GONG Xinyue,WEI Darong,GONG Xue,et al.Analysis on Clinical Characteristics and TCM Syndromes of 80 Patients with Novel Coronavirus Pneumonia in Wanzhou District of Chongqing[J].zhongguo zhongyiyao xinxi zazhi,2020,27(7):24-28.[doi:10.3969/j.issn.1005-5304.202002560]
重庆市万州区80例新型冠状病毒肺炎患者临床特征及证治分析
- Title:
- Analysis on Clinical Characteristics and TCM Syndromes of 80 Patients with Novel Coronavirus Pneumonia in Wanzhou District of Chongqing
- 文章编号:
- 1005-5304(2020)07-0024-05
- Keywords:
- novel coronavirus pneumonia; TCM syndrome; damp toxin stagnating in lung syndrome ; Chongqing
- 分类号:
- R259.11
- 文献标志码:
- A
- 摘要:
- 目的 探讨重庆市万州区新型冠状病毒肺炎（COVID-19）中医临床特征和证候特点，为中医相关治疗提供参考。方法 收集重庆市万州区集中治疗点COVID-19患者病例资料，于入院第1日采集流行病学史、白细胞计数、淋巴细胞计数、C反应蛋白、白细胞介素-6、CD4+计数、CD8+计数、胸部CT、症状体征等信息，分析患者基本特征及中医证候特点。结果 80 例COVID-19患者中男45例，女35例，男女比例1.29∶1。年龄18～82岁，平均年龄（54.20±12.76）岁。62例（77.50%）有明确武汉/湖北旅居史，13例（16.25%）有明确与确诊人员接触史，5例（6.25%）无明确流行病学史。20例（25.00%）有基础疾病。实验室检查显示，患者白细胞水平多无明显变化，多见C反应蛋白水平升高，胸部CT以多肺叶下野外带病变为主；重型患者多见白蛋白水平偏低、白细胞介素-6水平偏高。临床症状按频次高低依次为咳嗽64例（80.00%）、发热54例（67.50%）、纳差32例（40.00%）、腹泻30例（37.50%）、乏力22例（27.50%）、气促21例（26.25%）等。舌象以红舌、淡红舌为主，舌苔以厚/腻苔多见（56.25%），脉象以滑脉为主（60.00%）。中医辨证分型以湿毒郁肺证最多（53.75%），其后依次为气阴两虚证（25.00%）、肺脾气虚证（11.25%）、邪犯肺胃证（10.00%）。结论 重庆市万州区COVID-19患者以中青年居多，93.75%患者有直接或间接接触史，以发热、咳嗽为主要症状，中医证型以湿毒郁肺证为主。
- Abstract:
- Objective To discuss clinical characteristics and TCM syndromes of novel coronavirus pneumonia (COVID-19) in Wanzhou District of Chongqing; To provide reference for the treatment of TCM. Methods Case data of patients with COVID-19 in the centralized treatment site of Wanzhou District of Chongqing were collected. Epidemiological history, white blood cell count, lymphocyte count, C-reactive protein, interleukin-6, CD4 + count, CD8 + count, chest CT, symptoms and signs, etc. were collected on the 1st day of admission. The basic characteristics of patients and TCM characteristics and syndromes were analyzed. Results Among the 80 patients with COVID-19, 45 were males and 35 were females. The ratio of male to female was 1.29: 1. The patients were aged from 18 to 82 years, with an average age of (54.20±12.76) years. 62 cases (77.50%) had a clear history of residence in Wuhan/Hubei; 13 cases (16.25%) had a clear history of contact with patients with COVID-19; 5 cases (6.25%) had no clear epidemiological history. 20 cases (25.00%) had underlying diseases. Laboratory examinations showed that patients had no significant changes in white blood cell levels, and C-reactive protein level increased. Chest CT was dominated by lesions in the field of multiple lung lobes; Severe patients often showed low albumin levels and high interleukin-6 levels. The clinical manifestations were cough in 64 cases (80.00%), fever in 54 cases (67.50%), poor appetite in 32 cases (40.00%), diarrhea in 30 cases (37.50%), asthenia in 22 cases (27.50%), and shortness of breath in 21 cases (26.25%). The main tongue features of the patients were red tongue or light red tongue, with thick/greasy tongue coating (56.25%) and slippery pulse (60.00%). The TCM syndrome type was mainly the syndrome of damp toxin stagnating in lung (53.75%), followed by syndrome of qi-yin deficiency (25.00%), syndrome of lung-spleen qi deficiency (11.25%), and syndrome of pathogen invading lung and stomach (10.00%). Conclusion The patients of COVID-19 in Wanzhou District of Chongqing are mostly young and middle-aged people. 93.75% of the patients have a history of direct or indirect contact. Fever and cough are the main symptoms. Syndrome of damp toxin stagnating in lung is the main TCM syndrome type.
参考文献/References:
[1] 国家卫生健康委员会.新型冠状病毒感染的肺炎诊疗方案(试行第三版)[EB/OL].[2020-01-22].http://www.nhc.gov.cn/xcs/zhengcwj/202001/ 470b128513fe46f086d79667db9f76a5.shtml. [2] 王玉光,齐文升,马家驹,等.新型冠状病毒肺炎中医临床特征与辨证治疗初探[J].中医杂志,2020,61(4)：281-285. [3] 国家卫生健康委员会.新型冠状病毒感染的肺炎诊疗方案(试行第四版)[EB/OL].[2020-01-27].http://www.nhc.gov.cn/xcs/zhengcwj/202002/ 573340613ab243b3a7f1dd4.shtml. [4] 国家卫生健康委员会,国家中医药管理局.新型冠状病毒感染的肺炎诊疗方案(试行第五版)[EB/OL].[2020-02-05].http://www.nhc.gov.cn/ yzygjl/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtml. [5] LU H. Drug treatment options for the 2019-new coronavirus (2019-nCoV)[J]. Biosci Trends,2020,doi：10.5582/bst.2020.01020.
[6] KIM H, JO S, LEE J B, et al. Diagnostic performance of initial serum albumin level for predicting in hospital mortality among aspiration pneumonia patients[J]. Am J Emerg Med,2017,36(1)：5-11. [7] LEE J H, KIM J, KIM K, et al. Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia[J]. Crit Carc,2011,26(3)：287-294. [8] HE S S, WANG Y, CHEN H, et al. C-reactive protein/albumin ratio (CAR) as a prognostic factor in patients with non-metastatic nasopharyngeal carcinoma[J]. Cancer,2016,7(15)：2360-2366. [9] 徐秋霜.老年脑卒中相关性肺炎(SAP)的病原菌特点及其危险因素分析[J].卒中与神经疾病,2017,24(4)：338-341. [10] 胡涛,林琳,吴蕾,等.成人病毒性肺炎的中医证治与机制研究进展[J].天津中医药,2015,32(3)：189-192.
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备注/Memo
基金项目：中央高校基本科研业务费（2020CDJYGRH-YJ03）；重庆大学“新冠肺炎”应急科研专项资助医工融合项目（2020CDJYGRH-1002）
更新日期/Last Update:
2020-06-19