新型冠状病毒感染胃肠功能紊乱中医诊疗专家共识

2023年中国中西医结合消化杂志31卷6期Chin J Integr Trad West Med Dig·397·指南与共识·新型冠状病毒感染胃肠功能紊乱中医诊疗专家共识中华中医药学会[摘要]新型冠状病毒感染患者中胃肠功能素乱症状普遍存在，包括食欲减退、味觉障碍、恶心、呕吐、腹痛、腹胀、腹泻、便秘等，这些症状的出现影响患者的营养状况和生活质量，部分可能与重症转化及不良预后相关，中医药在诊疗胃肠症状方面具有特色和优势。本共识针对新型冠状病毒感染患者的发病特点及胃肠表现，结合中医诊疗的特点，在总结研究证据和专家意见的基础上制定形成。本共识提出了新型冠状病毒感染胃肠功能素乱的中医认识、病因病机、西医诊断、证候诊断、中医药治疗、调摄康复等内容。本共识适用于新型冠状病毒感染轻型、中型及恢复期患者，重型/危重型患者出现相关症状也可参考使用，适用于中医医师、中西医结合医师、西医医师使用，指导其临床规范诊断及中医治疗，[关键词]新型冠状病毒感染：胃肠功能素乱：中医诊疗：专家共识D01:10.3969/j.issn1671-038X.20230601[中图分类号]R256[文献标志码]AExpert consensus on clinical diagnosis and treatment by TraditionalChinese Medicine on the gastrointestinal disorderscaused by novel coronavirus infectionChina Association of Chinese MedicineAbstract Symptoms of gastrointestinal dysfunction are common in patients infected with the COVID-19,including loss of appetite,taste disorders,nausea,vomiting,abdominal pain,bloating,diarrhea,constipation,etal.The presence of these symptoms deteriorate the nutritional status and quality of life of patients,and may be re-lated to severe transformation and poor prognosis.Traditional Chinese Medicine has obvious advantages in the di-agnosis and treatment of gastrointestinal symptoms.This consensus was formulated on the basis of summarizingresearch evidence and expert opinions based on the pathogenesis characteristics and gastrointestinal manifestationsof patients infected with COVID-19.combined with the characteristics of Traditional Chinese Medicine diagnosisand treatment.This consensus puts forward the understanding of Traditional Chinese Medicine,etiology and path-ogenesis,Western medicine diagnosis,syndrome differentiation,Traditional Chinese Medicine treatment,andhealth caring.This consensus will be applied to the patients with mild,medium and convalescent patients infectedwith COVID-19.Severe or critical patients with related symptoms also can use it as a reference.This consensus also applies to the use of Traditional Chinese Medicine physicians,Integrative Medicine physicians,and Westernmedicine physicians to guide their clinical standard diagnosis and Traditional Chinese Medicine treatment.Key words novel coronavirus infection:gastrointestinal disorders:clinical diagnosis and treatment by Tradi-tional Chinese Medicine:expert consensus自2019年底，新型冠状病毒肺炎(coronavirus不利于疾病的全面恢复。disease2019,COVID19)在世界范围内广泛流行，在新型冠状病毒感染患者中，胃肠功能系乱症2023年1月《新型冠状病毒感染防控方案（第十状普遍存在。Meta分析显示高达20.3%的新型冠版)》将新型冠状病毒肺炎更名为新型冠状病毒感状病毒感染患者表现出了胃肠功能素乱症状，其中染，我国疫情防控工作进入“保健康、防重症”的新腹泻占13.2%，恶心占10.3%，食欲减退占阶段。新型冠状病毒感染主要表现为发热、咳嗽等199%四。此外，10%~16%的感染患者仅表现为呼吸系统症状，在感染过程中及恢复期，部分患者胃肠功能紊乱症状，而无呼吸道表现)]。新型冠出现食欲减退、味觉减退、恶心、呕吐、腹胀、腹泻、状病毒感染胃肠功能紊乱可能与重症转化及不良便秘等胃肠功能紊乱症状，这些功能紊乱及其症状预后相关。重症感染患者胃肠功能紊乱症状的总的出现直接影响患者机体的营养状况和生活质量，患病率高于轻症患者(17.1%vs11.8%)),有胃引用本文：中华中医药学会.新型冠状病毒感染胃肠功能素乱中医诊疗专家共识[门.中国中西医结合消化杂志，2023,31(6):397-404.D01:103969/j.issn.1671-038X.20230601.