新型冠状病毒感染后相关病证与证型的临床探讨

Clinical study of the related diseases and syndromes after corona virus disease 2019

目的:探讨新型冠状病毒感染后,抗原阳转阴后2周内出现的与感染相关的病证,予辨证治疗,为此类疾病防治提供参考。方法:对符合条件的病例,记录患者症状,予八纲辨证、治疗,对患者年龄段、合并症及中医证型构成比进行分析。结果:45例患者中,眩晕15例、痹病23例(疼痛16例、感觉异常7例)、不寐6例、口僻1例。虚证41例(91.12%),实证2例(4.44%),虚实夹杂证2例(4.44%),虚证组构成比大于实证或虚实夹杂证组(χ^(2)=67.6,P<0.01)。年龄≤60岁组35例(77.78%),>60岁组10例(22.22%),年轻组患者构成比明显大于年长组(χ^(2)=9.89,P<0.01)。无合并症者34例(75.56%),有合并症者11例(24.44%),无合并症组构成比大于有合并症组(χ^(2)=11.89,P<0.01)。所有患者予以中西医结合治疗,西医治标,中医治本,比如周围性面神经麻痹合并失眠的患者,用口服甲泼尼松龙抑制免疫异常,思诺思改善失眠,属于西医对症治疗,治标;用复方血栓通胶囊和复方银杏通脉口服液治疗气阴两虚,属于中医治本,标本兼治,疗效显著。结论:新型冠状病毒感染后可能出现多种感染相关病证。其构成比以虚证组、≤60岁组及无合并症组较大,与新型冠状病毒感染重症患者构成比有明显不同。所有患者接受中西医结合方法治疗效果良好。

Objective:To investigate the infection-related symptoms within 2 weeks after the negative transition after corona virus disease 2019,and to give syndrome differentiation treatment,so as to provide reference for the prevention and treatment of such diseases.Methods:For eligible cases,patient symptoms were recorded,and patients were given eight principal syndrome differentiation and treatment.The age,comorbidities and the composition ratio of TCM syndromes of patients were analyzed.Results:Of the 45 patients,there were 15 cases of vertigo,23 cases of paralysis syndrome(16 cases of pain,7 cases of paraesthesia),6 cases of insomnia,and 1 case of wry mouth.There were 41 cases(91.12%)of deficiency syndrome,2 cases(4.44%)of excessive syndrome and 2 cases(4.44%)of mixed deficiency and excessive syndrome.The composition ratio of deficiency syndrome group was higher than that of excessive syndrome group or mixed syndrome group(χ^(2)=67.6,P<0.01).There were 35 cases(77.78%)in the age group less than or equal to 60 years old,and 10 cases(22.22%)in the age group more than 60 years old.The proportion of patients in the younger group was significantly greater than that in the older group(χ^(2)=9.89,P<0.01).There were 34 cases(75.56%)without complication and 11 cases(24.44%)with complication.The proportion in the group without complication was higher than that in the group with complication(χ^(2)=11.89,P<0.01).All patients were treated in the integrative medicine,Western medicine was used to treat symptoms,traditional Chinese medicine was used to target the root causes.For example,patients with peripheral facial nerve palsy plus insomnia received oral methylprednisolone to suppress immune abnormalities,Western medicine symptomatic treatment Snos was used to relieve insomnia,traditional Chinese medicine compound Xueshuantong capsule(复方血栓通胶囊)and compound Yinxing Tongmai oral liquid(复方银杏通脉口服液)were given to treat both Qi(气)and Yin(阴)deficiency,which treated both the symptoms and the root causes,with a remarkable curative effect.Conclusion:After infection with the novel corona virus,a variety of infection-related symptoms may occur.Its composition ratio is larger in the deficiency syndrome group,the group less than or equal to 60 years old,and the group without comorbidities,which is significantly different from the composition ratio of severe patients with corona virus disease 2019.The combination of TCM and Western medicine has a good therapeutic effect on all the patients.