河南省524例新型冠状病毒肺炎患者临床特征及中医证候分布  

Clinical Characteristics and Chinese Medicine Syndrome Distribution of 524 Patients with Coronavirus Disease 2019 (COVID-19) in Henan Province

作　　者：李建生[1,2] 李素云[1,2] 谢洋 赵虎雷[1,2] 冯贞贞 春柳 王佳佳[1,2] 孙博倩 LI Jiansheng;LI Suyun;XIE Yang;ZHAO Hulei;FENG Zhenzhen;CHUN Liu;WANG Jiajia;SUN Boqian(Province-Ministry Hold Co-collaborative Innovation Center for Chinese Medicine Prevention and Treatment of Respiratory Diseases of Henan,Zhengzhou,450046;The First Affiliated Hospital of Henan University of Chinese Medicine)

机构地区：[1]河南中医药大学呼吸疾病中医药防治省部共建协同创新中心,河南省郑州市450046 [2]河南中医药大学第一附属医院

出　　处：《中医杂志》2020年第16期1391-1396,共6页Journal of Traditional Chinese Medicine

基　　金：中医药传承与创新“百千万”人才工程(岐黄工程)项目(国中医药人教发[2017]9号);河南省2020年新型冠状病毒防控应急攻关首批项目(201100310400,201100310500);中原学者科学家工作室项目(豫财行[2018]204号)。

摘　　要：目的调查分析河南省新型冠状病毒肺炎(新冠肺炎)患者的临床特征和中医证候分布规律,为进一步优化新冠肺炎中医辨证治疗方案提供依据。方法基于文献分析,并结合专家意见,制定"河南省新冠肺炎中医临床调查表",收集524例新冠肺炎患者一般资料、临床症状、舌脉等信息,并进行辨证分析,探讨不同年龄段(≤45岁、46~60岁、>60岁)及不同临床分型(轻型/普通型、重型、危重型)患者的中医证型分布情况。结果 524例患者中男性304例,女性220例;轻型/普通型349例,重型144例,危重型31例;中位年龄45(33,55)岁;中位症状持续时间10(6,15)天。患者主要临床症状(百分比>20%)包括发热、恶寒、乏力、呼吸困难、气短、喘息、气促。舌苔以苔腻(175次)、苔白(149次)和苔黄(127次)为主,舌质以舌质淡(170次)和舌质红(151次)常见,脉象方面以数脉(112次)和滑脉(100次)常见。中医证型主要以寒湿郁肺证(119例,22.71%)、湿热蕴肺证(113例,21.56%)、疫毒闭肺证(76例,14.50%)、湿阻肺胃证(70例,13.36%)、湿遏肺卫证(63例,12.02%)为主。各年龄段患者中医证型分布差异均无统计学意义(P>0.05)。寒湿郁肺证、湿热蕴肺证、疫毒闭肺证、湿阻肺胃证、湿遏肺卫证、内闭外脱证在不同临床分型的分布差异均有统计学意义(P<0.05)。结论河南省新冠肺炎患者以青中年居多,以普通型和重型为主;中医证型以寒湿郁肺证、湿热蕴肺证、疫毒闭肺证、湿阻肺胃证、湿遏肺卫证为主。Objective To investigate and analyze the clinical characteristics and distribution rules of traditional Chinese medicine(TCM) syndromes of patients with coronavirus disease 2019(COVID-19) in Henan Province, in order to provide a basis for further optimizing the plan of TCM syndrome differentiation and treatment of COVID-19. Methods Based on literature analysis, combined with expert opinion, the "Henan Province COVID-19 Clinical Survey Form" was formulated. A total of 524 cases of patients with COVID-19 were collected as the general data, clinical symptoms, tongue and pulse, etc., and dialectical analysis was conducted to explore distribution of TCM syndromes of patients in different age groups(≤45 years old, 46-60 years old, >60 years old) and different clinical types(mild or common, serious, critical type). Results Among the 524 patients, 304 were male and 220 were female;349 were mild or common type, 144 were serious type, and 31 were severe type;the median age was 45(33, 55) years;the median duration of symptoms was 10(6, 15)days. The patient′s main clinical symptoms(percentage >20%) include fever, chills, fatigue, dyspnea, shortness of breath, wheezing, and dyspnea. The tongue coating is mainly greasy(175 times), white coating(149 times) and yellow coating(127 times). The tongue quality is common pale tongue(170 times) and red tongue(151 times). Pulse manifestations are mainly rapid pulse(112 times) and slippery pulse(100 times). TCM syndromes mainly include cold dampness obstructed in lung syndrome(119 cases, 22.71%), damp heat stagnated in lung syndrome(113 cases, 21.56%), epidemic toxin blocking in lung syndrome(76 cases, 14.50%), dampness obstructing lung and stomach syndrome(70 Cases, 13.36%), dampness obstructing lung defense syndrome(63 cases, 12.02%). There was no statistically significant difference in the distribution of TCM syndromes among patients of all ages(P>0.05). The distribution of cold dampness obstructing lung syndrome, dampness and heat stagnating in lung syndrome, epidemic toxin bloc

关 键 词：新型冠状病毒肺炎 河南省 临床特征 中医证候 

分 类 号：R259[医药卫生—中西医结合]