25S.12 薛生白濕熱病理論治療COVID-19案例（含脈象分析）暨基層中醫策略
TJ TCM.25(S) : 89-98, 2022
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薛生白濕熱病理論治療COVID-19 案例
（含脈象分析）暨基層中醫策略
Treating COVID-19 as A Dampness Type
Febrile Disease: A Case Report with Pulse Manifestation
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林以正1*
1 東門中醫診所，台北，台灣
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【摘要】
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因為隔離政策，大多數的COVID-19（新冠肺炎）的中醫治療案例並無脈象之記載，本案例為一位會把脈的男性，在疾病的每個過程皆忠實的記錄自我脈象及血氧的變化，資料完整，足以做為中醫治療新興傳染病的寶貴經驗。案例在剛發病時，脈象上即呈現明顯的濕熱直入中下焦的現象，因而依照薛生白．濕熱病篇的觀點治療。病人歷經發燒、腹痛腹瀉、疼痛、咳嗽帶血、血氧下降、體重大幅下降，病後疲倦喘促⋯⋯。在整個過程中，並未住院，也沒有使用氧氣，完整地接受中醫藥治療。本文將介紹案例的病程及脈象資料，並討論基層中醫面對新興傳染病，在初期如何判斷發展為重症的可能性、過程援引古籍為治療的根本、後期以筋膜張力結構及中醫內科並行，作為主要的修復手段。
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【關鍵詞】甘露消毒丹、脈象中筋膜張力、胃俞穴
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Yii-Jeng Lin1*
1East-Gate Traditional Chinese Medicine Clinic, Taipei, Taiwan
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【Summary】
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Because of the isolation policy, there are no pulse manifestations in most of the case reports of COVID-19 treated with traditional Chinese medicine. In our case report, the patient who is professional in TCM pulse detection faithfully records his own pulse and blood oxygen changes during each course of the disease. This is a valuable experience.
At the time of disease onset, the pulse manifestation showed obvious dampness and heat going directly into the middle and lower part of the body. Thus, the patient was treated under the protocols of Shengbai Xue’s dampness type febrile disease theory. The patient experienced fever, abdominal pain, diarrhea, bloody sputum, decreased blood oxygen, significant weight loss, fatigue and shortness. He was not hospitalized nor used oxygen. He received Chinese medicine treatment during the whole course. By the view of the dampness type febrile disease, we discuss the observation points of the possibility of developing severe illness in the initial stage and the treatment protocol in each course of the disease. In post-COVID stage, we concurrently used Chinese medicine and acupuncture under the theory of “the pulse manifestation of fascial tension”.
【Keywords】Gan Lu Xiao Du Dan; the pulse manifestation of fascial tension;Weishu (BL 21)
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