摘要
新型冠状病毒肺炎的基本病机可概括为"疫毒外侵,肺经受邪,正气亏虚",结合舌苔及症状表现,湖北地区该病多为寒湿所致,病久多兼饮邪等病理产物。舌苔可以作为判断病机转归的重要依据,轻症转归看中焦:发病初期,疫毒多局限于肺卫、气分,病性属实,传变较快。舌中若苔薄白润泽为顺证,预后向好;若出现厚腻苔、焦燥苔、积粉苔及无苔往往提示疫毒内犯中焦,饮停脾胃或胃败津伤,预后均欠佳。重症预后看下焦:发病中后期,疫邪累及中下二焦,病性为虚实夹杂。舌根若出现少苔、无苔提示疫毒侵及肝肾,阴精亏耗,津液干涸,视为危重;若出现厚腻苔,多提示湿困膀胱,并非死候。在新冠肺炎治疗过程中需时时顾护脾胃,并防止肝肾受累、阴液亏耗。
The basic pathogenesis of novel coronavirus pneumonia could be summarized as epidemic toxin outside invasion,lung channel attacked and deficiency of vital Qi.From a clinical point of view,the disease spreading in Hubei was mainly caused by cold-dampness with pathological products such as fluid evil during late stage.Tongue coating could be used as an important basis to judge the pathogenesis of the disease.Condition of middle Jiao should be paid close attention in mild stage.In early stage,epidemic toxin was mostly located on fleshy exterior,but changed quickly which belonged to excess syndrome.Thin white moisturized tongue coating in the middle of tongue meant favourable case,while thick greasy tongue coating,adust tongue coating,powder-like tongue coating and absence of tongue coating in the middle of tongue often indicated poor prognosis caused by epidemic toxin attacking middle Jiao with internal fluid evil and stomach broken down with body fluid consumed up.Condition of lower Jiao should be paid close attention in critical condition.During late stage,epidemic toxin was mostly located on middle and lower Jiao which belonged to the syndrome of intermingled deficiency and excess.Absence of tongue coating in the back of tongue often indicated poor prognosis caused by epidemic toxin attacking liver and kidney and deficiency of Yin-fluid,while thick greasy tongue coating often indicated humidity pouring into the bladder,not poor prognosis.In case of liver and kidney damage and body fluid consumed up,protecting spleen and stomach should be taken seriously during the whole process of treating novel coronavirus pneumonia.
作者
梁亮
王圣治
杨鸫祥
曲妮妮
LIANG Liang;WANG Shengzhi;YANG Dongxiang;QU Nini(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2020年第3期120-123,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
辽宁省科学技术计划(2020JH2/10300004)。
关键词
舌苔
新型冠状病毒肺炎
疫毒
病机
脏腑
tongue coating
COVID-19
epidemic toxin
pathogenesis
Zang-Fu organs
