盘州地区新冠肺炎疫情期间发热患者中医辨证施治特征分析

A Analysis of Characteristics of TMC for Fever Patients During COVID-19 Periods from Panzhou District

目的:分析2020年1月21日-2020年3月16日在盘州市人民医院就诊留观的发热病例中医用药辨证施治特征,为COVID-19疫情的防控、诊断、治疗提供参考。方法:发热以患者腋温大于37.3℃为标准;新冠肺炎患者确诊依照《新型冠状病毒感染的肺炎诊疗方案(试行第三版)》的诊断标准。以2020年1月21日-2020年3月16日在盘州市人民医院收治留观的发热患者为研究对象,收集患者的流行病学调查资料、临床资料,对患者的一般情况、临床表现、症状特征、证属分型、治法治则、用药方案进行描述性分析。结果:2020年1月21日-2020年3月16日盘州市人民医院共收治发热留观患者82例,其中,确诊新冠肺炎患者8例。发热患者脉象中以脉濡、脉数、脉细数为常见;舌象中以舌红、苔黄厚最为常见。证属分型中以寒湿郁肺、痰热壅肺、热毒闭肺及蕴久化热最为多见。治法以清热解毒、凉血、止咳,散寒除湿,通腑泄热,宣肺解毒、透热及宣肺透邪、散寒最为常见。用药以桔梗、苍术、草果、陈皮、茯苓、防风、甘草、瓜蒌、桂枝、厚朴、连翘、麻黄、羌活、鱼腥草、紫苑、藿香、黄芩、栀子等为主。高频药物关联网络结果提示:茯苓-连翘、苍术-厚朴、大黄-桂枝、白头翁-黄连、柴胡-苍术等药物的关联程度最为密切,聚类分析为八类。结论:盘州地区发热患者呈现湿热的特点,治疗以清热凉血、宣肺透邪、滋阴生津为主;方药以桔梗、柴胡、紫苑、连翘、金银花、苍术、沙参、麦冬等为主。

Objective:To analyze the characteristics of Traditional Chinese Medicine(TCM)for the treatment and treatment of fever cases in Panzhou People’s Hospital during the COVID-19 from January 21st,2020 to March 16th,2020,in order to prevent,control,diagnose and treat the COVID-19 epidemic provide detailed data foundation and reference.Methods:The fever is based on the patient’s axillary temperature greater than 37.3℃;the diagnosis of patients with COVID-19 was based on the the COVID-19 diagnostic standard of the Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Plan(trial third edition).From January 21st,2020 to March 16th,2020,the fever patients admitted to Panzhou People’s Hospital as the research object were collected from the epidemiological investigation data and clinical data of the patients,and the general conditions,clinical manifestations and symptoms of the patients were collected.The syndromes are classified according to type,rule of law,and descriptive analysis.Results:From January 21st,2020 to March 16th,2020,a total of 82 patients with fever were admitted to Panzhou People’s Hospital,of which 8 were diagnosed novel coronavirus pneumonia.Among the patients with fever,the fast pulses,moisten pulses and fine moisten pulses are the most common in the pulse image.The tongues with red and the thickness of the yellow fur are the most common in the tongue image.The most common syndrome types are cold-dampness stagnation of the lung,phlegm-heat blocking the lung,heat toxin blocking the lung,and accumulation of long-term heat.The most common treatment methods include clearing away heat and detoxification,cooling blood,relieving cough,dispelling cold and dampness,clearing the body to relieve heat,dispelling the lungs,detoxifying,relieving cough,removing evil,and dispelling cold.The main medications are platycodon,atractylodes,grass fruit,tangerine peel,poria,parsnip,licorice,melon,cassia twig,magnolia,forsythia,ephedra,qianghuo,houttuynia cordata,asters,rugosa,scutellaria,gardenia,etc.The results of the high-frequency drug association network suggested that:Poria-Forsythia,Atractylodes-Magnolia,RhubarbGuizhi,Pulsatilla-Coptis,Bupleurum-Cangzhu and other drugs have the closest degree of association,and cluster analysis is divided into eight categories.Conclusion:The patients with fever in Panzhou area present the characteristics of dampness and heat.The main treatment is to clear away heat and cool blood,spread the lungs and expel evil,nourish yin and promote body fluid.The main prescriptions are Platycodon grandiflorum,Bupleurum,Asters,Forsythia,Honeysuckle,Cangzhu,Adenophora,Ophiopogon,etc.