原的理论来看,肺间质和肾系膜等都是三焦膜原发挥作用的物质基础,这与吴又可《温疫论》提出的“邪伏膜原”病机理论是高度契合的。在此次抗击新型冠状病毒肺炎疫情一线的中医实践中,叶天士《温热论》分消上下治法的方剂被广泛应用并取得较好临床效果,笔者结合前人研究,提出“肺—三焦膜原—肾”理论模型,用以阐释其内在机制,为今后中医经典理论在新发、突发传染性疾病中的深入应用提供科学内涵。

关键词: 新型冠状病毒肺炎, 三焦膜原, 肺肾同损, 分消上下

Abstract: The novel coronavirus pneumonia is mainly characterized by involvement of pulmonary interstitial lesions. Among patients with increased expression of virus in the kidney, lung-kidney impairment tends to manifest from the early stage after onset. For patients with older age and underlying diseases, their lung and kidney seem to be both involved at later stages, which may then develop into multiple organ failure syndrome (MOFS). The “lung-sanjiao (triple energizer) moyuan (membrane source)-kidney” theory in traditional Chinese medicine (TCM) considers that lung mesenchyme and kidney mesangial membranes are the material basis for triple energizer membrane source to play its role, which is highly consistent with the pathogenesis theory of “[epidemic] pathogens lurking in the membrane source” proposed by Wu Youke in book titled On Epidemic Diseases (Wen Yi Lun). This paper articulates the model theory of “lung-triple energizer moyuan-kidney”, to reason how and why the treatment methods of “treating the upper, [middle] and lower jiao respectively (fen xiao shang xia)” by Ye Tianshi in the book titled On Warm & Heat Diseases (Wen Re Lun) are widely used and also effective in clinical practice. This model theory may serve as reference for the further application of the TCM classic theories in the treatment of emerging and emergent infectious diseases.

Key words: novel coronavirus pneumonia, sanjiao moyuan, lung-kidney impairment, divide and resolve the upper and lower (fen xiao shang xia)

中图分类号: 

  • R254.3