中醫藥研究論叢

262.8 以傷寒雜病思路論治新冠肺炎病例報告
TJ TCM.26(2) : 81-88, 2023
DOI : 10.6516/TJTCM.202306_26(2).0008
 
 
以傷寒雜病思路論治新冠肺炎病例報告
Using the concept of Treatise on Cold Pathogenic Diseases Treats for Coronavirus
disease 2019 : Case Report
羅元志1,2 周暉哲1 吳佩芸1*
1 臺北市立聯合醫院仁愛院區中醫科,台北,台灣
2 仁心中醫診所,新北,台灣
【摘要】
新冠肺炎疫情肆虐全球已長達三年之久,改變了人類的生活型態,雖然隨著病毒不斷地突變,感染者大多數表現為輕症,且其中腹瀉是新冠肺炎最常見的胃腸道症狀之一,根據多篇報告顯示有2 至49.5% 的病例出現腹瀉症狀,並且說明造成腹瀉的原因可能包含病程發展、醫源性或藥物副作用等因素。中醫治療新冠肺炎的處方中,由衛生福利部國家中醫藥研究所開發的清冠一號,對於改善新冠肺炎的輕中症症狀擁有良好的療效,但因清冠一號的組成藥性偏寒涼,臨床上患者若體質偏虛寒型,使用此方後常出現腹瀉的症狀。而本篇病例報告是使用苓甘薑味辛夏仁湯化裁並搭配桔梗湯治療新冠肺炎住院的患者,其藥物組成的藥性皆屬於平或溫性,亦出現腹瀉的症狀。我們根據《傷寒論》書中提到下利的相關條文,探討此病例出現腹瀉的反應機轉,推測腹瀉應為病患身體機能恢復的暝眩反應,與使用寒涼藥物產生腹瀉的病因病機並不相同,供臨床同道參酌。
【關鍵詞】中藥;新冠肺炎;腹瀉;傷寒論;暝眩反應
Luo Yuan-Zhi1Chou Hui-Jer1Wu Pei-Yun1
1Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
【Summary】
Coronavirus disease 2019(COVID-19), a global epidemic, has been broken up for three years at least. It greatly changed the lifestyle of human beings all over the world. Because of SARS-CoV-2 rapid mutation to variable subtype, the infected show mild symptoms which one of was diarrhea, most common symptoms in gastrointestinal tract. According to the different reports, the results reveal that the prevalence of the diarrhea might range from 2 to 49.5 percent in the infected. Diarrhea would result from many factors, for example, natural course of disease, iatrogenic, or the drug side effects. The effects of NRICM101, novel Chinese traditional medicine, are eutherapeutic to treat mild to moderate symptoms of COVID-19, was developed by National Research Institute of Chinese Medicine, MOHW. However, diarrhea is a frequent occurrence of the patients who toke NRICM101. This paper is a case report about diarrhea after using the prescription of the modification of Ling Gan Jiang Wei Xin Xia Ren Tang and Jie Geng Tang. We want to discuss that whether the mechanism of diarrhea is reverse reaction or
not, which is based on the concepts of Treatise on Cold Pathogenic Diseases.
【Keywords】Chinese traditional medicine; COVID-19; diarrhea; Treatise on Cold
Pathogenic Diseases; reverse reaction