岭南儿童新型冠状病毒感染疑似病例的中医临床特征和舌象分析

Analysis of clinical TCM features and tongue manifestations of suspected cases of novel coronavirus infection in Lingnan children

目的研究岭南地区儿童新型冠状病毒感染疑似病例的中医临床特征及舌象特点。方法收集来自广州市妇女儿童医疗中心的43例儿童新型冠状病毒感染疑似病例的病例资料,分析其临床特征、舌象特点及舌象与症状的关联情况。结果患儿以发热、咳嗽、流涕、纳呆为主要临床表现,发热以壮热为主(48.8%),咳嗽有痰的居多(60.5%)。76.7%的疑似病例患儿舌质为红舌,舌苔以白腻苔居多(53.5%),薄白苔其次(44.2%),薄黄苔仅有1例(2.3%)。患儿白细胞总数、淋巴细胞总数处于正常范围的分别为88.4%、65.1%,但有32.6%的患儿出现了不同程度的淋巴细胞减少;63.6%的患儿胸部X线检查结果为双肺纹理增粗、模糊,出现肺部感染的仅为27.3%。有8例(18.6%)患儿的冠状病毒核酸检测结果为阳性。患儿症状与舌象的关联分析结果显示:舌红-咳嗽、发热-舌红、舌红-咳嗽and发热、舌红-苔白腻、咳嗽-苔白腻、发热-苔白腻这些组合之间的关联强度较高。结论疑似病例患儿的临床表现与确诊病例基本一致,从中医舌象与症状的关联情况来看,符合本季节岭南地区气候下患儿的发病特点,主要表现为湿证、热证为主,少部分为寒证。

Objective To study the clinical TCM features and tongue manifestations of suspected cases of novel coronavirus infection in Lingnan children.Methods The data of 43 suspected cases of novel coronavirus infection in children from Guangzhou Women and Children's Medical Center were collected,and the clinical features,tongue manifestations and the relationship between tongue manifestations and the symptoms were analyzed.Results The main clinical features of the children were fever,cough,runny nose and poor appetite.The majority of fever was Zhuang fever(48.8%),and the majority of cough was with phlegm(60.5%).Most of the suspected cases were with red tongue(76.7%),and white greasy tongue coating was most common(53.5%),followed by thin white tongue coating(44.2%).There is only one case with thin yellow coating(2.3%).The total number of white blood cells and lymphocytes was in the normal range in 88.4%and 65.1%of the children,respectively,but 32.6%of the children had different degrees of lymphopenia.The chest X-ray examination results showed that the bilateral lung texture was thickened and blurred in 63.6%of the children,and only 27.3%of the children had pulmonary infection.There were 8 cases(about 18.6%)with positive results of novel coronavirus nucleic acid detection.The results of correlation analysis between symptoms and tongue manifestations showed that there was a strong correlation in the following pairs:red tongue-cough,fever-red tongue,red tongue-cough and fever,red tongue-white greasy tongue coating,cough-white greasy tongue coating,and fever-white greasy tongue coating.Conclusion The clinical features of the suspected cases are basically the same with the confirmed cases.According to the tongue manifestations and symptoms,they are in line with the seasonal pathogenetic characteristics of children in Lingnan area.The main syndrome types are damp syndrome and heat syndrome,and there is a small part of cold syndrome.