基于临床文献的新型冠状病毒肺炎患者舌象特征研究

Research on the Tongue Features of Patients with COVID-19 Based on Clinical Literature

[目的]通过对新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)文献资料进行统计分析,探讨COVID-19患者的舌象特征。[方法]检索中国知网(China National Knowledge Infrastructure,CNKI)和PubMed、Web of Science数据库中COVID-19舌象、证候的临床研究,发表时间范围为2019年12月至2020年11月。提取纳入文献中的舌象特征,系统整理后建立数据库,分别统计COVID-19患者的舌色、舌形、苔色、苔质等舌象情况。[结果]共纳入48篇文献,其中中文文献47篇,外文文献1篇,涉及4750例COVID-19病例,患者舌象以绛红舌(32.11%)、腻苔(54.29%)最为常见,同时黄苔占有一定比例(40.88%),除轻型病例外,腻苔为COVID-19各病程主要苔质特征。在COVID-19不同的病程阶段,患者舌色、舌形、苔质、苔色呈现差异,同时随着病程的进展加重,COVID-19的主要舌象特征从淡红舌转为绛红舌,薄苔转为厚苔,体现了COVID-19不同病程阶段舌象的变化。对比轻型和普通型、重型和危重型两类患者舌象特征,发现随着病情的加重,厚苔、青紫舌比例增加,体现邪气的增长,病邪的深入,也说明了COVID-19病程进展后期容易出现"瘀""闭"的特性。通过对病例的地域分类统计,发现病例样本主要集中在华中地区(59.83%),不同地域患者的舌象呈现差异,舌色方面,东北地区以青紫舌为主,华北、华南、华东地区以绛红舌为主;腻苔为各地域共同的主要苔质特征。[结论]腻苔为COVID-19的主要舌象特征,因此"湿邪"为本病重要特征,病程进展不同、地域差异使得患者舌象呈现差异。

[Objective]To explore the tongue features of patients with coronavirus disease 2019(COVID-19),through the analysis of contributions.[Methods]The clinical studies of COVID-19 tongue picture and syndrome in China National Knowledge Infrastructure(CNKI)and PubMed and Web of Science database were searched,the publication time range was from December 2019 to November 2020.The tongue features included in the research articles were collected,the database was set up after systematization,the tongue color,tongue shape,fur color and fur quality of COVID-19 patients were calculated separately.[Results]A total of 48 articles were included,including47 in Chinese and one in foreign language,involving 4750 cases of COVID-19.Crimson tongue(32.11%)and greasy fur(54.29%)were the most common tongue characteristics.At the same time,yellow fur accounted for a certain proportion(40.88%).Except for mild cases,greasy fur was the main characteristic of COVID-19 in each course of disease.There were differences in tongue color,tongue shape,fur quality and fur color in different stages of COVID-19.At the same time,with the progression of the disease,the main tongue feature of COVID-19 changed from light red to crimson tongue,and thin fur to thick tongue.It showed the change of tongue characteristics in different stages of COVID-19.Comparing the tongue feature characteristics of mild and ordinary type,severe and critical type,it was found that with the aggravation of the disease,the proportions of thick fur and blue and purple tongue increased,reflecting the growth of evil Qi and the deepening of disease evil,which also showed that COVID-19 was prone to“blood stasis”and“closure”in the later stage of the course of disease.Through the regional classification of the cases,it was found the main collection of the disease samples was in the central China region(59.83%).The tongue images of the patients in different regions were different,the color of the tongue was square,and the blue and purple tongue was the main tongue in the north-east region.In North China,South China and East China,the crimson tongue was the main feature,and the greasy fur was the common characteristic of fur in all regions.[Conclusion]Greasy fur is the main characteristic of tongue image of COVID-19,so“damp evil”is the most important feature of this disease,and the tongue characteristics of the patient is different due to different courses of disease and different regions.