64例新型冠状病毒肺炎普通型患者中医临床特征分析

Analysis on Chinese medical clinical characteristics of 64 patients with common type COVID-19

目的:分析新型冠状病毒肺炎普通型患者一般情况及中医临床特征。方法:选取2020年2月5日至2月20日温州医科大学附属第二医院收治的新型冠状病毒肺炎普通型患者64例,于入院第1天采集流行病学资料及血常规、C反应蛋白、首发症状、舌象等信息,依据《新型冠状病毒肺炎中医诊疗手册》进行辨证。结果:新型冠状病毒肺炎普通型患者年龄(48.8±12.9)岁,男女比为1.56:1;14例(占21.88%)有武汉/湖北旅居史,38例(占59.38%)有确诊患者密切接触史;15例(占23.44%)患者白细胞计数下降,17例(占26.56%)患者淋巴细胞计数下降,35例(占54.69%)患者C反应蛋白升高;首发症状以发热(42例,占65.63%)、咳嗽(9例,占14.06%)多见,6例(占9.38%)患者无症状;舌象以舌质红黄腻苔(14例,占21.88%)、舌质淡红薄白腻苔(8例,占12.50%)、舌质红白腻苔(8例,占12.50%)多见;中医证型分为寒湿疫毒袭肺证6例(占9.38%)、湿热疫毒蕴肺证58例(占90.62%),湿热疫毒蕴肺证中热重于湿型20例(占34.48%)、湿重于热型38例(占65.52%)。结论:新型冠状病毒肺炎普通型的证型以湿热疫毒蕴肺证为主,涉及病理因素包括寒、热、湿、毒、虚,湿毒是核心病机。

Objective:To investigate the general features and distribution of Chinese medical syndrome of common type COVID-19 patients.Methods:A total of 64 common type COVID-19 patients from the Second Affiliated Hospital of Wenzhou Medical University during February 5 to February 202020 were enrolled.The epidemiological date,including blood routine,C-reactive protein,initial symptom and tongue image were collected on the first day of admission,and analyzed and differentiated according to traditional Chinese medicine diagnosis and treatment of COVID-19.Results:The average age of common type COVID-19 patients was(48.8±12.9),the ratio of male to female was 1.56:1.Of all patients,14 cases(21.88%)had the history of visiting or living in Wuhan/Hubei,38 cases(59.38%)had the history of close contact with the confirmed patients,15 cases(23.44%)had decreased count of leukocyte,17 cases(26.56%)had decreased lymphocyte count and 35 cases(54.69%)had increased C reactive protein.Most of the initial symptoms were fever(42 cases,65.63%)and cough(9 cases,14.06%),but 6 cases(9.38%)had no symptoms.The main tongue features were red tongue with yellow greasy coat(14 cases,21.88%),light red with white thin and greasy coat(8 cases,12.50%),red tongue with white greasy coat(8 cases,12.50%).The Chinese medical syndrome were present in 6 cases with dampness-cod pestilence attack lung(9.38%),and dampness-heat pestilence accumulate lung in 58 cases(90.62%).Dampnessheat pestilence accumulate lung included 20 cases(34.48%)of heat predominating over dampness and 38 cases(65.52%)of dampness predominating over heat.Conclusion:The main type of the Chinese medical syndrome of COVID-19 is dampness-heat pestilence accumulate lung with the pathological factors all related to cold,heat,dampness,toxicity and deficiency,and“damp-toxicity”is the its critical pathology.