雷神山医院44例2019冠状病毒病普通型患者中医临床特征分析  

Analysis on TCM clinical characteristics of 44 cases with Corona Virus Disease 2019 common type in Thunder God Mountain Hospital

作　　者：张兴[1] 王婧 蔡蔚然 吕婵[1] 郭君[1] 尹成伟[1] 商斌仪[1] 宋秀明[2] 张炜[2] ZHANG Xing;WANG Jing;CAI Wei-ran;LYU Chan;GUO Jun;YIN Cheng-wei;SHANG Bin-yi;SONG Xiu-ming;ZHANG Wei(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]上海中医药大学附属曙光医院肺病科,上海201203

出　　处：《中华中医药杂志》2020年第7期3746-3750,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海市科委中医药治疗新冠肺炎的临床研究(No.2041195020002);上海市卫健委、上海中医药管理局应急科研攻关项目(No.2020YJ01,No.2020XGKY05);上海临床重点专科(No.shslczdzk05101);上海中医临床重点实验室(No.14DZ2273200)。

摘　　要：目的:分析武汉市雷神山医院COVID-19普通型患者的中医临床特征。方法:纳入武汉市雷神山医院收治的COVID-19普通型患者44例,入院首日收集患者基本信息、中医证候相关症状、舌脉、血常规、C-反应蛋白、红细胞沉降率、降钙素原、胸部CT等临床资料。结果:COVID-19普通型患者平均年龄(61.07±11.37)岁,男女各22例,基础疾病以高血压病(17/144,38.64%患者)最多;主要症状为不寐、汗出、干咳、气喘等;舌色以舌红为主,苔色以苔白为主,苔质以苔腻为主,脉象以脉弦和脉滑为主;中医证型以湿热疫毒蕴肺证为主(33/44,75.00%),其中湿重于热型17例、热重于湿型16例,另有寒湿疫毒袭肺证10例(10/44,22.73%);外周血白细胞计数均无降低,少数病例淋巴细胞计数及百分比降低,部分病例炎症指标升高,多数(37/44,84.09%)病例胸部CT影像呈多肺叶炎症改变;未发现与中医证型有分布相关性的因素;所有患者平均病程为(17.61±5.33)d,出院时症状较入院时均有不同程度的改善,湿热疫毒蕴肺证湿重于热型平均病程最长。结论:COVID-19普通型患者以湿热疫毒蕴肺证为主,符合中医湿温的临床特征,其中湿重于热型的病程较长。Objective:To analyze the TCM syndrome characteristics of common type patients with Corona Virus Disease 2019(COVID-19)in Wuhan Thunder God Mountain Hospital.Methods:A total of 44 patients with common type of COCID-19 were included in the study.On the first day of admission,basic information of patients,symptoms related to TCM syndromes,tongue,pulse,blood routine,C-reactive protein,erythrocyte sedimentation rate,procalcitonin,chest CT and other clinical data were collected.Results:The average age of patients with common type of COVID-19 was(61.07±11.37)years old,half male and half female.Hypertension was the most common basic disease(17/44,38.64%).The main symptoms were insomnia,sweating,dry cough,asthma,etc..The color of tongue was mainly red,the color of fur was mainly white,the quality of fur was mainly greasy,and the pulse was mainly stringy and slippery.The syndrome of TCM was mainly damp heat and toxin accumulating lung syndrome(33/44,75.00%),and 17 cases were dampness predominating over heat,16 cases were heat predominating over dampness,another 10 cases(10/44,22.73%)were cold dampness and toxin attacking lung syndrome.There was no decrease in leukocyte count.Lymphocyte count and percentage decreased in a few cases.In some cases,the inflammatory indexes increased.Most of the cases(37/44,84.09%)showed multilobular inflammation on CT images.No factors related to the distribution of TCM syndromes were found.The average course of disease in all patients was(17.61±5.33)d.The symptoms were improved in different degrees when they were discharged from hospital,and in the type of dampness predominating over heat the average course of disease was the longest.Conclusion:The common type of COVID-19 patients were mainly characterized by damp heat and toxin accumulating lung syndrome.This is in line with the clinical characteristics of TCM damp-warm.The course of disease is longer in the type of dampness predominating over heat.

关 键 词：2019冠状病毒病 新型冠状病毒肺炎 普通型 中医证候 湿热疫毒蕴肺 瘟疫 传染病 雷神山医院 

分 类 号：R259[医药卫生—中西医结合]