目的 介绍老年新型冠状病毒肺炎（Coronavirus disease 2019，COVID-19）患者的中医病证特点以及临床重型案例治疗经验。方法 通过查阅文献以及整理分析本院收治的老年COVID-19患者的临床资料，总结其中医的病证特点及原因，并列举三则中医药治疗的重型案例进行分析和讨论。结果 老年COVID-19具有病邪易热化、多存在基础疾病，病情进展迅速且危重、疾病各阶段多存在气阴不足、多存在“湿”与“燥”相兼和转化的特点。三则老年新冠肺炎重型案例基本符合以上特点，且中医药在治疗上发挥了重要作用。案一为热入营分证，治法当清营分之热兼护阴液；案二为湿热郁肺，治法当清热化湿解毒兼顾正气；案三初为寒湿，迅速热化伤阴，故处方用药不宜过于温燥，应时时固护阴液，处理好“湿”与“燥”的关系。结论 充分发挥中医药治疗老年COVID-19的作用具有重要意义。

Objective To introduce the characteristics of TCM syndromes and clinical experience in severe cases of elderly patients with COVID-19.Methods By reviewing the literature and collating and analyzing the clinical data of elderly patients with COVID-19 treated in our hospital, the characteristics and causes of their TCM symptoms were summarized. The 3 severe cases treated with TCM were analyzed and discussed.Results The elderly COVID-19 had the following characteristics that disease pathogens were easy to heat, and most of them had basic diseases. The disease progressed rapidly and seriously, and the deficiency of Qi and Yin existed in each stage of the disease. Most of them had the combination and transformation of “dampness” and “dryness”. The three elderly severe cases of COVID-19 basically met the above characteristics, and TCM played an important role in the treatment. Case one was heat entered into yingfen, and the treatment should be to clear heat in yingfen and protect the Yin fluid. The second case was damp-heat depressed in the lung. The treatment was to clear heat, resolve dampness and detoxify and protect the healthy qi. The initial manifestation of Case three was cold and dampness syndrome, which was rapidly heated and injurious to Yin. Therefore, the prescription should not be too warm and dryness, and should protect the Yin fluid and properly handle the relationship between “dampness” and “dryness”.Conclusion It is of great significance to give full play to the role of TCM in the treatment of elderly COVID-19.

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杭州市科学技术局新型冠状病毒感染的肺炎防治科研攻关项目(第一批)（20202013A01）：新型冠状病毒肺炎临床诊疗体系的建立及其疗效评价的研究；承担单位:杭州市西溪医院