新型冠狀病毒中西醫治療簡要

Brief Summary of Traditional Chinese and Western Medicine Treatment for COVID-19

紀奕彰(I-Chang Chi) ； 賴英秀(Ing-Shiow Layl) ； 黃升騰(Sheng-Teng Huang) ； 涂育嘉(Yu-Chia Tu) ； 林宏任(Hung-Jen Lin)

《臺灣中醫醫學雜誌》 19卷1期 (2021/09) Pp. 43-53

摘要

新冠肺炎從110年五月開始在台灣造成大規模的社區感染，造成數百人死亡，不論西醫或是中醫的治療在現階段對於SARS-CoV-2進入人體後造成的身體反應仍未完全明瞭，治療方針與藥物的研發亦仍隨著新的研究與發現而有所更動，但對於疾病治療有其迫切性，故而整理統整現行台灣所遵循的新冠肺炎疾病分類（輕症、中度、重度、極重度）標準與其不同時期的治療；並就17位大陸中醫專家，對於新冠肺炎感染症在不同時期的主要病邪與受侵犯的臟腑進行分析，可見初期以寒濕病邪侵犯肺胃為主；中期轉成以濕熱疫毒壅肺、閉肺為主；重症期多見內閉外脫，恢復期以脾肺氣陰兩虛為主，並附上其常用處方，以提供臨床醫師執業參考。然而對於輕症與中度患者西醫現行並無特殊介入策略，多以支持性療法為主，或許在中醫的辨證處方治療下，有機會可以盡早截斷病邪傳變，進一步降低其發展成為重症的比率。

關鍵字

新冠肺炎 ； 新型冠狀病毒 ； COVID-19 ； 肺炎 ； 中醫

並列摘要

The COVID-19 outbreak in Taiwan from May 2021, leading to widespread community transmission and causing hundreds of deaths. The physiological mechanism about SARS-CoV-2 infection is not clear and treatments and drugs are changed in accordance with new research and findings. Now, we integrate the current classification of COVID-19 (mild, moderate, severe, and critical) and the treatments followed by Taiwan, and we alse analyze the experience of 17 traditional chinese medicine experts in china on pathogenic factors and visceral involvement in different period. In the early stage, cold and dampness pathogens invaded the lung and stomach. In the middle stage, the syndrome of heat and dampness-toxin congesting and obstructing lung were the most common. In severe cases, the internal blockade and external collapse was the most common syndrome. In the recovery period, the most common syndrome was Qi and Yin vacuity in lung and spleen. However, Western medicine has no special intervention strategies for mild and moderate patients. Perhaps under the treatment of syndrome differentiation and prescription of chinese medicine is an opportunity to cut off the transmission of disease progressing from mild to severe.

並列關鍵字

coronavirus disease ； Coronavirus disease 2019(COVID-19) ； pneumonia ； Chinese Medicine

參考文獻

陽光耀，廖文進，方文豐等：新型冠狀病毒感染（COVID-19）重症照護暫行共識。台灣胸腔暨重症加護醫學會。2021年5月24日第二版; 10-11,15-16。

行政院衛生福利部疾病管制署。新型冠狀病毒SARS-CoV-2感染臨床處置暫行指引。2021年6月23日第十二版; 4-11,16-19,32-36。

高國晉，陽光耀，張厚台等：新型冠狀病毒感染（COVID-19）併發急性呼吸衰竭臨床處置指引。台灣胸腔暨重症加護醫學會。2020年5月4日第二版; 27-28。

CDC. Interim Clinical Guidance for Management of Parians with Confirmed 2019 Novel Coronavirus ( 2019-nCoV) Infection. Updated Feb. 16, 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-parients.html

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet Journal 2020 ;395 ;507-512