116例奥密克戎新型冠状病毒感染轻型、普通型患者中医证候、病机特点分析

Analysis of TCM Syndromes and Pathogenesis Characteristics of 116 Mild and Common Patients with Omicron Infection of Novel Coronavirus

目的探究苏州地区感染新型冠状病毒奥密克戎变异株轻型、普通型患者中医证候及发病机制,为临床辨治提供参考。方法对苏州地区确诊的116例感染新型冠状病毒奥密克戎变异株轻型及普通型患者进行中医证候调查,采集其基本信息、入院时及治疗过程中临床症状以及舌象等,进行中医辨证和病机、病位分析,并对两组患者进行比较分析。结果1)一般情况:两组患者性别构成相近(P>0.05),轻型患者平均年龄明显低于普通型患者(P<0.05),普通型合并基础疾病者比例较高(P<0.05)。2)临床症状、体征:发病初期两组均以发热、咳嗽、咯痰等表证多见,至入院后第9天,两组表证已解,普通型仍有较多患者有咳嗽、咯痰、乏力,少数患者出现便溏、口苦、胸闷、恶心呕吐等表现。发病初期两组患者较多淡白舌、胖舌,舌苔多薄白、薄白腻。第9天普通型患者红舌、瘦舌及厚黄腻苔有增多。3)证候:两组患者在疾病初期多为风寒湿毒表证,9 d后轻型患者大多疾病已愈,其余多转归为肺脾气虚证。普通型患者治愈比例较低,较多患者转归为肺脾气虚证、湿毒蕴肺化热。结论苏州地区新型冠状病毒肺炎轻型及普通型患者发病初期临床症状相似,主要证候为风寒湿毒表证,普通型病程中病邪更易循三焦入里,需注重“因地、因时、因人”制宜,将发病地理、气候和个体因素均纳入考量。

Objective:To explore the TCM syndromes and pathogenesis of patients with mild and common types of novel coronavirus Omicron variant in Suzhou area,and to provide reference for clinical differentiation and treatment.Methods:The TCM syndromes of 116 patients with mild and common types of novel coronavirus Omicron variant confirmed in Suzhou area were investigated to collect their basic information,clinical symptoms and tongue image on admission and during treatment.Results:1)Common condition.There was no significant difference in the gender composition of the two groups of patients(P>0.05).The average age of the mild patients was significantly lower than that of the common patients(P<0.05),and the proportion of the common patients with underlying diseases was higher(P<0.05).2)Clinical symptoms and signs.In the early stage of the disease,symptoms such as fever,cough,and expectoration were more common in both groups.On the 9th day after admission,the symptoms of the two groups were resolved,and there were still many common patients had cough,expectoration,fatigue,and a few patients had symptoms such as loose stools,bitter mouth,chest tightness,nausea,and vomiting.In the early stage of the disease,the two groups of patients had more pale tongue and fat tongue,and the tongue coating was thin and white and greasy.On the 9th day,the symptoms of red tongue,thin tongue and thick yellow greasy fur in common type patients increased.3)Syndromes.In the early stage of the disease,most of the patients in the two groups had wind-cold-damp-toxin syndrome.After 9 days,most of the mild patients were cured,the rest were mostly classified as symptoms of lung and spleen deficiency.The cure rate of ordinary patients is low,and most patients were classified as symptoms of lung and spleen deficiency,dampness toxin accumulates heat from lung.Conclusion:The clinical symptoms of patients with mild and common types of novel coronavirus pneumonia in Suzhou area are similar at the initial stage of onset,and the main syndrome is wind-cold-damp-toxin syndrome.In the ordinary course of the disease,the pathogens are more likely to enter the interior through the Sanjiao.It is necessary to pay attention to“applying proper therapeutic measure in line with season,local conditions and individuality”,and take into account the onset geography,climate,and individual factors.