新型冠状病毒感染肺炎患者入院时中医证候分析  

Traditional Chinese Medicine Syndrome Analysis of Patients with Coronavirus Disease 2019 on Admission

作　　者：余思邈 崔延飞 王仲霞[1] 景婧[1] 王立福[1] 孙永强[1] 田淼 桑秀秀 许文涛 王丽苹[1] 陈竹 肖小河[1] 王睿林[1] YU Si-miao;CUI Yanfei;WANG Zhongxia;JING Jing;WANG Lifu;SUN Yongqiang;TIAN Miao;SANG Xiuxiu;XU Wentao;WANG Liping;CHEN Zhu;XIAO Xiaohe;WANG Ruilin(Integrated Traditional Chinese and Western Medicine Diagnosis and Research Center for Liver Diseases,Fifth Medical Center of the PLA General Hospital,Beijing 100039,China;He′nan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]中国人民解放军医院第五医学中心中西医结合肝病诊疗与研究中心,北京100039 [2]河南中医药大学,郑州450000

出　　处：《世界中医药》2020年第4期494-496,501,共4页World Chinese Medicine

基　　金：国家自然科学基金面上项目(81673806);军队生物安全建设计划(A3704041902-02)。

摘　　要：目的:研究新型冠状病毒感染肺炎患者入院时中医证候特点。方法:选取2020年1月至2020年2月解放军总医院第五医学中心收治的50例新型冠状病毒感染肺炎患者作为研究对象,对其基本信息、现病史、既往史、流行病学史、症状、体征,分析其中医证候及卫气营血辨证情况进行分析。结果:50例患者中,男32例(64.0%),女18例(36.0%);年龄3~79岁,平均年龄(40.0±18.4)岁,入院前平均病程为(3.2±2.5)d,平均潜伏期为(5.0±3.5)d。处于卫气分阶段34例(68.0%),气分阶段14例(28.0%),营分阶段2例(4.0%),其中挟湿者44例(88.0%)。影像学检查无异常者多见于卫分证,胸部X线片提示双肺炎性反应多见于营、气分证,差异有统计学意义。气分证较之卫分证血白细胞计数升高,淋巴细胞计数下降,差异有统计学意义。结论:新型冠状病毒感染肺炎多以发热、咳嗽为入院时的主要症状,湿邪是此次病机的关键因素,发病主要以卫分证阶段和气分阶段为主,部分进展至营分阶段,早期治疗可选用辛凉清轻宣透之品,注重祛湿治疗,不可过用苦寒。Objective:To study the characteristics of TCM syndromes in patients with Coronavirus Disease 2019(COVID-19).Methods:Fifty patients with COVID-19 treated in the Fifth Medical Center of the PLA General Hospital from January 2020 to February 2020 were selected as the research subjects.Their basic information,current history,past history,epidemiological history,symptoms,Physical signs,TCM syndromes and Wei,Qi,Ying,blood syndrome differentiation were analyzed.Results:Of the 50 patients,32 were male(64.0%)and 18 were female(36.0%);aged 3 to 79 years,mean age(40.0±18.4)years,and the average disease duration before admission was(3.2±2.5)days.The average incubation period was(5.0±3.5)d.There were 34 cases(68.0%)in the Weifen stage,14 cases(28.0%)in the Qifen stage,and 2 cases(4.0%)in Yingfen stage,of which 44 cases were complicated by dampness(88.0%).The abnormality of imaging examination was more common in patients in Weifen stage,and chest X-ray showed that the inflammatory response of both lungs was more common in the patients in Qifen and Yingfen stage,and the difference was statistically significant.Compared with the patients in Weifen stage,the patients in Qifen stage increased the white blood cell count and decreased the lymphocyte count.The difference was statistically significant.Conclusion:Fever and cough are the main symptoms of COVID-19 at the time of admission.Dampness is the key factor of the pathogenesis.The patients are most in the Weifen stage and Qeifen stage,some patients have progressed into Yingfen stage.In early stage,acrid-cool and light-diffusing herbs can be used,dampness dispelling should be emphasized,excess bitter-cold should be avoided.

关 键 词：新型冠状病毒肺炎 病毒性 中医证候 临床分析 

分 类 号：R254.3[医药卫生—中医内科学] R256.19[医药卫生—中医学]