30例新型冠状病毒肺炎核酸持续阳性患者临床特征回顾性分析

Retrospective Analysis of Clinical Characteristics of 30 Cases of Coronavirus Disease 2019 with Persistent Nucleic Acid Positive

目的分析探讨新型冠状病毒肺炎(简称“新冠肺炎”)新型冠状病毒核酸持续阳性超过4周患者的临床特征。方法采用回顾性分析方法,纳入武汉市金银潭医院南一病区2020年1月28日至3月30日收治的新型冠状病毒核酸检测阳性持续时间>4周的新冠肺炎患者共30例,采集其一般资料、临床资料并分析患者临床特征及体质类型分布规律。结果30例新冠肺炎患者中包括持续阳性未能出院患者10例,出院或隔离后复查阳性者20例。年龄34~86岁,平均(60.40±14.46)岁,≥60岁者19例(63.3%);临床分型:普通型8例(26.7%),重型22例(73.3%);主要基础疾病:高血压病14例次(46.6%),糖尿病6例次(20.0%),冠心病5例次(16.7%);初始发病时主症:发热(20例,占66.7%),喘息(10例,占33.3%),咳嗽(7例,占23.3%);咽拭子核酸反复阳性24例次(80.0%),痰液核酸反复阳性16例次(53.3%);接受过抗生素治疗24例次(80.0%),接受过抗病毒药物治疗16例次(53.4%),接受过中药治疗25例次(83.3%);舌质暗淡者19例(63.3%),舌质红11例(36.7%);舌苔腻者21例(70.0%),舌苔少者5例(16.7%),苔薄白者4例(13.3%);痰湿体质12例(40.0%),气郁体质8例(26.7%),气虚体质5例(16.6%),湿热体质3例(10.0%),阴虚体质2例(6.7%)。结论新型冠状病毒核酸持续阳性的患者中高龄、基础疾病多者相对较多,高血压病为最常见的合并基础病,咽拭子反复阳性最为常见;舌质暗淡及舌苔腻者以及痰湿、气郁体质的患者较多,故益气扶正、化湿驱邪、调畅气机或是其治疗的方向。

Objective To analyze the clinical characteristics of patients with Coronavirus Disease 2019(COVID-19)that have continued to have positive nucleic acid result for more than 4 weeks.Methods A retrospective analysis method was used to enroll a total of 30 patients with COVID-19 who were admitted to the South First Ward of Wuhan Jinyintan Hospital from January 28 to March 30,2020,who had a positive duration of nucleic acid test of the novel coronavirus and lasted more than 4 weeks.General information,clinical data were collected and distribution of clinical characteristics and physical types of patients were analyzed.Results Among the 30 patients with COVID-19,10 patients were continuously positive and failed to be discharged,and 20 patients were rechecked after discharge or isolation therapy.Age of the patients were 34-86 years old,average(60.40±14.46)years old,19 cases(63.3%)≥60 years old;clinical classification:8 cases(26.7%)were of ordinary type,22 cases(73.3%)of severe type;main underlying diseases:14 cases were of hypertension(46.6%),6 cases of diabetes(20.0%),5 cases of coronary heart disease(16.7%);the main symptoms at the initial onset including fever(20 cases,66.7%),wheezing(10 cases,33.3%),cough(7 cases,23.3%);throat swab nucleic acid repeated positive 24 times(80.0%),sputum nucleic acid repeated positive 16 times(53.3%);24 cases received antibiotic treatment(80.0%),16 cases(53.4%)received antiviral drug treatment,25 cases(83.3%)received traditional Chinese medicine treatment;19 cases(63.3%)had dull tongue,11 cases(36.7%)had red tongue;21 cases(70.0%)with greasy tongue coating,5 cases(16.7%)with less tongue coating,4 cases(13.3%)with thin and white coating;12 cases(40.0%)were of phlegm constitution,8 cases of qi depression constitution(26.7%),5 cases(16.6%)of qi deficiency constitution,3 cases(10.0%)of damp-heat constitution,2 cases(6.7%)of yin deficiency constitution.Conclusion There are relatively more patients with persistently positive nucleic acid of the novel coronavirus in the elderly and those with underlying diseases.Hypertension is the most common combined underlying disease,and repeated positive throat swabs are the most common;those with dull tongue and greasy tongue coating,as well as phlegm and dampness were most common.There are many patients with qi stagnation physique,so it is the direction of its treatment to invigorate qi and reinforce the vitality,dispel dampness and exorcise evil,regulate the qi machine.