新型冠状病毒肺炎患者中医证候分布特点

Distribution Characteristics of TCM Syndromes of COVID-19 Patients Based on Literature Combing and Multidimensional Analysis

目的:探讨新型冠状病毒肺炎患者中医临床证候特点,为进一步提高该病的诊治水平提供参考依据。方法:采用计算机检索和人工检索相结合的方法,系统梳理新型冠状病毒肺炎文献资料,提取患者基本信息、中医症状体征、舌脉、中医证型,采用描述性分析、关联规则分析、因子分析等多维分析方法,探讨新型冠状病毒肺炎患者的中医证候分布特点。结果:最终筛选文献39篇,共纳入4544例患者,中医症状分析显示,频次前10位的是发热(69.92%)、咳嗽(33.23%)、乏力(27.24%)、胸闷气短(19.50%)、干咳无痰(14.74%)、肌肉酸痛(1.07%)、纳差(10.43)、腹泻便溏(10.37%)、头痛(10.21%)、咳白痰(9.86%);舌质主要见红舌或暗红舌(45.96%)、淡红舌(18.50%),舌苔主要见白腻苔(51.27%)、黄腻苔(28.55%)、白厚苔(21.92%);脉象以滑脉(22.73%)、数脉(20.91%)、濡脉(8.31%)、浮脉(7.79%)等多见。关联规则分析设置信度≥0.5,支持度≥95%,最大前项数为5,提升≥1,共计得到高频关联组合条目29组,挖掘出咳嗽、乏力、发热、咽痛、便秘、肌肉酸痛、头痛、腹泻便溏、脉弦10个核心证候信息。因子分析共得到10个公因子,进一步将10个因子聚类分析,最终共聚为3类,中医证候依次为湿遏肺卫证(54.65%)、湿困中焦证(22.88%)、热毒炽盛证(22.47%),其中以湿遏肺卫证为主。结论:新型冠状病毒肺炎中医证候特点为湿遏肺卫证、湿困中焦证、热毒炽盛证,可为临床治疗及证候规范化研究提供参考依据。

Objective:To explore the characteristics of clinical syndromes of traditional Chinese medicine in patients with corona virus disease 2019(COVID-19),and to provide a reference for further improving the diagnosis and treatment of the disease.Methods:A combination of computer search and manual search is used to systematically sort out COVID-19 literatures and extract basic patient information,symptoms and signs of traditional Chinese medicine,tongue veins,and TCM syndromes,and use descriptive analysis,association rule analysis,factor analysis and other multi-dimensional Analysis methods to explore the distribution characteristics of TCM syndromes in patients with COVID-19.Results:A total of 39 articles were screened and 4544 patients were included.The analysis of symptoms of traditional Chinese medicine showed that the top 10 frequencies were fever(69.92%),cough(33.23%),fatigue(27.24%),chest tightness and shortness of breath(19.50%),dry cough without sputum(14.74%),muscle soreness(1.07%),anorexia(10.43),diarrhea and loose stools(10.37%),headache(10.21%),cough and white sputum(9.86%),red tongue or dark red tongue(45.96%),light red tongue(18.50%),white greasy coating(51.27%),yellow greasy coating(28.55%),thick white coating(21.92%),slippery veins(22.73%),speedy pulse(20.91%),soft pulse(8.31%),floating pulse(7.79%)are more common;the association rule analysis sets the reliability≥0.5,the support≥95%,the maximum number of preceding items is 5,the increase≥1,total Obtained 29 groups of high-frequency related combination items,excavated 10 core syndrome information of cough,fatigue,fever,sore throat,constipation,muscle soreness,headache,diarrhea and loose stools,pulse string;factor analysis obtained a total of 10 common factors,further Cluster analysis of 10 factors,and finally aggregated into 3 categories,the TCM syndromes were Dampness blocking Lung Syndrome(54.65%),Dampness stagnation Middle Burner Syndrome(22.88%)and Heat Toxin flaming Syndrome(22.47%),of which Mainly damp lung syndrome.Conclusion:The TCM syndromes of COVID-19 are characterized by Dampness blocking Lung Syndrome,Dampness stagnation Middle Burner Syndrome and Heat Toxin flaming Syndrome,which can provide reference for clinical treatment and standardized research of syndromes.