新型冠状病毒奥密克戎变异株感染患者舌象特点

Tongue manifestations of patients infected with Omicron variants of novel coronavirus

目的 分析1112例新型冠状病毒奥密克戎变异株感染患者舌象与症状表现,为中医辨证论治提供依据。方法 纳入2022年3月15日-4月7日吉林省长春通源方舱医院无症状及轻型奥密克戎变异株感染患者1 112例,观察舌色、舌苔、舌形,总结舌象特点与疾病的相关性,探讨其临床意义。结果 舌色出现频次由高到低依次为淡红舌352例(31.65%)、绛舌255例(22.93%)、淡白舌215例(19.33%)、青紫舌187例(16.82%)、红(边尖、全舌)舌113例(10.16%)、其他8例(0.72%);舌形中由高到低分布为齿痕舌374例(33.63%)、胖大舌339例(30.49%)、瘦薄舌182例(16.37%)、质嫩舌108例(9.71%)、裂纹舌107例(9.62%)、其他舌59例(5.31%);舌苔频次由高到低依次为:白腻苔443例(39.84%)、薄白苔262例(23.56%)、白滑苔152例(13.67%)、黄腻苔87例(7.82%)、少苔78例(7.01%)、薄黄苔60例(5.40%),燥苔48例(4.32%),其他17例(1.53%)。结论 结合舌象及症状分析,本次奥密克戎感染人群以肺脾气虚,寒湿偏盛状态人群为主,症状较轻,以肺卫表现为主,舌色多为淡红舌,舌型常见胖大、齿痕;舌苔多为白腻苔、白滑苔。根据病情及人体特点,多数患者存在表证,治疗上应先驱散卫表邪气,先表后里,或表里同治,可辨证斟酌应用荆防败毒散、柴葛解肌汤等方剂。同时要注意对脾胃的保护,可选用健脾除湿类药物,如苍术、白术、薏苡仁、茯苓等,慎用苦寒泻下药物,以免重伤脾胃,引邪入里。随着中医药信息化的发展,舌诊在中医诊断及治疗中将会发挥越来越重要的作用。

Objective To analyze the tongue manifestations and symptoms of 1112 patients infected with the novel coronavirus Omikron variants and to provide an evidence for their TCM treatment based on a syndrome differentiation.Methods A total of 1112 patients with an asymptomatic or a mild Omicron variant infection in the shelter hospital in Tongyuan,Changchun City,Jilin Province from March 15,2022 to April 7,2022 were included in this study.Their tongue colors,tongue furs and tongue shapes were observed,the correlation between tongue manifestations and the disease was summarized,and its clinical significance was discussed.Results The frequency oftongue color from high to low was 352 cases of light red tongue(31.65%),255 cases of crimson tongue(22.93%),215 cases of light white tongue(19.33%),187 cases ofblue and purple tongue(16.82%),113 cases ofred(edge tip,whole tongue)tongue(10.16%)and 8 cases of others(0.72%).From high to low,there were 374(33.63%)cases ofteeth-printed tongue,339(30.49%)cases ofplump tongue,182(16.37%)cases of thin tongue,108(9.71%)cases of tender tongue,107(9.62%)cases of fissured tongue and 59(531%)cases ofother tongue shapes.The frequency oftongue coating from high to low was:white greasy coating 443(39.84%),thin white coating 262(23.56%),white slippery coating 152(13.67%),yellow greasy coating 87(7.82%),less coating 78(7.01%),thin yellow coating 60(5.40%),dry coating 48(4.32%)and others 17(1.53%).Conclusion Combined with the analysis of tongue manifestations and symptoms,the patients with an Omicron infection are mainly manifested as the syndrome of qi deficiency of lung and spleen and the syndrome of excessive cold-damp.Their symptoms are mild,mainly manifested as an invasion to the lung-defense phase.Their tongue color is mostly light red,and plump and teeth-printed tongues are the more common shapes.Their tongue furs are mostly white greasy coating and white slippery coating.Based on their symptoms and physical conditions,most patients have superficies syndromes.Accordingly,they should be treated by first dispersing the pathogenic qi on the defensive exterior,in an order from the exterior to the interior or simultaneously,applying prescriptions such as Jingfang Baidu San and Chaige Jieji Decoction based on syndrome differentiations.At the same time,attention should be paid to the protection of the spleen and stomach,choosing drugs that act to invigorate the spleen and remove dampness,while using bitter cold drugs for purgation with caution to avoid a serious injury to the spleen and stomach and inducing pathogens into the body.With the development ofTCM informatization,a tongue inspection will become increasingly important in the TCM diagnosis and treatment of diseases.