新型冠状病毒感染恢复期合并糖尿病患者中医证候特征分析

Characteristics of Traditional Chinese Medicine Syndromes in Patients with Diabetes Mellitus During the Recovery Period of Corona Virus Disease 2019

目的分析新型冠状病毒感染恢复期合并糖尿病患者的临床特征和中医证候分布规律,对精细化治疗和护理伴有糖尿病的新冠病毒感染恢复期患者具有指导意义。方法收集湖北省武汉市新冠病毒感染恢复期合并糖尿病病史患者60例,分析中医证型分布情况。使用GeenCards等数据库检索证型主要临床表现和疾病的交集靶点,进行京都基因和基因组百科全书(KEGG)通路富集分析。结果60例伴有糖尿病的新冠病毒感染恢复期患者男28例,女32例,临床症状最多见的为乏力(占85%),其次为喘促气短(占81.7%),舌质以淡白舌为主(占46.7%),舌体偏胖大(占60%),舌苔大多为薄白苔(占31.7%)或白腻苔(占28.3%),脉象以沉、细、虚而无力为主,均占比50%以上。综合主证型与兼证型情况,肺脾气虚证37例(占61.7%),肺肾气虚证21例(占35%),气阴两虚证14例(占23.3%)。3个证型临床表现和新冠病毒感染恢复期合并糖尿病交集靶点个数为肺脾气虚证601个,肺肾气虚证613个,气阴两虚证596个。KEGG富集分析显示通路的种类基本一致,主要包括病毒感染在内的病原体感染相关通路和炎症、免疫反应相关通路,3个证型之间具体通路的相关性和基因数量又有各自的特点,但差异较小。结论患者中医证候特征与气候环境和体质密切相关。3个主证型临床表现和新冠病毒感染合并糖尿病交集靶点与病毒感染、炎症、免疫应答有密切的关系。

Objective To investigate and analyze the clinical characteristics and distribution of TCM syndrome in patients with diabetes mellitus during the recovery period of corona virus disease 2019 (COVID-19),which is of guiding significance for the refined treatment and care of patients recovering from COVID-19 with diabetes. Methods A total of 60 patients with a history of diabetes complicated by the recovery period of COVID-19 in Wuhan,Hubei province were collected,and the distribution of TCM symptom types was analyzed. GeenCards and other databases were used to search for the intersection targets of the main clinical manifestations of the type and the disease,and the KEGG pathway enrichment analysis was performed. Results Among the 60 patients recovering from the COVID-19 with diabetes,28 were male and 32 female,the most common clinical symptoms were fatigue(accounting for 85%),followed by shortness of breath(81.7%),tongue texture was mainly pale white tongue(accounting for 46.7%),tongue body was fat and large(accounting for 60%),tongue moss was mostly thin white or white moss(accounting for about 31.7%),and the veins were mainly heavy,fine,weak and weak,all accounting for more than 50%. Combined with the main and concurrent types,there were 37 cases of lung and spleen Qi deficiency type (accounting for 61.7%),21 cases of lung and kidney Qi deficiency type(accounting for 35%),and 14 cases of Qi and Yin deficiency type(accounting for 23.3%). The number of clinical manifestations of the three types and the intersection of diabetes in the recovery period of COVID-19 was 601 for lung and spleen deficiency type,613 for lung and kidney Qi deficiency type,and 596 for Qi and Yin deficiency type. KEGG enrichment analysis showed that the types of pathways were basically the same,mainly including pathogens, including viral infection-related pathways,inflammation,and immune response-related pathways,and the correlation and gene number of specific pathways between the three types had their own characteristics, but the differences were small. Conclusion The characteristics of medical syndrome in patients are closely related to the climatic environment and constitution. The three primary clinical manifestations were closely related to the intersection of COVID-19 and diabetes,and the target was closely related to viral infection, inflammation and immune response.