51例新型冠状病毒肺炎核酸复阳患者的中医药治疗

Treatment of 51 cases of COVID-19 nucleic acid Fuyang with traditional Chinese medicine

目的观察51例新型冠状病毒肺炎(COVID-19)核酸复阳患者复阳和转阴前后症状及舌像,并探讨中医病因病机与其关系。方法应用视觉模拟评分法(VAS)与中医传统舌诊相结合,比较患者复阳时和转阴后胸闷、咳嗽等症状与舌像(舌色,舌苔,舌质)变化。结果51例复阳患者治疗前后,合并3个以上症状的患者由19例降至5例,无症状者由15例增至21例;单一症状如咳嗽、失眠、腹胀等均有不同程度减少;转阴时存在胸闷/胸痛、咳嗽/咽部不适和失眠3种症状,与治疗前相比,治疗后VAS评分降低,差异有统计学意义(P<0.05);治疗前,复阳患者舌象以舌红(58.82%),伴齿痕(52.94%),舌苔白腻(49.01%)为主,治疗后,舌象以舌红(62.75%),苔薄白(68.63%)为主。其中齿痕舌消失,腻苔减退为主要舌象改变;经中药、艾灸治疗,1周后转阴者38例,占比74.51%,2周转阴者6例,占比11.76%,3周转阴者5例,占比9.80%。解除隔离14 d后电话随访51例患者未出现再次复阳。结论中医综合治疗不仅能明显改善复阳患者咳嗽、胸闷等临床症状,还可使舌像由异常趋于正常,对促进复阳患者转阴有积极作用。

Objective To observe the symptoms and tongue picture of 51 cases of COVID-19(COVID-19)nucleic acid positive patients before and after Fuyang and negative,and to explore the relationship between TCM etiology and pathogenesis.Methods The visual analogue score(VAS)was combined with traditional Chinese medicine tongue diagnosis to compare the symptoms such as chest tightness,cough and the changes of tongue image(tongue color,tongue coating,tongue quality).Results Before and after treatment,the number of 51 patients with more than three symptoms decreased from 19 to 5,and the number of asymptomatic patients increased from 15 to 21.Single symptoms such as cough,insomnia and abdominal distension decreased in varying degrees.There were three symptoms of chest tightness/chest pain,cough/pharynx discomfort and insomnia when Fuyang.Compared with those before treatment,the VAS score decreased after treatment,and the difference was statistically significant(P<0.05).Before treatment,the tongue image of the patients with Fuyang was red tongue(58.82%),with tooth marks(52.94%),and white and greasy tongue coating(49.01%).After treatment,the tongue image was mainly red tongue(62.75%)and thin white fur(68.63%).Among them,the tooth mark tongue disappeared and the greasy fur decreased as the main change of tongue image;after the treatment of traditional Chinese medicine and moxibustion,38 cases turned negative after 1 week,accounting for 74.51%,6 cases turned negative for 2 weeks,and 5 cases,accounting for 11.76%,turned negative for 3 weeks,accounting for 9.80%.After 14 days of isolation,51 patients were followed up by telephone and no Fuyang was found.Conclusion The comprehensive treatment of traditional Chinese medicine can not only significantly improve the clinical symptoms such as cough and chest tightness,but also change the tongue image from abnormal to normal,which plays a positive role in promoting the rehabilitation of patients with Fuyang.