四川省168例新型冠状病毒肺炎患者流行病学特征及中医证候分析  

Epidemiological Characteristics and TCM Syndrome Analysis of 168 Patients with COVID-19 in Sichuan Province

作　　者：王饶琼 杨思进 李敏清[2] 沈其霖 王明选[4] 李继科 雷枭[6] 黄梅 Wang Raoqiong;Yang Sijin;Li Minqing;Shen Qilin;Wang Mingxuan;Li Jike;Lei Xiao;Huang Mei(Hospital of traditional Chinese medicine affiliated to southwest medical university,Luzhou 646000;Dazhou Central Hospital,Dazhou 635000;Mianyang Traditional Chinese Medicine Hospital,Mianyang 621000;Suining Central Hospital,Suining 629000;Chengdu Public Health Clinical Medical Center,Chengdu 610066;Affiliated Hospital of North Sichuan Medical College,Nanchong 637000;Nanchong Central Hospital,Nanchong 63700)

机构地区：[1]西南医科大学附属中医医院,泸州646000 [2]达州市中心医院,达州635000 [3]绵阳市中医院,绵阳621000 [4]遂宁市中心医院,遂宁629000 [5]成都市公共卫生临床医疗中心,成都610066 [6]川北医学院附属医院,南充637000 [7]南充市中心医院,南充637000

出　　处：《中药药理与临床》2020年第5期2-6,共5页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家中医药管理局《中医药防治新型冠状病毒肺炎应急研究专项课题》;国家中医药管理局治疗新型冠状病毒肺炎临床研究项目四川组。

摘　　要：目的:分析四川省168例新型冠状病毒肺炎患者流行特征及中医证候特点。方法:回顾性调查四川省收治的168例新型冠状病毒肺炎患者资料,分析不同人群、不同地区、不同时间患者分布情况、流行特征,探究其中医证候特点。结果:流行病学特征:截止2020年3月14日,四川地区累计确诊168例新型冠状病毒肺炎患者,其中男性多于女性;中年比例(41岁~60岁)居多;临床分型主要以普通型为主;主要以接触确诊患者和家族内密切接触感染为主,有22例来自湖北疫区;潜伏期最短3 d,最长16 d;168例新冠肺炎确诊患者均治愈出院,无死亡病例,平均住院天数(13.51±5.24)d;合并基础疾病以重型患者占比最高;中药使用率100%。中医证候特征:在具有中医症状的患者中主要以发热、咳嗽、心悸、乏力、胸闷、苔黄腻、脉濡或滑为主;中医证型以湿热郁肺证(湿重于热)最为常见;恢复期以肺脾气虚、气阴两虚为主;男性以寒湿郁肺证、湿热蕴肺证(热重于湿)为主,而女性患者以湿热蕴肺证(湿重于热)、湿毒郁肺证、气阴两虚常见;≤20岁患者以寒湿郁肺证为主;21岁~40岁患者以湿热蕴肺证(热重于湿)主;41岁~60岁患者以湿热郁肺证(湿重于热)、湿毒郁肺证、疫毒闭肺证为主。≥61岁以肺脾气虚证、气阴两虚为主。结论:四川省新型冠状病毒肺炎病例存在明显的家庭聚集性和地区聚集性。早期接诊新冠肺炎患者预估病情时,需结合年龄、基础疾病、疫区或确诊患者接触史、潜伏期、症状和实验室检查进行综合评估,并进行中西医结合治疗,有助于及早判断病情发展趋势,早期干预重症化进程;其中医证候分布具有一定规律性,不同性别、年龄、发病时间、不同临床分型和治疗期的患者中医证候存在差异性。Objective:To analyze the epidemiological characteristics and TCM syndrome characteristics of 168 patients with COVID-19 in Sichuan Province.Methods:168 patients with COVID-19 admitted to Sichuan Province were investigated retrospectively,to analyze the distribution and epidemic characteristics of patients in different populations,different regions,and different time,and to explore its TCM syndromes.Results:Epidemiological characteristics:Up to March 14,2020,a total of 168 patients with COVID-19 had been diagnosed in Sichuan,in which more male than female.The large proportion of age was the middle age(41 to 60 years old).The main clinical classification was the common type,the main infection type was contacting with confirmed patients and close family contact infection,in which 22 cases were from Hubei affected area.The shortest incubation period was 3 days,while the longest was 16 days.The 168 patients with COVID-19 were cured with no dead case.The average length of stay in hospital was(13.51±5.24)days.The proportion of patients with severe diseases was the highest.The use rate of Chinese medicine was 100%.Features of TCM syndromes:Among patients with TCM symptoms,fever,cough,palpitations,fatigue,chest tightness,Taihuangni in tongue,Ru or Hua in pulse.The most common type of TCM syndrome was Shireyufei(Shi was more severe than Re).Feipiqixu and Qiyinliangxu were mainly showed in the recovery period.The main syndromes male patients with were Hanshiyufei and Shireyunfei(Re was severe than Shi),while the main syndromes female patients with were Shireyunfei(Shi was more severe than Re),Shiduyufei and Qiyinliangxu.For patents less than 20 years old,Hanshiyufei was the main syndrome.For patients aged 21-40 years old,Shireyunfei(Re was severe than Shi)was the main syndrome.For patients aged 41-60 years old,the main syndromes were Shireyufei(Shi was more severe than Re),Shiduyufei and Yodibifei.For patients over 60 years old,the main syndromes were Feipiqixu and Qiyinliangxu.Conclusion:There are obvious family clusterin

关 键 词：新型冠状病毒肺炎 流行病学特征 中医证候 

分 类 号：R259[医药卫生—中西医结合]