新型冠狀病毒肺炎重症會診病例報告兩則

Traditional Chinese Medicine Consultation of Severe Coronavirus Disease 2019: Two Case Reports

張馨予(Hsin-Yu Chang) ； 謝瓊慧(Chiung-Hui Hsieh) ； 黃建榮(Chien-Jung Huang) ； 陳煒達(Wei-Da Chen)

《中醫藥研究論叢》 25卷特刊 (2022/03) Pp. 1-12

https://doi.org/10.6516/TJTCM.202203/SP_25.0001

摘要

新型冠狀病毒肺炎（COVID-19）自2019年12月至今在全球引起大流行，台灣至2021年12月止亦確診達1萬6千多人，因5月份起的一波疫情流行導致死亡人數突破8百例。本文報告疫情流行當時於本院收治住院的兩個重症病例，兩例於住院期間除接受瑞德西韋（Remdesivir）療程外，亦同時要求中醫會診。透過中醫的診察，判斷兩例證型皆屬濕熱蘊肺、邪伏膜原之證，採宣肺清熱利濕、透達膜原方法治療後，兩例皆在服用中藥7日內病情穩定且PCR採檢陰性或Ct值≥30，符合解除隔離條件，而於第8日出院返家。兩例皆療效顯著，故撰本文予以探討。

關鍵字

新型冠狀病毒 ； 新型冠狀病毒肺炎 ； 新型冠狀病毒肺炎重症 ； 濕熱蘊肺 ； 宣肺清熱利濕

並列摘要

The Coronavirus Disease 2019 (COVID-19) has caused a pandemic since December 2019, and more than 16,000 people have been diagnosed with COVID-19 in Taiwan as of December 2021. A wave of outbreaks in May caused more than 800 deaths. In this report, we present two severe COVID-19 inpatients in our hospital during the epidemic who not only underwent Remdesivir treatment during the hospitalization, but also receiving Traditional Chinese medicine (TCM) consultation. Through the diagnosis of TCM, the two cases are both categorized into the syndromes of damp-heat accumulating in the lungs and pathogen hiding in the pleurodiaphragmatic interspace. After treatment with dispersing lung, eliminating damp-heat and removing pathogens in pleurodiaphragmatic interspace therapy, both cases came stable within 7 days of taking TCM and had a negative PCR test or a Ct value ≥30. They were both eligible for release from quarantine and discharged on the 8^(th) day after taking TCM. Here we provide these two successful experiences to suggest that dispersing lung, eliminating damp-heat and eliminating pathogens in pleurodiaphragmatic interspace therapy may be effective and applicable for COVID-19 treatment.

並列關鍵字

SARS-CoV-2 ； Coronavirus Disease 2019 ； damp-heat accumulating in the lungs ； dispersing lung ； eliminating damp-heat

參考文獻

行政院衛生福利部疾病管制署。COVID-19 防疫專區。2021 年 12 月 10 日；檢索自：http://www.cdc.gov.tw/。

行政院衛生福利部疾病管制署。COVID-19 防疫專區。《新型冠狀病毒（SARS-CoV-2）感染臨床處置暫行指引》2021 年 12 月 10 日；檢索自：https://www.cdc.gov.tw/Category/Page/xCSwc5oznwcqunujPc-qmQ。

莊曜禎、莊昆翰：新型冠狀病毒肺炎中醫護理原則。澳門護理雜誌 2020；19(1)：12-17。

呂明進、蔡金川、吳訓旺、游智勝：中醫溫病學（第四版）。台中市︰學友資訊股份有限公司，2018：239-245。

張哲儒、李威毅、黃頌儼、羅綸謙、柯富揚、孫茂峰、楊仁宏：中醫在 SARS 及 COVID-19 嚴重流行疫病臨床應用之系統性回顧。中醫藥雜誌 31 卷 2 期（2020/12），28-49。