1034例甲型流行性感冒患者中医证候特点的回顾性分析

Retrospective Analysis of Traditional Chinese Medicine Syndrome Characteristics of 1034 Patients with Influenza A

目的:明确2023年春季望京地区甲型流行性感冒患者中医证候特点。方法:回顾性分析2023年2—3月中国中医科学院望京医院感染科1034例甲型流感患者临床资料,对其一般情况、中医四诊信息等进行频数统计分析。通过因子分析提炼甲型流感的中医证候要素;运用聚类方法总结甲型流感主要中医证型及分布规律。结果:1034例患者男539例,女495例,男女之比为1.09∶1;患者平均年龄(32.62±12.95)岁,14~44岁患者878例(84.91%),≥45岁患者156例(15.09%),2组在性别上差异无统计学意义(P=0.355)。排名前5位的临床症状为发热、咳嗽、咽痛、全身肌肉酸痛、头痛;舌象以舌质红、苔薄黄、苔薄白腻为主;脉象以脉浮数、脉数为主;14~44岁组发热程度高于≥45岁组,差异有统计学意义(P=0.018)。通过因子分析明确病性涉及热、外风、湿、痰等病理因素,病位在卫表和肺,与脾和少阳有关;聚类分析提炼出3类证候分别为风热犯卫证(40.62%)、热毒袭肺证(35.98%)、表寒里热证(23.40%)。结论:2023年春季望京地区甲型流行性感冒中医证候以风热犯卫为主,病性总体以实为主,病位在卫表和肺,本研究结论可为今后流感中医诊治方案的优化提供理论依据。

Objective:To clarify the traditional Chinese medicine(TCM)syndrome characteristics of patients with influenza A in the Wangjing area during the spring of 2023.Methods:A retrospective analysis was conducted on the clinical data of 1034 patients with influenza A who were treated at the Department of Infectious Diseases of Wangjing Hospital,China Academy of Chinese Medical Sciences,between February and March 2023.General conditions and TCM diagnostic information(observation,auscultation and olfaction,inquiry,and pulse diagnosis)were subjected to frequency statistical analysis.Factor analysis was used to extract the TCM syndrome elements of influenza A,and clustering methods were applied to summarize the main TCM syndromes and their distribution patterns.Results:Among the 1034 patients,there were 539 males and 495 females,with a male-to-female ratio of 1.09∶1.The average age was 32.62±12.95 years,with 878 patients(84.91%)aged 14 to 44 years and 156 patients(15.09%)aged 45 years or older.There was no statistically significant difference in gender distribution between the two age groups(P=0.355).The top five clinical symptoms were fever,cough,sore throat,generalized muscle aches,and headache.The tongue presentation was predominantly red with thin yellow or thin white greasy coating,and the pulse was mainly floating and rapid.The fever severity was higher in the 14 to 44 age group than the≥45 age group(P=0.018).Factor analysis identified the pathological factors of heat,external wind,dampness,and phlegm,with the disease location in the defensive exterior and the lungs,also involving the spleen and Shaoyang.Cluster analysis identified three main syndromes,i.e.,wind-heat attacking the defensive exterior(40.62%),heat toxin attacking the lungs(35.98%),and exterior cold with interior heat(23.40%).Conclusion:The TCM syndromes of influenza A in the Wangjing area during the spring of 2023 were primarily characterized by wind-heat attacking the defensive exterior,with the overall pathology being predominantly excess in nature and the disease location in the defensive exterior and lungs.The findings of this study provide a theoretical basis for optimizing future TCM treatment protocols for influenza.