武汉地区57例新型冠状病毒肺炎的临床特征及中医证候初探

Analysis of Chinese Medical Characteristics of 57 Patients with COVID-19 in Wuhan Area

目的:分析武汉市泰康同济新型冠状病毒肺炎(以下简称新冠肺炎)专科医院患者的临床资料及中医情况,探讨武汉地区新冠肺炎的中医证候特征,为下一步协定方的制订提供依据。方法:将2020年2月19日—2020年3月2日本院有完整舌象资料的57例新冠肺炎患者作为研究对象,收集患者的一般情况、临床症状、血液常规检验及胸部CT结果,由2名高级职称中医师对患者进行查体,并得出患者的中医证候。结果:57名新冠肺炎患者中,轻型1人,普通型46人,重型8人,危重型2人。患者平均年龄(55.01±15.53)岁,女性偏多,均有武汉居住史。12.28%(7/57)的患者有明确的家族聚集性发病史。起病当天的初始症状:54.35%(31/57)的患者发热,多为中低热;47.37%(27/57)的患者咳嗽,多为干咳;5.26%(3/57)的患者表现为鼻塞、流涕症状;17.54%(10/57)的患者则无任何不适。45.61%(26/57)的患者淋巴细胞绝对值降低,28.07%(16/57)的患者C反应蛋白水平增加。98.25%(56/57)的患者胸部CT示肺部病变,多为磨玻璃样影或斑片状影。舌质以红和暗红为主,舌苔以腻苔为主。中医病性以湿热证为主,病位在肺脾。结论:武汉地区新型冠状病毒肺炎患者的中医证候以疫热内闭、湿遏肺脾为主,可针对性地采取中医协定方治疗。

Objective:To analyze the clinical data and Traditional Chinese Medicine(TCM)situation of patients in the Taikang Tongji Novel Coronavirus Disease(COVID-19)Hospital in Wuhan City,and to explore the characteristics of TCM syndromes of patients with COVID-19 in Wuhan area,and provide the basis for the formulation of the recipe.Methods:Taking 57 patients with COVID-19 with complete tongue image data from February 19,2020 to March 2,2020 as the research object,the general conditions,clinical symptoms,blood biochemical analysis and chest CT results of the patients were collected.Two senior professional Chinese medicine practitioners judge the tongue image of the patient,so as to obtain the patient's TCM syndrome.Results:Among the 57 patients with COVID-19,1 was diagnosed as mild,46 as normal,8 as heavy,and 2 as critical.The average age of the patients was(55.01±15.53)years old,there was more female,and all had a history of living in Wuhan.12.28%(7/57)of patients had a clear history of familial aggregation.Initial symptoms on the day of onset:54.35%(31/57)of patients had fever,mostly moderate to low fever;47.37%(27/57)of patients coughed,mostly dry cough;5.26%(3/57)of patients showed nasal congestion runny symptoms;17.54%(10/57)of patients had no discomfort.The absolute value of lymphocytes decreased in 45.61%(26/57)patients,and C-reactive protein levels increased in 28.07%(16/57)patients.98.25%(56/57)of patients with chest CT showed lung lesions,mostly ground glass-like shadows or patchy shadows.The tongue is mainly red and light red,and the tongue coating is mainly greasy.The pathogenesis of traditional Chinese medicine is mainly based on damp heat syndrome and the location lies in lung and spleen.Conclusion:The TCM syndromes of patients with COVID-19 in Wuhan area mainly include epidemic fever and occlusion,and dampening the lungs and spleen,which can be treated by traditional Chinese medicine.