天津市32例新型冠状病毒肺炎(奥密克戎)成人患者中医临床特征分析

Analysis on traditional Chinese medicine clinical characteristics of 32 patients with common type COVID-19(Omicron)in Tianjin

[目的]分析天津市新型冠状病毒肺炎(奥密克戎)成人普通型患者一般情况及中医临床特征。[方法]选取2022年1月27日—2月5日于天津海河医院中医病区收治的本土新型冠状病毒肺炎(奥密克戎)成人普通型患者32例,入院后采集流行病学资料及血常规、C反应蛋白、白细胞介素-6(IL-6)、降钙素原、首发症状、舌象等信息并进行辨证。[结果]研究共纳入32例新型冠状病毒肺炎(奥密克戎)成人普通型患者,包括男13例,女19例,年龄21~71岁,平均年龄(49.34±15.00)岁,其中9例(28.13%)存在基础疾病。流行病学调查发现发热门诊筛查病例1例(3.12%),新型冠状病毒肺炎患者密切接触史12例(37.5%),家庭聚集性发病19例(59.38%)。7例患者(21.87%)白细胞计数、淋巴细胞计数、C反应蛋白和IL-6正常;17例患者(53.12%)出现淋巴细胞计数下降,6例患者(18.75%)淋巴细胞合并白细胞计数减少。首发症状:1例患者(3.13%)无症状,31例患者(96.87%)首发症状为咽干,23例患者(71.88%)有咳嗽症状,9例患者出现发热,1例患者(3.13%)伴味觉、嗅觉减退。舌象:淡红舌25例(78.12%)、红舌7例(28.88%),2例患者(6.25%)舌体胖大有齿痕;黄苔21例(65.63%),其中薄黄苔9例(28.13%)、黄腻苔12例(37.5%);白苔10例(31.25%),其中薄白苔6例(18.75%)、白腻苔4例(12.5%);中医证型:湿邪困表证3例(9.37%),瘟热犯卫证24例(75%),热毒袭肺证3例(9.37%),湿蕴脾胃证2例(6.25%)。[结论]经过研究分析32例新型冠状病毒肺炎(奥密克戎)成人普通型患者中医临床特点,认为温热蕴结,肺气不宣为主要病机,治疗宜以宣肺化湿、清热透邪为主。

[Objective]To investigate the general conditions and traditional Chinese medicine(TCM)clinical features of local common type COVID-19(Omicron)patients in Tianjin.[Methods]A total of 32 common type COVID-19 patients treated in the Tianjin Haihe Hospital from January 27th to February 5th,2022 were enrolled.The epidemiological data,including blood routine,C-reactive protein,Interleukin-6(IL-6),procalcitonin,initial symptoms and tongue manifestations were collected on admission and differentiated according to TCM diagnosis and treatment of COVID-19.[Results]A total of the 32 adult patients with common-type COVID-19 patients included in the study,including 13 males and 19 females,aged 21 to 71 years,mean age(49.34±15.00),and 9 cases(28.13%)had an underlying disease.Epidemiological investigation found that 1 case(3.12%)was from the fever outpatient department.12 cases(37.5%)were close contacts of confirmed patients,and 19 cases(59.38%)were family cluster cases.7 cases(21.87%)had a normal value of white blood cell count,lymphocyte count CRP and IL-6,17 cases(53.12%)had a decreased lymphocyte count,and 6 cases(18.75%)had a decrease of white blood cell count and lymphocyte count.Initial symptoms:one patient(3.12%)was asymptomatic,31 patients(96.87%)had dry throat,23 patients(71.88%)had cough,9 patients(28.13%)had fever,and one patient(3.12%)was accompanied by decreased taste and smell.The appearance of tongue:there were 25 cases(78.12%)with red tongue,seven cases(21.88%)with red tongue,and 2 cases(6.24%)with big and fat tongue with teeth marks.There were 21 cases(65.63%)with yellow fur,including 9 cases(28.13%)with thin yellow fur and 12 cases(37.5%)with yellow greasy fur.There were 10 cases of white fur(31.25%),including 6 cases of thin white fur(18.75%)and 4 cases of white greasy fur(12.5%).TCM syndrome:there were 3 cases with pathogenic dampness attacking body fur,24 cases(75%)with heat pestilence attacking body fur,3 cases(9.37%)with heat pestilence attacking lung,and 2 cases(6.24%)with dampness accumulation in the spleen and stomach.[Conclusion]In this study,the main types of TCM syndrome of COVID-19 is heat pestilence attacking body fur,accompanied with pathogenic dampness.The treatment should be mainly to removing dampness with dispersing lung qi and clearing heat for expulsing pathogen.