2019年12月以來(lái)，新型冠狀病毒肺炎（COVID-19）在中國(guó)迅速蔓延。中華人民共和國(guó)國(guó)家衛(wèi)生健康委員會(huì)及各地相關(guān)部門(mén)陸續(xù)發(fā)布多個(gè)針對(duì)COVID-19的診療方案。部分方案推薦喜炎平注射液用于COVID-19的臨床治療。該藥的有效成分為穿心蓮內(nèi)酯總磺化物，為穿心蓮內(nèi)酯的衍生物。其具有清熱解毒、抗菌消炎等功能，對(duì)包括病毒性肺炎、上呼吸道感染在內(nèi)的呼吸系統(tǒng)疾病療效確切，且積累了大量臨床數(shù)據(jù)。穿心蓮內(nèi)酯在COVID-19治療中具有潛在的抗病毒作用，且能降低患者炎癥水平，改善呼吸道癥狀，抑制并發(fā)細(xì)菌感染，提升機(jī)體免疫力。同時(shí)亦不會(huì)帶來(lái)激素類(lèi)藥物的免疫抑制作用，不良反應(yīng)發(fā)生率低。除此之外，穿心蓮內(nèi)酯有一定的保肝作用和治療心血管疾病的臨床使用經(jīng)驗(yàn)，提示其可能會(huì)對(duì)由COVID-19引發(fā)的肝損傷、心臟損傷以及藥物性肝損傷有一定的保護(hù)作用，但還有待臨床進(jìn)一步驗(yàn)證。對(duì)穿心蓮內(nèi)酯的藥理作用和臨床應(yīng)用進(jìn)行總結(jié)梳理，從中醫(yī)角度分析COVID-19的病因病機(jī)和辨證治法，為穿心蓮內(nèi)酯用于COVID-19的治療提供理論基礎(chǔ)。

Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly in China. National Health Commission of the People's Republic of China and local departments have released a number of diagnosis and treatment plans for COVID-19. Some plans recommend Xiyanping Injection for the clinical treatment of COVID-19. The active component of the drug is the total sulfonate of andrographolide, which is a derivative of andrographolide. This paper summarized the pharmacological action and clinical application of andrographolide, and proposed that it has the functions of clearing heat and detoxification, anti-bacterial and anti-inflammatory, and definite therapeutic effect on respiratory system diseases including viral pneumonia and upper respiratory tract infection, and a large number of clinical data have been accumulated. Andrographolide has a potential antiviral effect on the treatment of COVID-19, and can reduce the level of inflammation in patients, improve respiratory symptoms, inhibit concurrent bacterial infection, and improve the body immunity. At the same time, it will not bring the immunosuppressive effect of hormone drugs, and the incidence of adverse reactions is low. In addition, Andrographolide has certain hepatoprotective effects and clinical value for treating cardiovascular diseases in clinical experience, suggesting that it may have some protective effects on drug-induced liver injury, heart injury and liver injury caused by durgs against COVID-19, but further clinical verification is needed. The pharmacological action and clinical application of andrographolide are summarized. This paper also analyzes the etiology, pathogenesis and dialectical treatment of COVID-19 from the perspective of traditional Chinese medicine, and points out that the treatment of COVID-19 with andrographolide is consistent with the theory of traditional Chinese medicine.

R285

國(guó)家科技重大專(zhuān)項(xiàng)：中醫(yī)藥優(yōu)勢(shì)領(lǐng)域的創(chuàng)新中藥關(guān)鍵技術(shù)開(kāi)發(fā)研究（2017ZX09301005）；山東省重點(diǎn)研發(fā)計(jì)劃：新型冠狀病毒潛在藥物臨床評(píng)價(jià)研究（2020SFXGFY07）