中醫藥研究論叢

23S.2 新型冠狀病毒(SARS-CoV-2)感染中醫整合臨床處置暫行指引第一版

 TJ TCM.23(S) : 5-34, 2020

新型冠狀病毒(SARS-CoV-2)感染中醫
整合臨床處置暫行指引第一版
Interim Traditional Medicine Clinical Guideline for Management of Patients with Confirmed
Coronavirus Disease (COVID-19) 1st edition
林恭儀1* 黃建榮2 鄭宏足3 陳文戎4 陳曉鈞5
王翊錞1 吳詩儀6 盧景裕1 劉姿妤7
1 頌讚中醫診所,台北,台灣
2 台北市中醫師公會,台北,台灣
3 國立清華大學,新竹,台灣
4 翰林中醫診所,台北,台灣
5 悅展中醫診所,台北,台灣
6 圓扶圓中醫診所,台中,台灣
7 台北醫學大學,台北,台灣
【摘要】
新型冠狀病毒(SARS-CoV-2)肺炎全球大流行,中醫臨床支持性經驗治療具實證醫學基礎。本研究目的,在於藉由系統性文獻回顧,建立中醫實證基礎新冠肺炎支持與經驗臨床準則。
研究方法:系統性搜尋傳統中醫藥在嚴重特殊傳染性肺炎醫學文獻,以混和內容與文本分析法,經由輔助軟體,分析醫療文獻資料,依序登錄、編碼、歸檔、萃取概念、形成分類、重建架構來形成內容文本。
結果:指引內容,分為臨床表現、病程進展、臨床與診斷、臨床治療與照護,和試驗性治療等五大類。其中病程進展細分為疾病嚴重度、臨床病程、重症危險因子、藥物資訊和恢復期再感染等五項。中醫臨床治療與照護分為無症狀或臨床前期、輕度、中度、嚴重、危重與感染恢復症候六大型。
結論:新型冠狀病毒感染之中醫整合臨床處置暫行性指引第一版共分六大症候。以傷寒為經,採用科學病程分類無症狀與臨床前期症型、輕度症型、中度症型、嚴重症型、危重症型與感染恢復症候等六型。因此,在照護SARSCoV-2 感染個案辨證論治上,建議應包括感控、住院隔離照護、重症加護支持性療法與中醫整合醫療。
【關鍵詞】新型冠狀病毒、武漢肺炎、傳統醫學、暫行臨床指引、傷寒論
Justin Kung Yi Lin1*Chien-Jung Huang2Hung-Tsu Cheng3Wen-Jung Chen4
Hsiao-Chun Chen5Yi-Chui Wang1Shi-Yi Wu 6Ching-Yu Lu1Tzu-Yu Liu7
1Singing Praises TCM Clinic, Taipei, Taiwan
2Taipei Chinese Medical Association, Taipei, Taiwan
3National Tsing Hua University, Hsinchu, Taipei
4Han-Lin TCM Clinic, Taipei, Taiwan
5Yueh-Tsan TCM Clinic, Taipei, Taiwan
6Yuan-Fu-Yuan TCM Clinic, Taichung, Taiwan
7Taipei Medical University, Taipei, Taiwan
【Summary】
Introduction: The severe pneumonia with novel pathogens, COVID-19, was rampant globally. However, the TCM was so fully clinical evidence-based for supportive treatment and symptom care. The purpose of this study was to establish an interim clinical guideline in scientific base by the systematic literature review of the empirical basis of TCM data.
Methods: We systematically searched for traditional Chinese medicine in the medical literature of COVID-19, and analyzed all data through auxiliary software with mixed method of content and text analysis to reconstruct the architecture to form main contexture.
Results: The content of the guideline was divided into five categories as clinical manifestations, progression of disease, clinical and diagnosis, clinical treatment and care, and finally experimental treatment. The progress of the course of disease was subdivided into five domains with disease severity, clinical course, severe risk factors, drug information, and reinfection during recovery. The clinical treatment and care of TCM were divided into asymptomatic or pre-clinical, mild, moderate, severe, critical, and infection recovery.
Conclusions: The first version of the Interim Guidelines for Integrated Clinical Treatment of New Coronavirus (SARS-CoV-2) Infection in TCM was divided into six major symptoms. Taking marine Treatise on Febrile and Miscellaneous Disease as a classic, the scientific course of disease was used to classify six types of asymptomatic and preclinical, mild, moderate, severe, critical and infection recovery syndromes. Therefore, in the treatment of SARS CoV-2 infection cases, all recommendations should be included infection control, inpatient isolation and protective isolation care, supportive care for intensive critical care and integrated Chinese medicine.
【Keywords】SARS-CoV-2, covid-19, TCM, interim traditional medicine clinical
guideline, treatise on cold damage (Shang-han-lun)