轻型、普通型新型冠状病毒肺炎患者中医证候分布与外周血细胞计数及胸部影像学变化观察  

Observation on Distribution of TCM Patterns and Changes of Peripheral Blood Cell Count and Chest Imaging in Mild and Moderate COVID-19 Patients

作　　者：简小云[1] 蒋开平[2] 刘效仿[3] 梁炳辉[1] 张云海[4] 陈国强[5] 罗志扬[6] 周杰 吴智龙 陈小燕 江群芳 黄凯舟 JIAN Xiao-yun;JIANG Kai-ping;LIU Xiao-fang;LIANG Binghui;ZHANG Yun-hai;CHEN Guo-qiang;LUO Zhi-yang;ZHOU Jie;WU Zhi-long;CHEN Xiao-yan;JIANG Qun-fang;HUANG Kai-zhou(Department of Lung(Respiratory)Diseases,Foshan Hospital of Traditional Chinese Medicine,Guangdong,528000;Department of Internal Medicine,Foshan Hospital of Traditional Chinese Medicine,Guangdong,528000;Department of Orthopedics and Traumatology,Foshan Hospital of Traditional Chinese Medicine,Guangdong,528000;Department of Critical Care Medicine,Foshan Hospital of Traditional Chinese Medicine,Guangdong,528000;Department of Rheumatology and Immunology,First People's Hospital of Foshan,Guangdong,528000;Department of Respiratory Diseases,First People's Hospital of Foshan,Guangdong,528000;Department of Traditional Chinese Medicine,Fourth People's Hospital of Foshan,Guangdong,528000;Department of Respiratory Diseases,Fourth People's Hospital of Foshan,Guangdong,528000;Department of Hepatology,Foshan Hospital of Traditional Chinese Medicine,Guangdong,528000)

机构地区：[1]佛山市中医院肺病(呼吸)科,广东528000 [2]佛山市中医院大内科,广东528000 [3]佛山市中医院骨伤科中心,广东528000 [4]佛山市中医院重症医学科,广东528000 [5]佛山市第一人民医院风湿免疫科,广东528000 [6]佛山市第一人民医院呼吸内科,广东528000 [7]佛山市第四人民医院中医科,广东528000 [8]佛山市第四人民医院呼吸内科,广东528000 [9]佛山市中医院肝病科,广东528000

出　　处：《中国中西医结合杂志》2020年第12期1454-1457,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察轻型、普通型新型冠状病毒肺炎(新冠肺炎)患者中医证候分布与外周血细胞计数及胸部影像学变化。方法对轻型、普通型新冠肺炎确诊患者55例进行中医证候诊断,分析比较不同临床分型各中医证候外周血白细胞总数、淋巴细胞计数及胸部影像学病变部位、病灶形态、病变程度等变化特点。结果9例轻型新冠肺炎患者中,寒湿郁肺证7例(77.8%)、湿热蕴肺证2例(22.2%);46例普通型新冠肺炎患者中,寒湿阻肺证9例(19.6%)、湿毒郁肺证37例(80.4%)。普通型新冠肺炎湿毒郁肺证患者,外周血白细胞总数低于寒湿阻肺证(P<0.05),淋巴细胞绝计数不但绝对值水平明显低于寒湿阻肺证(P<0.01)且低于检测范围下限患者例数亦较寒湿阻肺证多(P<0.05);在胸部影像学变化中,湿毒郁肺证患者病变部位累及双肺者多于寒湿阻肺证(P<0.05),寒湿阻肺证以少量小病灶多见,而湿毒郁肺证则以较多大范围病变明显(P<0.05)。结论轻型、普通型新冠肺炎患者主要中医证候分别为寒湿郁肺证、湿毒郁肺证。普通型新冠肺炎湿毒郁肺证患者,易出现外周血白细胞及淋巴细胞计数减少且胸部影像学病灶数量多、病变范围大。Objective To observe distribution of traditional Chinese medicine(TCM)patterns and changes of peripheral blood cell count and chest imaging in mild and moderate COVID-19 patients.Methods Totally 55 pa-tients with confirmed mild and moderate COVID-19 were diagnosed according to the criteria of TCM patterns.The characteristics of the total number of peripheral blood leukocytes,lymphocyte count and the changes of lesion location,lesion shape and lesion degree in chest imaging in the TCM patterns of different clinical types were analyzed and compared.Results In the 9 cases of patients with mild COVID-19,there were 7 cases(77.8%)of cold-damp constraint Fei pattern and 2 cases(22.2%)of damp-heat accumulation Fei pattern.In the 46 cases of patients with moderate COVID-19,there were 9 cases(19.6%)of cold-damp obstructing Fei pattern and 37 cases(80.4%)of damp-toxin constraint Fei pattern.In these moderate COVID-19 patients with damp-toxin constraint Fei pattern,the total number of leukocytes in peripheral blood was lower than that in the cold-damp obstructing Fei pattern(P<0.05).Meanwhile,the absolute count of lymphocyte was not only lower than that of the cold-damp obstructing Fei pattern(P<0.01),but also lower than the lower limit of detection range(P<0.05).In the changes of chest imaging in moder-ate COVID-19 patients,the lesion region involving both lungs in the damp-toxin constraint Fei pattern was more than that in the cold-damp obstructing Fei pattern(P<0.05),and a small number of small lesions were common in the cold-damp obstructing Fei pattern while a large range of lesions highlighted in the damp-toxin constraint Fei pattern(P<0.05).Conclusions The mainly TCM pattern in mild COVID-19 patients was the cold-damp constraint Fei pattern,the damp-heat accumulation lung pattern was mainly found in moderate COVID-19 patients.In these moderate COVID-19 patients with damp-toxin constraint Fei pattern,the number of peripheral blood white blood cells and lymphocytes were decreased,and the changes of chest imaging showed

关 键 词：新型冠状病毒肺炎 中医证候 白细胞 淋巴细胞 胸部影像学 

分 类 号：R259[医药卫生—中西医结合]