甘肃地区60例普通型新型冠状病毒肺炎患者中医证候规律分析

Analysis on TCM Syndrome Rules of 60 Cases of Novel Coronavirus Pneumonia in Gansu Area

目的探讨甘肃地区普通型新型冠状病毒肺炎(COVID-19)患者中医证候特点,为中医干预和辨证论治提供参考。方法采用中医证候量表收集甘肃地区60例普通型COVID-19患者基本信息、中医症状、体征、舌象、脉象、中医证型,采用描述性分析和聚类分析方法,观察不同性别、年龄、发病时间的COVID-19患者的中医证候特点,分析其病机演变规律。结果 60例患者中医临床症状频数高低依次为咳嗽、发热、咳痰、乏力、肌肉酸痛、气短、胸闷憋气、咽痛、咽干、口渴、头痛。舌质主要见淡红舌、红舌和黯红舌;舌苔主要见黄腻苔、白腻苔、薄白苔;脉象主要见滑脉、濡脉、浮脉。中医证型频数高低依次为湿热郁肺证、寒湿犯肺证、湿热并重证、热毒闭肺证、肺脾气虚证、温邪犯肺证、湿毒血瘀证。男性患者以湿热郁肺证、寒湿犯肺证为主,女性患者以寒湿犯肺证、湿热并重证较为常见。20~29岁患者以寒湿犯肺证为主,30~49岁以湿热郁肺证、湿热并重证较多,50~59岁以肺脾气虚证为主。发病时间<3 d者,以寒湿犯肺证多见,3~7 d者以湿热郁肺证、湿热并重证较为多见,>7 d者以热毒闭肺证、肺脾气虚证为主。结论甘肃地区普通型COVID-19患者中医证候分布具有一定规律性,60例普通型COVID-19患者中,湿热郁肺证最为常见,其次为寒湿犯肺证、湿热并重证、热毒闭肺证、肺脾气虚证等。不同性别、年龄、发病时间的患者中医证候存在差异性,其病机演变为寒湿向热郁夹湿、热毒进展,后期出现肺脾气虚。

Objective To explore characteristics of TCM syndromes of patients with novel coronavirus pneumonia(COVID-19)in Gansu area;To provide references for TCM intervention and syndrome differentiation.Methods Totally 60 cases of common COVID-19 patients in Gansu area were collected by TCM syndrome scale,and their basic information,TCM symptoms,signs,tongue,pulse and syndrome types were analyzed by descriptive analysis and cluster analysis.The characteristics of TCM syndromes of COVID-19 patients of different genders,ages,and course of disease were observed,and the evolution of the pathogenesis was analyzed.Results TCM clinical symptoms of 60 COVID-19 patients from high to low were cough,fever,expectoration,asthenia,muscle ache,shortness of breath,chest tightness and suffocation,pharyngeal pain,pharyngeal dryness,thirst,headache.Tongue was mainly seen in light red tongue,red tongue and dark red tongue;tongue coating was mainly seen in yellow greasy coating,white thick coating and thin white coating;pulse was mostly seen in slippery pulse,soft pulse and floating pulse.According to the frequency,TCM syndrome types were damp heat stagnation in the lung syndrome,cold dampness invading lung syndrome,heat and dampness combined syndrome,heat toxin closing the lung syndrome,deficiency of lung-spleen qi syndrome,warm pathogen attacking the lung syndrome,damp toxin and blood stasis syndrome.The syndrome types of male patients were mainly damp heat stagnation in the lung syndrome and cold dampness invading lung syndrome;the female patients were more common in cold dampness invading lung syndrome and heat and dampness combined syndrome.The TCM syndrome types of the patients aged 20–29 years old were mainly cold dampness invading lung syndrome;30–49 years old were mainly damp heat stagnation in the lung syndrome and heat and dampness combined syndrome;50–59 years old were mainly deficiency of lung-spleen qi syndrome.When the course of disease was shorter than 3 d,the syndrome was mainly cold dampness invading lung;when the course of disease was 3–7 d,the syndromes were mainly damp heat stagnation in the lung and heat and dampness combined;when the course of disease was longer than 7 d,the syndromes were mainly heat toxin closing the lung and deficiency of lung-spleen qi.Conclusion The distribution of TCM syndromes of patients with common COVID-19 in Gansu area has certain regularity.Among the 60 cases of COVID-19,damp heat stagnation in the lung syndrome is the most common syndrome,followed by cold dampness invading lung syndrome,heat and dampness combined syndrome,heat toxin closing the lung syndrome,and deficiency of lung qi and spleen syndrome.Different genders,ages and courses of disease also have differences in TCM syndromes,the pathogenesis of which has evolved from cold dampness to heat stagnation with dampness and heat toxin,and deficiency of lung-spleen qi may appear in later stage of the disease.