90例普通型新型冠状病毒肺炎患者中医证候与体质分析

Analysis on Traditional Chinese Medicine Syndromes and Constitutions of 90 Patients with Common COVID-19

目的初步探讨普通型新型冠状病毒肺炎(简称新冠肺炎)患者中医临床证候特点和体质类型,为中医早期干预和辨证论治提供依据。方法应用横断面研究方法,设计中医证候量表,采用中医证候量表和体质量表对90例普通型新冠肺炎患者进行中医证候和中医体质调查,通过描述性分析和聚类分析,总结普通型新冠肺炎患者中医证候特点及体质类型分布规律。结果患者症状发生频率前5位的是:发热(83.3%)、倦怠乏力(62.2%)、纳呆(53.3%)、肌肉酸痛(52.2%)、干咳少痰(51.1%);舌质主要见淡红舌(56.7%)、红舌(35.6%);舌苔主要见薄白苔(36.7%)、白腻苔(20.0%)、黄腻苔(20.0%);85例患者完成脉象统计,以沉脉类(51.8%)、滑脉类(21.2%)多见。出现频率超过10%的体质类型分别是痰湿质(50.0%)、气虚质(41.7%)、血瘀质(27.4%)、湿热质(11.9%)。常见证型为寒湿袭肺型(34例,37.8%)、湿阻中焦型(48例,53.3%)、脾肺气虚型(8例,8.9%)。病程<3天者以寒湿袭肺型为主,病程3~7天者以湿阻中焦型为主,病程>7天者以脾肺气虚型较为多见。结论普通型新冠肺炎患者的中医证型以湿阻中焦型、寒湿袭肺型为主,患者主要体质类型为痰湿质、气虚质、血瘀质、湿热质。

Objective To preliminarily explore characteristics of traditional Chinese medicine(TCM) clinical syndromes and constitutions in patients with coronavirus pneumonia(COVID-19) of common type, so as to provide a basis for early intervention as well as syndrome differentiation and treatment in TCM. Methods A cross-sectional research method was applied and a TCM syndrome scale was designed. TCM syndrome and constitution surveys were performed on 90 patients with common type COVID-19 by using the TCM syndrome scale and constitution scale. Through descriptive analysis and cluster analysis, the characteristics of TCM syndromes and distribution law of constitution types in the patients with common type COVID-19 were analyzed and summarized. Results The top five symptoms of patients were fever(83.3%), fatigue(62.2%), anorexia(53.3%), muscle soreness(52.2%) and dry cough with less sputum(51.1%). Tongue was mainly light red(56.7%) and red(35.6%) and the tongue fur mainly included thin white fur(36.7%), white greasy fur(20.0%) and yellow greasy fur(20.0%). Pulse analysis was completed in 85 patients, and deep pulses(51.8%) and slippery pulses(21.2%) were more common. The constitution types with frequency of over 10% were phlegm-dampness constitution(50.0%), qi-deficiency constitution(41.7%), blood-stasis constitution(27.4%) and dampness-heat constitution(11.9%). The common syndrome types were cold-dampness attacking lung type(34 cases, 37.8%), dampness obstructing in middle jiao type(48 cases, 53.3%) and spleen-lung qi deficiency type(8 cases, 8.9%). Those with a course of disease for less than 3 days were mainly cold-dampness attacking lung type, those with a course of disease for 3-7 days were mainly dampness obstructing in middle jiao type, and those with a course of disease for more than 7 days were more common with spleen-lung qi deficiency type. Conclusion The TCM syndromes of patients with common type COVID-19 are mainly dampness obstructing in middle jiao type and cold-dampness attacking lung type. The main constitution types of patients are phlegm-dampness constitution, qi-deficiency constitution, blood-stasis constitution and dampness-heat constitution.