98例新型冠状病毒肺炎患者中医临床特征及演变分析

TCM Chinical Syndromes Analysis and Evolution of 98 Cases with Novel Coronavirus Pneumonia(NCP)

[目的]探讨新型冠状病毒肺炎患者的中医临床证候特点和分布规律。[方法]采用横断面调研结合动态连续观察的方法,收集98例新型冠状病毒肺炎患者的临床资料,通过描述性分析和聚类分析,探讨患者确诊时中医证候以及中医治疗后证候变化规律。[结果]新型冠状病毒肺炎患者确诊时以发热(70.41%)、咳嗽(57.14%)、胸闷(29.59%)、乏力(28.57%)、咽喉不适(28.57%)、气促(27.55%)等为主要临床表现,舌象多见淡红舌(46.94%)、红舌(31.63%)、胖大舌(13.27%)、齿痕舌(13.27%)等,苔质以厚腻苔(53.06%)、薄苔(34.69%)、薄腻苔(10.20%)为主,苔色多见白苔(52.04%)、黄苔(32.65%),脉象以濡脉(44.90%)、细脉(16.33%)、弦脉(15.31%)为主。聚类分析提示患者中脾虚湿阻证47例(47.96%)、湿郁化热证51例(52.04%)。经中医治疗后,舌象多见红舌(52.04%)、淡红舌(36.73%)、齿痕舌(18.37%),苔质以厚腻苔(45.92%)、薄苔(43.88%)为主,苔色多见白苔(68.37%)、黄苔(18.37%),脉象以濡脉(75.51%)居多。[结论]新型冠状病毒肺炎患者中医辨证分型以脾虚湿阻证及湿郁化热证两型为主。治疗后,患者舌脉变化提示湿热病邪得以去除,正气恢复。

[Objective]To explore the characteristics and distribution of TCM clinical syndromes in novel coronavirus pneumonia(NCP).[Methods]Crosssectional survey method was used to collect clinical data of 98 cases with NCP and descriptive analysis and cluster analysis were used to explore the distribution of TCM syndromes and laws of syndrome change after TCM Treatment.[Results]Fever(70.41%),cough(57.14%),chest tightness(29.59%),fatigue(28.57%),throat discomfort(28.57%),and shortness of breath(27.55%)were the main clinical manifestations of patients with NCP.Reddish tongue(46.94%),red tongue(31.63%),fat tongue(13.27%),and dentate tongue(13.27%)were the most common tongue images;thick greasy moss(53.06%),thin moss(34.69%),and thin greasy moss(10.20%)were the main tongue coating texture,and white moss(52.04%)and yellow moss(32.65%)were common color of tongue fur.Insoggy pulse(44.90%),thready pulse(16.33%),and string-like pulse(15.31%)were the main type of pulse.Cluster analysis indicated that 47 cases(47.96%)were differentiatied as syndrome of spleen deficiency and dampness stagnation and 51 cases(52.04%)were syndrome of heat due to stagnation of dampness.After the treatment of TCM,tongue quality became more normal and red tongue(52.04%),reddish tongue(36.73%),and dentate tongue(18.37%)were the most common tongue images;while thick greasy moss(45.92%),thin moss(43.88%),white moss(68.37%)and yellow moss(18.37%)were the most type in tongue coating texture.Soggy pulse(75.51%)became the more normal type of pulse.[Conclusion]The TCM clinical syndromes of NCP patients were mainly syndrome of spleen deficiency and dampness stagnation and syndrome of heat due to stagnation of dampness.After treatment,the changes of tongue and pulse suggested that the pathogenic factors of damp and heat had be removed and the vital Qi recovered.