天津地区88例新型冠状病毒肺炎患者中医证候特征初探  

Characteristics of Traditional Chinese Medicine Syndromes in 88 Patients with Coronavirus Diseases 2019 in Tianjin

作　　者：孙宏源[1] 毕颖斐[1] 朱振刚[1] 刘旻[1] 刘新桥[1] 马兆润[2] 王贤良[1] 赵国元[1] 苏全[1] 毛静远[1] 张伯礼[1] SUN Hongyuan;BI Yingfei;ZHU Zhengang;LIU Min;LIU Xinqiao;MA Zhaorun;WANG Xianliang;ZHAO Guoyuan;SU Quan;MAO Jingyuan;ZHANG Boli(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,300380;Tianjin Haihe Hospital)

机构地区：[1]天津中医药大学第一附属医院,天津市300380 [2]天津市海河医院

出　　处：《中医杂志》2020年第10期837-841,共5页Journal of Traditional Chinese Medicine

基　　金：天津市科技计划项目(15ZXLCSY00020);天津中医药大学第一附属医院新型冠状病毒肺炎专项科研课题(2020001);天津市“新型冠状病毒感染应急防治”科技重大专项。

摘　　要：目的探讨天津地区新型冠状病毒肺炎患者的中医证候特征,为临床辨治提供参考。方法对天津地区确诊的88例新型冠状病毒肺炎患者进行中医证候调查,主要包括基本信息、发病初期临床症状、入院后临床症状以及舌象等。运用中医传承辅助平台(V2.5)进行关联规则及复杂系统熵聚类分析。结果88例患者中发病初期临床症状主要表现为发热(87.5%)、咳嗽(42.0%)、乏力(26.1%)、咯痰(21.6%)等。入院时最常见中医症状排名前5位的为纳呆(46.7%)、腹泻(45.5%)、低热(39.8%)、少汗(36.4%)、咳嗽(34.1%),最常见舌象包括腻苔(79.5%)、白苔(47.7%)、薄苔(34.1%)等。关联规则分析结果显示,最常见条目组合为低热、腹泻、纳呆、白腻苔。熵聚类后的条目组合指向证候包括肺表证(咳嗽、咯痰、黄痰、恶寒),火热证(口苦、口干、口渴或渴不欲饮、小便黄),气阴两虚证(渴不欲饮、盗汗、少津苔、乏力)及气虚血瘀证(暗舌、淡舌、齿痕舌、心悸),气虚痰浊证(腻苔、无汗、齿痕舌、少气懒言)。结论天津地区新型冠状病毒肺炎患者的中医证候分布早期以上焦肺系病症为主,入院时多以中焦脾胃表现为主,重症多以痰热壅肺为主,后期又多见气阴两虚及气虚痰浊、气虚血瘀等证。Objective To explore the characteristics of traditional Chinese medicine(TCM)syndromes of coronavirus diseases 2019(COVID-19)in Tianjin area,and to provide the references for the clinical differentiation and treatment.Methods A total of 88 patients with COVID-19 diagnosed in Tianjin were investigated in TCM syndromes,including basic information,early clinical symptoms,clinical symptoms after admission,tongue signs etc.Entropy clustering analysis of association rules and complex systems were carried out by using TCM Inheritance Assist Platform(V2.5).Results The clinical symptoms of 88 patients in the early stage of the disease mainly included fever(87.5%),cough(42.0%),fatigue(26.1%),and expectoration(21.6%).The top 5 common symptoms of TCM on admission were anorexia(46.7%),diarrhea(45.5%),low fever(39.8%),less sweat(36.4%),cough(34.1%),and the most common tongue manifestation included greasy coating(79.5%),white coating(47.7%),thin coating(34.1%).The results of association rule analysis showed that the most common item combinations were low fever,diarrhea,anorexia,white and greasy tongue coating.The combination of items after entropy clustering indicating syndromes include lung exterior syndromes(cough,expectoration,yellow sputum,aversion to cold),fire-heat pattern/syndromes(bitter taste in the mouth,dry mouth,thirsty or thirst without a desire to drink,yellow urine),deficiency of both qi and yin syndromes(thirst without a desire to drink,night sweats,less fluid coating,fatigue)qi deficiency and blood stasis syndromes(dark tongue,bland tongue,teeth-marked tongue,palpitations),and qi deficiency phlegm turbidity syndromes(greasy coating,no sweat,tooth-marked tongue,lack of qi and no desire to speak).Conclusion The distribution of TCM syndromes in patients with COVID-19 in Tianjin is mainly of the pulmonary system in upper jiao at the early stage of the disease.At the time of admission,the symptoms are mostly spleen and stomach in middle jiao and the severe cases are mainly phlegm-heat obstructing lung.Later the synd

关 键 词：新型冠状病毒肺炎 天津 中医证候 关联规则 熵聚类 

分 类 号：R259[医药卫生—中西医结合]