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 (6): 457-462.doi: 10.3969/j.issn.1006-2157.2020.06.003

• 新冠肺炎专题 • 上一篇    下一篇

111例新型冠状病毒肺炎患者中医辨治临床观察*

黄东晖1, 冯淬灵2, 蔡俊翔1, 王凯源3, 谢东平1, 冯枫2, 宋林4, 温敏勇5, 王同汉6, 张忠德1#   

  1. 1 广东省中医院 广东 510000;
    2 北京大学人民医院;
    3 北京中医药大学;
    4 湖北省中西医结合医院;
    5 广州中医药大学第一附属医院;
    6 广东省第二中医院
  • 收稿日期:2020-02-15 发布日期:2020-07-06
  • 通讯作者: #张忠德,男,硕士,主任医师,教授,博士生导师,主要研究方向:中医药防治呼吸系统疾病,E-mail:doctorzzd99@163.com
  • 作者简介:黄东晖,男,硕士,主任医师,教授
  • 基金资助:
    *国家中医药管理局应急专项资助项目(No.2020ZYLCYJ05-12),广东省第二批中医优秀人才研修资助项目[No.粤中医办函(2017)267号],广东省教育厅普通高校新冠疫情防控专项资助项目(No.2020KZDZX1053)

Diagnosis and treatment of novel coronavirus pneumonia with traditional Chinese medicine based on clinical observation of 111 cases*

Huang Donghui1, Feng Cuiling2, Cai Junxiang1, Wang Kaiyuan3, Xie Dongping1, Feng Feng2, Song Lin4, Wen Minyong5, Wang Tonghan6, Zhang Zhongde1#   

  1. 1 Guangdong Provincial Hospital of Chinese Medicine, Guangdong 510000, China;
    2 Peking University People’s Hospital, Beijing 100044, China;
    3 Beijing University of Chinese Medicine, Beijing 100029, China;
    4 Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Hubei 430015, China;
    5 The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong 510405, China;
    6 Guangdong Second Traditional Chinese Medicine Hospital, Guangdong 510095, China
  • Received:2020-02-15 Published:2020-07-06
  • Contact: Prof. Zhang Zhongde, Master’s, Chief Physician, Doctoral Supervisor. Guangdong Provincial Hospital of Chinese Medicine. No.111 Dadelu Road, Yuexiu District, Guangzhou 510000. E-mail: doctorzzd99@163.com
  • Supported by:
    Emergency Management Special Projects Funded by National Administration of Traditional Chinese Medicine (No.2020ZYLCYJ05-12), The Second Batch of Training Programs for Outstanding Talents of Traditional Chinese Medicine in Guangdong Province (No.[2017]267), Novel Coronavirus Pneumonia Prevention and Control Special Programs in Institutions of Higher Learning Funded by Department of Education of Guangdong Province (No.2020KZDZX1053)

摘要: 目的 报道中医辨治111例新型冠状病毒肺炎患者的临床疗效,探讨新型冠状病毒肺炎的中医病因及病机。方法 广东省中医医疗队于2020年1月29日至2020年2月11日接管湖北省中西医结合医院收治的111例新冠肺炎患者,在西医治疗基础上按轻型、普通型、重型、危重型进行中医辨证施治,均给予中药汤剂或者颗粒剂。分别进行总体疗效评价及症状改善情况统计。结果 111例新型冠状病毒肺炎患者中出院37例,病情改善62例,病情无变化3例,病情恶化转入ICU病房1例,死亡8例(其中4例为医疗队接管病区后12 h内死亡)。主要症状改善情况:轻型、普通型患者症状100%消失,重型、危重型患者发热、咳嗽、腹泻、便秘、恶心呕吐等显著改善。结论 新型冠状病毒肺炎隶属中医疫病范畴。湿毒疫邪是最主要的致病因素,湿邪困脾、疫毒闭肺是核心病机,湿邪贯穿始终,随疾病进展及个体禀赋差异可出现化热、化燥,少数可见寒化。治疗应中西医并重,中医药全程参与,辨证施治,可以取得良好的临床疗效。

关键词: 新型冠状病毒肺炎, 辨证论治, 临床观察

Abstract: Objective To report the clinical effectiveness of traditional Chinese medicine (TCM) in the treatment of novel coronavirus pneumonia (NCP) and explore the TCM understanding of this disease including its etiology, pathogenesis and treatment approaches. Methods 111 patients diagnosed with NCP from January 29 to February 11, 2020 were enrolled at Hubei Provincial Hospital of Integrated Chinese & Western Medicine in the city of Wuhan and treated by Guangdong TCM medical team with Chinese medicine decoction or granule on the basis of conventional supportive therapy. TCM treatment was individualized based on patient categories of mild, moderate, severe and critical conditions under the guidance of pattern differentiation principle. Global improvement and symptom relief were evaluated after treatment. Results Among the 111 patients, 37 patients were recovered and discharged. 62 patients were improving. Disease conditions of 3 cases remained unchanged. One patient deteriorated and was transferred to ICU, and 8 cases died (among which, 4 cases died within 12 hours since the Guangdong medical team took them over on January 29). Symptoms of patients with mild and moderate conditions were 100% gone. For severe and critical cases, their symptoms like fever, cough, diarrhea, constipation, nausea and vomiting were significantly relieved. Conclusion NCP falls into the category of epidemic diseases in TCM. Epidemic dampness toxin seemed to be the main etiological factor. Pathogenic dampness encumbering the spleen and epidemic toxin blocking the lung are the core pathogenesis while pathogenic dampness is persistent throughout the disease and may easily transform into heat, dryness and occasionally cold during disease progression. TCM therapies based on pattern differentiation should be offered alongside standard care of modern medicine throughout the course of disease as favorable clinical outcomes are now observed with this integrative approach.

Key words: novel coronavirus pneumonia (NCP), pattern differentiation and treatment, clinical efficacy evaluation

中图分类号: 

  • R259