世界针灸学会联合会

(CN/EN)Q&A from the International Lectures of COVID-19 by Dr Wang Qi

author:WFAS source:WFAS Click:659 update:2020-04-20
  

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问题1:基于不同的人的体质,是否存在新冠肺炎易感的体质?

——巴西中医学院院长海金斯 

Q1: Based on classification of TCM constitutions, is there any constitutional type susceptible to COVID-19?

—Dr Reginaldo Filho, Director of Brazilian School of Chinese Medicine

王琦教授:关于这个问题,刚才的讲座中已提到,武汉通过对84例普通型新冠肺炎患者的体质进行了调查,有四种体质易感人群比较多的包括痰湿体质、气虚体质、血瘀体质和湿热体质。我们可以看到四川、云南、河南等省份都制定了相关的体质预防方案,而且我们国家颁布的《新型冠状肺炎的诊疗方案(第七版)》里面,也提出了根据病情和体质进行诊治,说明了疾病康复与体质也是很有关系的,在制定康复方案的时候,考虑到康复对象的体质差异。所以我们还可以看到一个问题,根据不同的体质,疾病的表现不同。湿热体质的人容易形成湿热疫,湿热毒,阳虚体质为寒湿疫,疫毒根据不同的体质会出现从化现象,湿热体质的病人容易化湿化热,阳虚体质的病人容易化寒,体质对于疾病的治疗、康复等方面都要考虑到这些体质因素,给予辩体施治、辨体康复和辨体防复(防止复发)。

Prof. Wang: Regarding this issue, it has been mentioned in my lecture just now that an investigation has been made in Wuhan of the constitutional types among 84 confirmed COVID-19 patients. Those who belong to four following types are more susceptible to COVID-19 than others: phlegm-damp constitution, qi-deficiency constitution, blood-stasis constitution, and damp-heat constitution. We can see that relevant constitution prevention programs have been made in Sichuan, Yunnan, Henan and other provinces. And it is also mentioned that the diagnosis and treatment should be based on the condition of the disease and the constitution of the patient according to "Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7)" promulgated by China government. Also when formulating a rehabilitation plan, the difference of constitutional types of the patient should be taken into account because of the relationship between rehabilitation and constitution. We also observed that the different manifestation of the disease depends on the constitution of the patient. People with damp-heat constitution are prone to suffer from damp-heat epidemic and damp-heat poison, while those with yang deficiency often suffer from cold-damp epidemic. The transformation of epidemic poison may occur according to different constitutions: it is apt to turn into dampness and heat for patients with damp-heat constitution, while into cold for those with yang deficiency constitution. These constitutional factors must be taken into account for the treatment and rehabilitation of the disease, so treatment, rehabilitation and relapse prevention can be implemented according to constitution differentiation.

问题2:位于南半球毛里求斯现正处暖季转凉兼雨时节,现爆发新冠疫情,当地华人受西方饮食习惯影响喜生冷,脾胃普遍虚寒。所以我们认为预防以“健脾祛湿、益气固表”,治法宜“清凉攻下”。请问是否正确?有何预防上的用药推荐?

——毛里求斯针推协会会长李明

Q2:Mauritius is located in the southern hemisphere. It is currently in a warm, cool and rainy season. Now we have COVID-19 outbreak here. Influenced by western dietary customs, local Chinese have spleen-stomach deficiency generally. Therefore we believe that we can “invigorate the spleen, dispel internal dampness, replenish vital energies and enliven external features” for prevention, and “clear heat and purge” for treatment. Is it correct? What kind of Chinese herbs do you recommend for prevention?

—Li Ming, President of Chinese Traditional Tuina- Acupuncture Association ,Mauritius

王琦教授:这个问题是这样的,因为毛里求斯是一个火山的岛国,属亚热带的海洋气候,分雨季和旱季,现在处于温暖转凉的雨季,而且有喜冷的饮食习惯,在这样的情况下容易虚寒。我推荐尽量用中成药,湿邪偏重的用藿香正气(丸或胶囊),若寒邪偏重的用附子理中丸,若单纯脾气虚,也有兼湿的用香砂六君子或参苓白术散。从治法上来说,我的建议是不要用“寒凉攻下”,因为这个地方不是湿就是热,单纯的偏寒或单纯的偏热比较少,建议用甘露消毒丹,这样兼顾湿热为好。

Prof. Wang: Regarding this problem, Mauritius is a volcanic island country with a subtropical marine climate. It has a rainy season and a dry season. It is now in the turn point from warm to cool and rainy season, and the people there prefer cold food diet. Under such circumstances, they often have cold -deficiency constitution. I recommend to use Chinese patent medicine as much as possible, Huoxiang Zhengqi (pill or capsule) for heavy dampness, Fuzi Lizhong pill for heavy cold, and simply Xiangsha Liujunzi or Shenling Baizhu powder for spleen-qi deficiency  accompanied by dampness. As for the principle of treatment, my advice is not to “clear heat and purge”, because it is either damp or hot in this place, relatively less people have only cold or heat. It is recommended to use Gan Lu Xiao Du Dan so as both dampness and heat are considered.

问题3:关于疫情结束的预期:现在欧洲各国都在积极应对疫情,现在也开始关注疫情何时结束的事情。现在媒体上做出悲观预估的大都是西医背景的专家。参照以前几次疫情的经验:2003年SARS疫情是5月底结束,2010年的甲流H1N1疫情是8月初结束,哪怕是2015年5月才爆发的中东呼吸综合征,实际上也是到了当年10月初就没有了新发病例。之前也有专家组讲座上提到当气温升高时,一线医生发现了感染率降低了80%的事实;之前也有两到三个地方卫健委的消息说气温高于25度时,病毒活性降低...我们好像看到了一些气温跟病毒传染规律的迹象。根据中医理论,疾病的发生应该还是会跟着一年节气的变化而变化,那教授您对新冠肺炎的走向的预测是什么呢?

——葡萄牙传统中医药文化推广协会会长颜春明 

Q3:Dr Yan: Regarding prediction of the end of epidemic: Recently all European countries are actively responding to the epidemic, and now they are also focusing on when the epidemic is ended. Most of the pessimistic predictions are made by experts who have western medicine background on media. Referring to experiences of previous outbreaks: SARS was ended at the end of May in 2003, whereas H1N1 was terminated at the beginning of August 2010. Even for MERS broken out in May 2015,actually there were no new cases in the early October of that year. Some expert groups mentioned before in some lectures that when the temperature rises, the first-line doctors found that infection rate has decreased by 80%. There were also two or three local Health Commissions sayings, when temperature is over 25 degrees, the activity of virus is lowered. It seems that there are some signs relationship of temperature and virus transmissions witnessed by us. According to Traditional Chinese Medicine theories, the occurrence of diseases may still follow change with solar terms changes throughout the year. Therefore what is your prediction on the trend of COVID-19?

——Yan Chunming,Association for Promotion of Culture and TCM

王琦教授:对新冠肺炎有些关于温度方面的认识,有一些季节性的观点,认为与温度、湿度及季节因素与病毒的传播影响有关。现在像东南亚的一些国家气温高,但仍然处于多发的季节。那么,我们要怎样看待这个问题?有关新冠肺炎的问题,我们大多数学者认为与湿邪有关,那么如果跟寒有关,为寒湿疫;跟热有关,为湿热疫;跟毒有关,为湿毒疫。这些疫的程度,在热带地区跟湿热有关,在寒带地区跟寒湿有关,我们要综合看到温度和湿度的变化。从运气学说来说,《素问》里就提出,今年是一个什么年呢?今年是庚子年,湿气盛行,将会有瘟疫致病。说明了这个年份与运气等因素有关,五运六气有主气、客气、司天和在泉,我们要从天因、病因和人因三个方面分析新冠肺炎疫情的走向。所以我们要结合流行病学专家的推断,人们生活的环境不同、区域不同才能够很好地判断。

Prof. Wang: There is some understanding of the temperature of COVID-19, and according to some theories, the spread of the virus is related to the temperature, humidity and seasonal factors. Now, in some countries like Southeast Asia, the temperature is high, but it is still in the season of high incidence of disease. So, how do we look at this problem? Regarding the etiology of COVID-19, most of our scholars think that it is related to damp pathogen. If it is related to cold, it is cold-damp epidemic. If related to heat, it is damp-heat. If related to poison, it is damp-poison. The manifestation of this epidemics is related to damp-heat in tropical regions and cold-dampness in cold regions. We should comprehensively observe the changes in temperature and humidity. From the point of view of Yun qi theory, it is mentioned in Suwen about this year (2020): This year is the year of geng zi, dampness prevails, and there will be plague. This shows that this year is related to yun qi, temperature and other factors. From the theory of Five Yun and Six Qi, we have factors like zhu qi, ke qi, si tian and zai quan. We should analyze the trend of COVID-19 epidemic from three aspects: weather (heaven), etiology (disease) and constitutions(human). Therefore, we should combine the inference of epidemiologists and consider different environments and regions of the people, then we can make a good judgment.

问题4:海外中药不普及的情况下(只有中医师可以订购),如何预防?比如通过食疗?

Q4: Could you please give advices how to protect people in Poland in case when Chinese herbs are not available for public (only few TCM professionals can order it). How about diet?

王琦教授:这个问题,根据刚才讲的,可以根据不同的体质,进行一些食疗的预防,这里我就不重复了。关于预防方,给普通人群采用药食同源的方,包括了(金)银花、芦根、白茅根、藿香、白芷、草果,苏叶,这些药在中国的卫生部公布的药食同源当中,它们既是药物,也是食物。在其他国家中,我不清楚哪些是所谓的食物,所以我只能介绍到这里,不过你可以根据人的不同体质给予推荐,比如气虚的人要吃莲子、山药,湿热的人要吃赤小豆,痰湿的人要吃荷叶,这些都是食疗的方法。但是在不同的国家要配以什么样的食物,比如在伊朗的红花作为食物,而在中国是药(不是食物),要根据当地的情况加以分析。

Prof. Wang: According to what I said just now, some diet therapy prevention can be carried out according to different constitutions. I will not repeat here. For preventive prescription of ordinary people, I recommend to use the formula of medicinal and edible medicines, including (Jin) honeysuckle, reed root, rhizoma imperata, agastache, angelica dahurica, tsaoko amomum fruit and folium perillae. They are among homologous medicines and foods announced by Ministry of Health, P.R.China, they are both medicine and foods. In the other countries, I don’t know which one is the so-called food to recommend here. But you can give recommendations based on people's different constitutions. For example, some people with qi deficiency should take lotus seeds, yam, and some with heat and dampness should eatadsuki Bean. People with damp phlegm need to take lotus leaves, these are the methods of diet. However in the different countries, it is necessary to accompany with the certain food according to local customs. 

For example, saffron crocus is used as food in Iran, but medicine (not food) in China, which should be analyzed according to local conditions.

问题5:请问刺五加和人参哪个对于新冠病毒感染的保护作用更好?每天应使用多大剂量?是否可以同时使用,刺五加7g+人参25g/日?

——波兰中医药学会负责人卡尔·姆斯

Q5:What is better as a protection against virus COVID-19infection: Siberian Ginseng (Ci Wu Ju) or Panax Ginseng (Ren Shen)? How much per day should be used? Can they be used together: Ci Wu Ju 7g + Ren Shen 25g each day?

——Marek Kalmus,Director of Polish Society of TCM

王琦教授:关于刺五加和人参这两个单味药来预防新冠肺炎,我不敢说这两个单味药能对新冠肺炎起到预防的作用,当然从提高免疫力来说,两味药都能在提高免疫力方面起到作用,这两味药有所不同,刺五加应该是偏温的,它有祛湿的作用,对于阴虚火旺的人,一般不宜吃太多刺五加。人参具有补气的作用,它能补气、固脱、生津,因此我更主张用人参,但是人参的剂量也不能太大,常规的剂量一般10g/剂,25g/天似乎剂量偏大了一些。

Prof. Wang: Regarding acanthopanax senticosus and ginseng as two single Chinese medicine to prevent COVID-19, I dare not say that these two single Chinese medicines can prevent disease. Certainly in terms of improving immunity, both Chinese medicine can play a important role in improving immunity. There are some differences between two herbs, acanthopanax senticosus is warm, and it has the effect of clearing dampness. It is inappropriate to take too much acanthopanax senticosus for people with heat caused by yin deficiency. Ginseng can invigorate Qi, rescue qi desertion, and engender liquid. As far as I’m concerned, it is asserted that ginseng can be recommended, whereas the dosage of ginseng should not be used too much, general dosage is g