基于温病舌诊理论浅议COVID-19转归
China Journal of Chinese Medicine（2020）
Abstract
新型冠状病毒肺炎临证应注重患者舌象变化.病邪由卫分转气分甚至渐入营分时,舌象以舌质红、苔黄腻和黄燥多见.舌色红而其苔燥者,属表邪入于里之候也,需兼辛凉解表,如金银花、连翘为君药的银翘散可发挥疏散风热、辟秽化浊之功效;若苔色黄且气分热象明显者可偏重于通腑泻热,予白虎汤清泻阳明气分热,承气汤峻下热结,谨防邪热传营血分,扰动心神而至神昏、抽搐等危重证候;舌苔腻者,为秽浊邪气入里太深,体内正气不能将其祛除于外而上泛于口所致;舌苔黄腻而垢,或干涩深黄厚腻是表邪入里之候.苔黄腻者是湿热未净之候,可用五苓散加木通合益元散加味,茯苓、猪苓、泽泻三药,味甘淡,归脾经,可健脾祛痰,归肾经可渗湿利尿.合方益气而不助邪,逐邪而不伤正,兼可渗湿清热.
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