1225例新型冠状病毒感染老年患者证候规律研究

Study on Syndrome Regularity of 1225 Elderly Patients with COVID-19

目的探索老年群体新型冠状病毒感染常见证候分类及特征,为临床辨治提供参考。方法采集四川省内6家三甲医院的新型冠状病毒感染的老年患者的四诊信息,构建数据库。运用隐结构法的Lantern 5.0软件,基于双步隐树分析,构建隐结构模型,通过综合聚类提取新型冠状病毒感染常见证候。采用SPSS 23.0软件进行因子分析和系统聚类分析,推断潜在证候。结合不同方法结果和专业知识确定新型冠状病毒感染证候分类。结果共纳入1225例新型冠状病毒感染患者,共收集103个症状。纳入分析频次≥40的59个症状构建隐结构模型,得到15个隐变量,综合聚类得到4种常见证候,分别为邪袭肺卫证、邪热蕴肺证、湿邪困脾证、阴虚夹湿证。得到19个公因子,用公因子进行系统聚类分析,推断出4个常见证候。结合不同方法和专业知识最终确定4种常见证候及特征。结论四川地区老年群体新型冠状病毒感染常见证候为邪袭肺卫证、邪热蕴肺证、湿邪困脾证、阴虚夹湿证。研究结果较客观地反映了四川地区老年患者新型冠状病毒感染的实际情况,可为四川地区老年患者新型冠状病毒感染辨证治疗提供参考。

Objective To explore the classification and characteristics of common syndromes of corona virus disease 2019(COVID-19)in the elderly population and to provide reference for clinical syndrome differentiation and treatment.Methods The four diagnostic information of elderly patients with COVID-19 in six tertiary hospitals in Sichuan Province was collected to construct a database.The Lantern 5.0 software of latent structure method was used to construct a latent structure model based on two-step latent tree analysis,and the common syndromes of COVID-19 were extracted by comprehensive clustering.SPSS 23.0 software was used for factor analysis and systematic cluster analysis to infer potential syndromes.Combined with the results of different methods and professional knowledge,the classification of COVID-19 syndromes was determined.Results A total of 1225 patients with 103 symptoms of COVID-19 were included.A latent structure model was constructed by including 59 symptoms with a frequency of analysis≥40,and 15 latent variables were obtained.Four common syndromes were obtained by comprehensive clustering,which were syndrome of evil attacking lung,syndrome of evil heat accumulating lung,syndrome of dampness obstructing spleen and syndrome of Yin deficiency with dampness.A total of 19 common factors were obtained,and the common factors were used for systematic cluster analysis to infer 4 common syndromes.Combined with different methods and professional knowledge,four common syndromes and characteristics were finally determined.Conclusion The common syndromes of COVID-19 in the elderly population in Sichuan are evil attacking lung-defense syndrome and evil heat accumulating lung syndrome.