2型糖尿病合并新型冠状病毒肺炎患者的临床特征及中医病机分析

Clinical Characteristics and Pathogenesis of Traditional Chinese Medicine in Patients with Type 2 Diabetes Mellitus Combined with Novel Coronavirus Pneumonia

目的总结2型糖尿病合并新型冠状病毒肺炎患者临床特征,分析其中医病机。方法纳入2020年2月10日—2020年2月25日湖北省中医院收治的67例新型冠状病毒肺炎患者采集患者的基本信息、中医症候特征、血常规、C反应蛋白、白介素-6、降钙素原、T淋巴细胞亚群、血生化、凝血功能、N端脑钠肽、心肌酶谱、胸部CT等,并分为糖尿病组和非糖尿病组进行比较。结果67例新型冠状病毒肺炎患者中2型糖尿病患者11例,占比16.42%。糖尿病组患者咳嗽、发热、咽痛、大便稀溏、肌痛、气短、纳差、心慌、呼吸困难、大便干结、口干、口苦、头痛症状比例均高于非糖尿病患者,体温以低热、中热为主,咳嗽以黄痰或无痰为主,口干喜饮多见,舌象多见舌质暗红,舌苔白腻或黄腻。糖尿病组患者淋巴细胞绝对值、血尿素、血肌酐较非糖尿病组显著降低(P<0.05),而D-二聚体显著升高(P<0.05)。糖尿病组患者胸部CT病灶具有多样、多灶性。结论2型糖尿病合并新型冠状病毒肺炎病机核心为虚、湿、热、瘀、痰,主要病位在肺与脾。

Objective To summarize the clinical characteristics of patients with type 2 diabetes mellitus combined with novel coronavirus pneumonia,and to analyze its pathogenesis.Methods 67 cases of patients with common novel pneumonia treated in Hubei Provincial Hospital of Traditional Chinese Medicine from February 10 to February 25,2020 were included.Their basic informations,traditional Chinese medicine symptom characteristics,blood routine,C-reactive protein,interleukin-6,procalcitonin,T lymphocyte subsets,blood biochemistry,coagulation function,N-terminal brain natriuretic peptide myocardial enzymes,and lung CT were collected,and divided into diabetic group and non-diabetic group for comparison.Results Of the67 patients with new-type coronavirus pneumonia,11 had type 2 diabetes accounting for 16.42%.The proportion of patients with diabetes cough,fever,sore throat,loose stools,myalgia,shortness of breath,poor appetite,palpitation,dyspnea,dry stool,dry mouth,bitter mouth,and headache symptoms were higher than those of non-diabetics.Their body temperature was mainly low and moderate fever,cough was mainly with yellow sputum or no sputum,dry mouth and drink were more common,longue was more common dark red,with white or yellow greasy tongue coating.The absolute value of lymphocytes,blood urea,and serum creatinine in diabetic group were significantly lower than those in non-diabetic group(P<0.05),while D-dimer was significantly increased(P<0.05).The CT lesions of the chest in diabetic group were diverse and multifocal.Conclusion The core of the pathogenesis of type 2 diabetes mellitus combined with novel coronavirus pneumonia is deficiency,dampness,heat,stasis,and sputum,and the main diseases are in the lungs and spleen.