50例新型冠状病毒感染的肺炎患者中医临床特征分析

Analysis on Chinese medical clinical characteristics of 50 patients with novel coronavirus-infected pneumonia

目的:分析上海地区新型冠状病毒感染的肺炎患者一般情况及中医证候分布特点。方法:纳入上海市公共卫生临床中心收治的新型冠状病毒感染的肺炎患者50例,均于入院第1天采集流行病学资料及血常规、胸部CT、中医证候特征、舌象、脉象等信息;并依据《上海市新型冠状病毒感染的肺炎中医诊疗方案(试行)》进行分析辨证。结果:新型冠状病毒感染的肺炎患者年龄在50岁左右,男性居多,男女比为1.27∶1;74%的患者有武汉/湖北旅居史,20%的患者有确诊患者密切接触史;胸部CT以多肺叶病变为主,白细胞未见明显升高,多见淋巴细胞降低、C反应蛋白升高。半数以上患者伴有发热(84%)、咳嗽(62%)、乏力(62%)、纳差(58%)、口干(56%)、腹泻(56%)、自汗(54%)症状;舌象以淡红舌或红舌为主,多见腻苔(68%)、白苔(74%)。证型以湿毒郁肺证为主(82%),少数患者表现为热毒闭肺证(18%);其中湿毒郁肺型患者的平均年龄显著低于热毒闭肺型患者(P=0.002),而湿毒郁肺型患者男性构成比明显高于热毒闭肺型(P=0.024)。结论:新型冠状病毒感染的肺炎以湿毒郁肺型为主,符合中医湿疫的特点。

Objective: To investigate the general features and distribution of Chinese medical syndrome of novel coronavirus-infected pneumonia patients in Shanghai. Methods: Fifty novel coronavirus-infected pneumonia patients from Shanghai Public Health Clinical Center were enrolled in this analysis. The epidemiological data, blood routine, chest CT, Chinese medical syndrome characteristics, tongue image and pulse information were collected on the first day of admission, and analyzed and differentiated according to Chinese Medical Diagnosis and Treatment Plan for Shanghai Novel Coronavirus-Infected Pneumonia(Trial). Results: The average age of novel coronavirus-infected pneumonia patients was about 50 years old, most of them were male, the ratio of male to female was 1.27∶1, 74% of them had the history of visiting or living in Wuhan/Hubei, 20% of them had the history of close contact with the confirmed patients. The chest CT mainly showed multi lobed lesions, no obvious abnormality in white blood cells was found, and the low level of lymphoid cells and high level of C-reactive protein were also identified. More than half of the patients showed fever( 84%),cough( 62%),fatigue( 62%),poor appetite( 58%),dry mouth( 56%),diarrhea( 56%) and spontaneous sweating( 54%). The main tongue features were light red tongue or red tongue,with greasy coat( 68%) and white coat( 74%). The main Chinese medical syndrome was dampnesstoxicity stagnation in lung( 82%),a small number of patients presented with syndrome of heat-toxicity blocking lung( 18%). The average age of patients with syndrome of dampness-toxicity stagnation in lung was significantly lower than that of patients with syndrome of heattoxicity blocking lung( P = 0.002). The proportion of male patients with syndrome of dampness-toxicity stagnation in lung was obviously higher than that with syndrome of heat-toxicity blocking lung( P = 0. 024). Conclusion: The main Chinese medical syndrome of novel coronavirus-infected pneumonia patients is dampness-toxicity stagnation in lung,which is in line with characteristics of dampness epidemic in traditional Chinese medicine.