深圳地区新型冠状病毒肺炎中医临床特征及证型调查分析

Analysis on Chinese Clinical Characteristics and TCM Syndrome of Patients with COVID-19 in Shenzhen

目的:通过分析深圳地区新型冠状病毒肺炎患者的临床资料,探讨中医临床特征及证型特点。方法:纳入深圳市第三人民医院收治的新型冠状病毒肺炎患者406例,采集其临床表现及中医证候特点等信息,分析中医临床特点及证型规律。结果:新型冠状病毒肺炎患者中位年龄为47岁,男女比例为1∶1.13。其中,有湖北旅居史的患者占72.41%,有确诊患者接触史的患者占14.04%。胸部CT表现以磨玻璃影为主(81.03%),白细胞降低的患者占31.03%,淋巴细胞降低的患者占62.56%,C反应蛋白升高的患者占56.90%。中医证候分析提示,常见的症状为发热(78.82%)、干咳(66.26%)、咳痰(46.31%)、纳差(37.93%)、倦怠乏力(36.95%)。舌象以淡红舌(43.63%)或红舌(26.25%)为主,多见薄白苔(32.82%)、白腻苔(32.43%),脉象以滑脉(40.54%)多见。中医辨证以轻证为主(79.06%),病情程度与年龄呈正相关;辨证分型以湿毒内侵证(49.13%)、湿毒犯肺证(37.37%)为主,少数患者辨证为肺脾两虚、热毒壅肺。结论:深圳地区新型冠状病毒肺炎以湿毒内侵、湿毒犯肺证多见,符合中医疫病的特点及地域特征。

Objective:To analyze the clinical characteristics and distribution of Chinese medical syndrome of patients diagnosed with COVID-19 in Shenzhen city.Methods:The epidemiological data,laboratory findings,chest CT,syndrome characteristics,tongue image and pulse information for a total of 406 patients with confirmed COVID-19 and treated in Shenzhen Third People’s Hospital were investigated.All cases were analyzed and differentiated according to Chinese Medical Prevention and Treatment Plan for COVID-19 in Shenzhen.Results:The median age was 47 years,and the ratio of male to female was 1∶1.13.There were 72.41%patients had the history of travel or residence in Hubei province,14.04%patients had contacted with confirmed patients.On CT image,most of the lesion(81.03%)were ground-glass like.31.03%patients had decreased white cell and lymphopenia was occurred in 62.56%of patients.56.90%of patients had elevated C-reactive protein.There were 78.82%of patients presented with fever,66.26%of cases with dry cough,46.31%of them with sputum,37.93%of them with bad appetite and 36.95%of them with fatigue.The main tongue feature was light red tongue(43.63%)or red tongue(26.25%),with white and thin coat(32.82%)or white and greasy coat(32.43%).Slippery Pulse accounted for 40.54%of patients.Most of the patients were diagnosed as mild syndrome(79.06%),and the severity of the disease was closely related to the age.The main Chinese syndrome was invasion of dampness-toxicity(49.13%)and dampness-toxicity stagnation in lung(37.37%),as a minority of patients manifested with syndrome of lung and spleen deficiency or heat-toxicity blocking lung.Conclusion:The main Chinese medical syndrome of COVID-19 patients in Shenzhen was invasion of dampness-toxicity and dampness-toxicity stagnation in lung,which was correlated with characteristics of dampness epidemic in Chinese medicine,and in line with the changes of climatic and regional conditions.