重庆市万州区80例新型冠状病毒肺炎患者临床特征及证治分析

Analysis on Clinical Characteristics and TCM Syndromes of 80 Patients with Novel Coronavirus Pneumonia in Wanzhou District of Chongqing

目的探讨重庆市万州区新型冠状病毒肺炎(COVID-19)中医临床特征和证候特点,为中医相关治疗提供参考。方法收集重庆市万州区集中治疗点COVID-19患者病例资料,于入院第1日采集流行病学史、白细胞计数、淋巴细胞计数、C反应蛋白、白细胞介素-6、CD4^+计数、CD8^+计数、胸部CT、症状体征等信息,分析患者基本特征及中医证候特点。结果 80例COVID-19患者中男45例,女35例,男女比例1.29∶1。年龄18~82岁,平均年龄(54.20±12.76)岁。62例(77.50%)有明确武汉/湖北旅居史,13例(16.25%)有明确与确诊人员接触史,5例(6.25%)无明确流行病学史。20例(25.00%)有基础疾病。实验室检查显示,患者白细胞水平多无明显变化,多见C反应蛋白水平升高,胸部CT以多肺叶下野外带病变为主;重型患者多见白蛋白水平偏低、白细胞介素-6水平偏高。临床症状按频次高低依次为咳嗽64例(80.00%)、发热54例(67.50%)、纳差32例(40.00%)、腹泻30例(37.50%)、乏力22例(27.50%)、气促21例(26.25%)等。舌象以红舌、淡红舌为主,舌苔以厚/腻苔多见(56.25%),脉象以滑脉为主(60.00%)。中医辨证分型以湿毒郁肺证最多(53.75%),其后依次为气阴两虚证(25.00%)、肺脾气虚证(11.25%)、邪犯肺胃证(10.00%)。结论重庆市万州区COVID-19患者以中青年居多,93.75%患者有直接或间接接触史,以发热、咳嗽为主要症状,中医证型以湿毒郁肺证为主。

Objective To discuss clinical characteristics and TCM syndromes of novel coronavirus pneumonia(COVID-19)in Wanzhou District of Chongqing;To provide reference for the treatment of TCM.Methods Case data of patients with COVID-19 in the centralized treatment site of Wanzhou District of Chongqing were collected.Epidemiological history,white blood cell count,lymphocyte count,C-reactive protein,interleukin-6,CD4^+count,CD8^+count,chest CT,symptoms and signs,etc.were collected on the 1st day of admission.The basic characteristics of patients and TCM characteristics and syndromes were analyzed.Results Among the 80 patients with COVID-19,45 were males and 35 were females.The ratio of male to female was 1.29:1.The patients were aged from 18 to 82 years,with an average age of(54.20±12.76)years.62 cases(77.50%)had a clear history of residence in Wuhan/Hubei;13 cases(16.25%)had a clear history of contact with patients with COVID-19;5 cases(6.25%)had no clear epidemiological history.20 cases(25.00%)had underlying diseases.Laboratory examinations showed that patients had no significant changes in white blood cell levels,and C-reactive protein level increased.Chest CT was dominated by lesions in the field of multiple lung lobes;Severe patients often showed low albumin levels and high interleukin-6 levels.The clinical manifestations were cough in 64 cases(80.00%),fever in 54 cases(67.50%),poor appetite in 32 cases(40.00%),diarrhea in 30 cases(37.50%),asthenia in 22 cases(27.50%),and shortness of breath in 21 cases(26.25%).The main tongue features of the patients were red tongue or light red tongue,with thick/greasy tongue coating(56.25%)and slippery pulse(60.00%).The TCM syndrome type was mainly the syndrome of damp toxin stagnating in lung(53.75%),followed by syndrome of qi-yin deficiency(25.00%),syndrome of lung-spleen qi deficiency(11.25%),and syndrome of pathogen invading lung and stomach(10.00%).Conclusion The patients of COVID-19 in Wanzhou District of Chongqing are mostly young and middle-aged people.93.75%of the patients have a history of direct or indirect contact.Fever and cough are the main symptoms.Syndrome of damp toxin stagnating in lung is the main TCM syndrome type.