上海市220例新型冠状病毒Omicron变异株感染者中医体质类型分布与防控策略

Distribution of Traditional Chinese Medicine Constitution Types and Prevention and Control Strategies in Patients Infected with the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 in Shanghai,China:An Analysis of 220 Cases

目的初步探讨上海局部传播的新型冠状病毒Omicron变异株感染者中医体质类型的分布,为确立核酸筛查和常态化核酸检测的重点人群提供中医体质学说依据。方法设计中医体质量表,对上海市花博园安徽方舱医院新型冠状病毒Omicron变异株感染者进行中医体质调查,通过中医临床数据采集平台录入一般资料和体质调查数据,并进行统计学分析。结果220例新型冠状病毒Omicron变异株无症状感染者中,全程无症状感染病例163例,无症状感染者转化为轻型者57例。163例全程无症状感染者中,平和质141例(86.5%),偏颇质22例(13.5%),57例无症状感染者转化为轻型者中,平和质3例(5.3%),偏颇质54例(94.7%)。两组平和质、偏颇质分布率比较,差异均有统计学意义(P<0.05);全程无症状感染者的平和质分布率显著高于无症状感染者转化为轻型者(P<0.05)。全程无症状感染者出现频率超过10%的体质类型仅有平和质,而无症状感染者转化为轻型病例出现频率超过10%的体质类型有4种,分别是湿热质、气郁质、痰湿质、气虚质。全程无症状感染者的湿热质、气郁质、痰湿质、气虚质分布率显著低于无症状感染转化为轻型者(P<0.05)。结论上海市新型冠状病毒Omicron变异株感染者,由无症状感染者转化为轻型者的发病过程与体质偏颇、基础疾病密切相关;新型冠状病毒Omicron变异株感染平和质者的隐蔽性强,是优先进行核酸筛查和常态化核酸检测的重点人群。

Objective To investigate the distribution of traditional Chinese medicine(TCM)constitution types in patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)locally transmitted in Shanghai,China,and to provide a TCM constitution basis for establishing the key population for nucleic acid screening and normalized nucleic acid detection.Methods A TCM constitution scale was designed to investigate the TCM constitution of the patients infected with the Omicron variant of SARS-CoV-2 who were admitted to Anhui Mobile Cabin Hospital of Shanghai Huaboyuan,and general information and TCM constitution data were entered into a TCM clinical data collection platform to perform a statistical analysis.Results Among the 220 patients with asymptomatic infection with SARS-CoV-2 Omicron variant,163 remained asymptomatic throughout the course of the infection and 57 changed from asymptomatic infection to mild infection.Among the 163 patients who remained asymptomatic throughout the course of the infection,141(86.5%)had normal constitution and 22(13.5%)had biased constitution,while among the 57 patients who changed from asymptomatic infection to mild infection,3(5.3%)had normal constitution and 54(94.7%)had biased constitution.There were significant differences in the distribution rates of normal constitution and biased constitution between the two groups(P<0.05),and the patients who remained asymptomatic throughout the course of the infection had a significantly higher distribution rate of normal constitution than those who changed from asymptomatic infection to mild infection(P<0.05).For the patients who remained asymptomatic throughout the course of the infection,normal constitution was the only type of constitution with a frequency of>10%,while for those who changed from asymptomatic infection to mild infection,there were four types of constitution with a frequency of>10%,among which damp-heat constitution had the highest frequency,followed by Qi-stagnation constitution,phlegm-dampness constitution,and Qi-deficiency constitution.Compared with the patients who changed from asymptomatic infection to mild infection,the patients who remained asymptomatic throughout the course of the infection had significantly lower distribution rates of phlegm-dampness constitution,dampheat constitution,Qi-stagnation constitution,and Qi-deficiency constitution(P<0.05).Conclusion For the patients infected with SARS-CoV-2Omicron variant in Shanghai,the change from asymptomatic infection to mild infection is closely associated with biased constitution and underlying diseases.Infection with SARS-CoV-2Omicron variant tend to have an insidious onset in the population with normal constitution,and therefore,such population should be the key population for nucleic acid screening and normalized nucleic acid detection.