“全球疫情会诊室”：四国医生分享新冠肺炎治疗的中医药应用
5月22日晚，中央广播电视总台中国国际电视台（CGTN）特别节目“全球疫情会诊室”举办了中医专场直播，邀请来自中国、意大利、法国、巴西的中医师们参与讨论，探讨和分享中医药在新冠肺炎治疗中发挥的作用。
中方嘉宾方邦江教授来自上海中医药大学附属龙华医院，也是该院支援武汉医疗组急诊科主任，在武汉工作期间，主要负责雷神山医院的新冠肺炎患者。据方医生介绍，他所在的病区共收治病人114人，其中纯中医治疗患者70人，没有一例患者死亡。
参与交流的还有来自意大利的佳达高级中医学院院长罗拉·西米纳利（Laura Diminelli），来自法国的阿莱斯-赛文中心医院中医部主任托马斯·塔图利（Thomas Tatulli），以及巴西中医院院长海金斯医生。
美国约翰斯·霍普金斯大学数据显示，截止5月23日上午，巴西新冠肺炎累计确诊人数已经达到330,890，其中死亡人数达到21,048。意大利累计确诊228,658例，死亡32,616例；另据意大利民事保护部5月22日消息，该国现存新冠肺炎确诊病例自3月25日以来首次降至6万人以内，为59,322例。法国目前累计确诊病例数是179,306例，死亡28,167例。
In the latest episode of CGTN's live stream program "COVID-19 Frontline" on Friday, May 22, CGTN invited Dr. Fang Bangjiang, who served on the front line of the fight against COVID-19 in Wuhan's Leishenshan Hospital, and other medical workers from overseas to exchange expertise on the use of traditional Chinese medicine (TCM) against COVID-19.
中医治疗新冠肺炎的理论基础和经验
Clinical practice of prevention and treatment of COVID-19 based on TCM theory
方邦江医生首先系统介绍了一些在武汉抗疫期间总结出来的中医治疗理论方法和经验。他说，中国传统医学对传染病的认识可以追溯至殷商时期，在著名的中医学著作《黄帝内经》中也有相关记载：“不相染者，正气存内，邪不可干”。
对此，方医生指出，中医治疗新冠肺炎一个基础理论就是注意调节患者免疫能力，即中医所说的“扶正”。他介绍，在临床上使用黄芪、西洋参、太子参、灵芝，以及其他补气的药物进行早期治疗，都取得了不错的效果。
另外，中医针对传染病治疗强调“排毒”，大黄的现代研究显示其有抗炎、抗病毒的疗效，可以改善微循环，改善肠内症状，防止胃肠功能衰竭，对肝肾功能有保护作用，因此他在临床治疗上也广泛使用这一味药，具体用量为轻症患者10克，重症患者20克至60克，也取得了一定的效果。
方医生还强调了中西医结合的重要性，并推荐了两种对消化道病毒和呼吸道病毒临床效果显著的中药材：虎杖和马鞭草。方医生说，中医在古代典籍中也记录了防止病毒传播的措施，例如通过蒸煮衣物等方式进行高温消毒，或者通过中草药进行空气消毒，并提出，有效的防护对控制疫情也有不可或缺的重要作用。
Doctor Fang Bangjiang, director of the emergency department in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, introduced the treatment of the novel coronavirus by integrating TCM and western medicine.
He said the etiology and transmission of infectious diseases has been recorded in many classical TCM books. "Yellow Emperor's Classic of Internal Medicine," the fundamental doctrinal source for TCM, says: "The uprightness exists in your heart, so the evil won't disturb you, then you don't get infected," which means the enhanced immunity can ward off the disease and virus. It also says "saints prevent diseases rather than cure them," which suggests people to pay attention to the prevention of the disease.
In the past, people steamed clothes of infected family members to prevent the rest of the family from getting sick. Wu You-ke, a renowned physician of the Ming Dynasty (1368-1644), suggested people should avoid going out during the plague, try to go out late and go home early. He also suggested to burn atractylodes in the room or chew garlic in the mouth.
The principles of TCM treatments include supporting the healthy Qi first, which means strengthening immunity.
Doctor Fang said that raw rhubarb is efficient in treating COVID-19 symptoms and giant knotweed can also resist novel coronavirus. Besides, guidelines for novel coronavirus diagnosis and treatment (7th edition) of China's National Health Commission suggests blood purification to remove inflammatory mediators and block "cytokine storm," it can be used for the early treatment of cytokine storm in severe and critical patients.
中医如何发挥作用，提高人体免疫力？
Vaccine and TCM treatment for COVID-19
意大利的罗拉·西米纳利医生说，意大利目前新冠肺炎确诊患者仍然每天都在增加，但是由于多数患者在发病早期去家庭医生处就诊，可能导致病情延误，演变为重症，另外意大利国内可选择的中医药种类并不多，希望中方医生就这种情况提一些建议。
方医生说，目前国外多数轻症患者都通过居家隔离的方法自我调节，对于这类患者，中医药治疗效果非常明显，甚至只采用中医手段也可以有效阻止病情的恶化。他说，中医有安神定智方面的功效，通过中医的针灸等疗法可以有效缓解患者的紧张情绪，从而起到调节免疫力的作用。
CGTN主持人焦旸在北京演播室主持“全球疫情会诊室”
他也提到，中医药很多药物是药食同源，例如对轻症效果明显的几种药物如黄芪、人参等在西方药店均可以找到，灵芝孢子粉等也可以使用。方医生介绍了对于轻症和普通型患者的用药量，分别是大黄10-15克，西洋参或人参15-20克，麦冬30克左右，可以根据患者病情进行治疗。而对于重症患者，特别是有多脏器衰竭或者呼吸衰竭的情况，可以用人参和大黄30克左右，一方面可以提高免疫力，另一方面可以对炎症介质起到清除作用。
方医生强调，危重症患者多数存在基础性疾病，例如高血压、心脏病、免疫性疾病等，另外肥胖也是高危因素，因此建议这类人群加强个人自身防护，少出门，勤洗手，戴口罩，减少聚集，同时保证合理的休息和饮食，调整心态，尽量做到不被感染，才是上策。
Laura Ciminelli, dean of Villa Giada Institution of TCM in Italy, said many people suspect that the novel coronavirus will come back stronger around August. So she wanted to know whether the vaccine will be the best solution and whether it can cause harm to the human's immune system. She also wondered how TCM treats COVID-19 patients.
Dr. Fang said as the WHO had stated, not to expect too much from the vaccine or specific drug at the moment. The safety and efficacy of vaccines in clinical application need to be further confirmed. He said some patients couldn't eat nor sleep well, which seriously affected their immune systems. In this regard, acupuncture can be used. Patients with mild symptoms can be treated with TCM such as American ginseng, astragalus, radix pseudostellariae, and lucid ganoderma. For patients in critical conditions, raw rhubarb is recommended to use for good results.
中医药对凝血问题有何良方？
Other TCM treatment of COVID-19
来自巴西的海金斯医生说，巴西新冠肺炎疫情十分严峻，死亡人数不断上升，他提到中医在活血化瘀方面有很多传统药方，希望方医生介绍一些相关药物，除此之外，他也希望方医生分享一些在西方广为人知中医药诊疗手段，例如针灸和艾灸等。
方医生说，新冠肺炎导致患者出现凝血问题是目前各国都在关注的情况，有些患者表现出四肢紫绀，甚至中风等症状。他提到自己在临床治疗中使用过的活血化瘀药物，包括大黄、虎杖、益母草、水蛭等，都对缓解凝血问题有很好的效果。另外，方医生提到三七粉也对凝血机制紊乱有非常好的疗效，可以在临床上加以应用。
而关于针灸等方法，方医生说，针灸是目前海外接受最广泛的临床中药治疗手段，在雷神山医院病区，90%的患者接受了针灸治疗，但是他同时提醒各位中医师，应当在有防护的条件下使用针灸治疗，并且尽量使用套管针。方医生还分享了几个关键穴位，例如足三里、肺俞穴、太冲穴等。
Dr. Regis, president of Brazilian School of Chinese Medicine, said the COVID-19 situation in Brazil is grim and the death toll is rising. He wanted to know more about TCM formulas to treat COVID-19 patients.
Dr. Fang said COVID-19 can cause blood clotting problems, and some patients may develop cyanosis in their extremities, or even stroke. He said he had met some of patients whose tongues appeared purple and dark in Leishenshan Hospital. Besides raw rhubarb, other herbs, such as giant knotweed, motherwort and panax notoginseng powder are also used to promote blood circulation.
"In Leishenshan Hospital, 90 percent of our patients receive acupuncture," Dr. Fang added. He also said the acupuncture treatment should not be carried out directly without protection measures.
中医药治疗新冠肺炎是否有相关书籍出版？
Books about TCM treatment against COVID-19
托马斯·塔图利医生也分享了中医药在法国新冠肺炎患者治疗中的应用。他说中医诊疗在法国主要用于医护人员，帮助他们提高免疫力，避免感染。在阿莱斯和芒斯等地，中医师们分别为约15%和20%的医护人员进行了中医问诊，并通过推拿、针灸、中医营养学等方式为他们提供诊疗，并取得了不错的成效。
塔图利医生说，目前正有越来越多的医院在新冠肺炎大流行时期接受并开展中医诊疗，帮助医护人员。法国的中医院也和一些非政府组织合作，为新冠肺炎患者提供特殊医疗诊疗卡，建立快速通道。
上海中医药大学附属龙华医院急诊科主任，岐黄学者方邦江参加直播交流
在这种情况下，他希望中方医生可以分享一些已出版的关于中医药治疗新冠肺炎研究方面的翻译书籍，供国际中医师们参考。
方医生说，目前中医药治疗新冠肺炎的研究已经发表了一些相关论文，但都较为分散。2月份，中国也出版了一本关于中西医结合治疗新冠肺炎的防治手册，其中包含了一线诊疗经验，可以为各国提供借鉴。除此之外，方医生也提到一本他本人参与编著的120例临床药案，将在月底出版，他表示，将与国际同行在广泛交流的基础上，推进出版和翻译工作。
在90多分钟的交流中，国际医生们就中医药专业问题进行了充分、广泛的交流，并回答了网友的提问。医生们表示，希望这些经验和成果的分享可以广泛应用于各国的疫情防控、患者治疗等工作，助力全球抗疫。
French doctor Thomas Tatulli asked about the books on TCM treatment of COVID-19, so people can search for the formulas more easily.
Dr. Fang said there are many clinical studies on COVID-19, but they are relatively scattered. He wrote the first manual on the prevention and treatment of COVID-19 by integrated traditional Chinese and western medicine in China and the manual was published in February this year. He and other doctors are compiling another book which is going to be published this month. "I often communicate with my counterparts overseas, including the medics in the United States and in the European countries, and I am actively promoting this work. Once it's finished, I can recommend it to you if you need it," Dr. Fang said.
In later episodes of "COVID-19 Frontline," more front line doctors and experts from Wuhan will join in to share their experience with their colleagues from other parts of the world. If you have any questions regarding COVID-19, you can share with us using #MyOpinionOnCOVID19 on Facebook.