武汉地区19例妊娠合并新型冠状病毒肺炎临床特征和中医证候特点

Clinical Characteristics and TCM Syndrome Features of 19 Cases of Pregnancy with COVID-19 in Wuhan

目的通过分析武汉地区19例妊娠合并新型冠状病毒肺炎的临床资料,探讨妊娠合并新型冠状病毒肺炎的中医证候特点和发病机制。方法收集在2020年1月21日至3月1日期间于华中科技大学同济医学院附属协和医院住院治疗的妊娠合并新型冠状病毒肺炎患者19例,分析其临床表现和舌象资料,总结其中医证候特点。结果19例患者均为普通型,其中发热者15例(78.95%),高热者5例(33.34%),发热患者中位发热持续时间为11.5 d,发热以午后和夜间为主。咳嗽9例,咳痰12例,胸闷症状9例,活动后呼吸困难14例,汗出异常16例(自汗4例、盗汗12例),头痛8例,乏力14例,纳差3例,恶心呕吐2例,腹胀2例,腹泻2例,尿频2例,尿色发黄6例,口味异常8例(口干3例、口苦3例、口淡2例),喜欢饮用热水14例,喜欢饮用凉水2例。19例患者中寒湿阻肺13例(68.42%),湿毒郁肺证6例(31.58%)。结论妊娠合并新型冠状病毒肺炎患者群体的临床症状与普通的新型冠状病毒肺炎患者群体有所不同,无发热者和高热者比例较高;除了发热、咳嗽咳痰、乏力、肢体困重等症状之外,其胸闷、活动后呼吸困难和汗出异常症状也较为明显。寒湿阻肺是妊娠合并新型冠状病毒肺炎患者患病的主要病机。

Objective To analyze the clinical data of 19 cases of pregnancy combined with Corona Virus Disease 2019(COVID-19)in Wuhan,to explore the characteristics and TCM syndrome features.Methods A total of 19 pregnant patients with COVID-19 who were admitted to the union hospital,Tongji medical college,Huazhong university of science and technology from January 21 to March 1,2020 were collected.The clinical manifestations and tongue images were analyzed,and the TCM syndrome features were summarized.Results The 19 patients were all of ordinary type,including 15 cases of fever(78.95%),5 cases of high fever(33.34%).The median duration of fever was 11.5 days,and the fever was mainly in the afternoon and night.9 cases of cough,12 cases of sputum,9 cases of chest tightness,14 cases of dyspnea after activity,16 cases of abnormal sweating,4 cases of spontaneous sweating,12 cases of night sweats,8 cases of headache,14 cases of fatigue,3 cases of anorexia,nausea 2 cases of vomiting,2 cases of abdominal distension,2 cases of diarrhea,2 cases of frequent urination,6 cases of yellow urine,12 cases of chest tightness,8 cases of abnormal taste,including 3 cases of dry mouth,3 cases of bitter mouth,2 cases of light mouth,14 cases drank hot water and 2 cases liked to drink cold water.13 cases of the 19 patients(68.42%)had cold and dampness syndrome,and the etiology was cold and damp,while 6 cases(31.58%)had dampness and stagnation syndrome and the etiology was damp and hot.Conclusion The clinical symptoms of patients with pregnancy combined with COVID-19 are different from those of ordinary patients with COVID-19.The proportion of those without fever and those with high fever is higher.In addition to the symptoms of fever,cough,sputum,fatigue,and limb weakness,the symptoms of chest tightness,dyspnea and sweating after exercise are more obvious.Cold and dampness is the main etiology and pathogenesis of pregnant patients with COVID-19.