30例新型冠状病毒肺炎核酸持续阳性患者临床特征回顾性分析  

Retrospective Analysis of Clinical Characteristics of 30 Cases of Coronavirus Disease 2019 with Persistent Nucleic Acid Positive

作　　者：丛晓东[1] 杨金亮[2] 李斌[1] 石嘉恒 董国菊[1] 王冰[1] 线永悦 朱浩宁 杨志旭[1] 阮连国 吕诚[4] 边永君[2] 齐文升[2] 李浩[1] 苗青[1] 黄璐琦[4] CONG Xiaodong;YANG Jinliang;LI Bin;SHI Jiaheng;DONG Guoju;WANG Bing;XIAN Yongyue;ZHU Haoning;YANG Zhixu;RUAN Lianguo;LYU Cheng;BIAN Yongjun;QI Wensheng;LI Hao;MIAO Qing;HUANG Luqi(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091;Guang'anmen,Hospital China Academy of Chinese Medical Sciences,Beijing;Wuhan Jinyintan Hospital,Wuhan;China Academy of Chinese Medical Sciences,Beijing)

机构地区：[1]中国中医科学院西苑医院,北京市100091 [2]中国中医科学院广安门医院 [3]武汉市金银潭医院 [4]中国中医科学院

出　　处：《中医杂志》2020年第24期2121-2125,共5页Journal of Traditional Chinese Medicine

基　　金：中国中医科学院中医药防治新冠肺炎应急攻关专项(ZZ14-FY-004)。

摘　　要：目的分析探讨新型冠状病毒肺炎(简称“新冠肺炎”)新型冠状病毒核酸持续阳性超过4周患者的临床特征。方法采用回顾性分析方法,纳入武汉市金银潭医院南一病区2020年1月28日至3月30日收治的新型冠状病毒核酸检测阳性持续时间>4周的新冠肺炎患者共30例,采集其一般资料、临床资料并分析患者临床特征及体质类型分布规律。结果30例新冠肺炎患者中包括持续阳性未能出院患者10例,出院或隔离后复查阳性者20例。年龄34~86岁,平均(60.40±14.46)岁,≥60岁者19例(63.3%);临床分型:普通型8例(26.7%),重型22例(73.3%);主要基础疾病:高血压病14例次(46.6%),糖尿病6例次(20.0%),冠心病5例次(16.7%);初始发病时主症:发热(20例,占66.7%),喘息(10例,占33.3%),咳嗽(7例,占23.3%);咽拭子核酸反复阳性24例次(80.0%),痰液核酸反复阳性16例次(53.3%);接受过抗生素治疗24例次(80.0%),接受过抗病毒药物治疗16例次(53.4%),接受过中药治疗25例次(83.3%);舌质暗淡者19例(63.3%),舌质红11例(36.7%);舌苔腻者21例(70.0%),舌苔少者5例(16.7%),苔薄白者4例(13.3%);痰湿体质12例(40.0%),气郁体质8例(26.7%),气虚体质5例(16.6%),湿热体质3例(10.0%),阴虚体质2例(6.7%)。结论新型冠状病毒核酸持续阳性的患者中高龄、基础疾病多者相对较多,高血压病为最常见的合并基础病,咽拭子反复阳性最为常见;舌质暗淡及舌苔腻者以及痰湿、气郁体质的患者较多,故益气扶正、化湿驱邪、调畅气机或是其治疗的方向。Objective To analyze the clinical characteristics of patients with Coronavirus Disease 2019(COVID-19)that have continued to have positive nucleic acid result for more than 4 weeks.Methods A retrospective analysis method was used to enroll a total of 30 patients with COVID-19 who were admitted to the South First Ward of Wuhan Jinyintan Hospital from January 28 to March 30,2020,who had a positive duration of nucleic acid test of the novel coronavirus and lasted more than 4 weeks.General information,clinical data were collected and distribution of clinical characteristics and physical types of patients were analyzed.Results Among the 30 patients with COVID-19,10 patients were continuously positive and failed to be discharged,and 20 patients were rechecked after discharge or isolation therapy.Age of the patients were 34-86 years old,average(60.40±14.46)years old,19 cases(63.3%)≥60 years old;clinical classification:8 cases(26.7%)were of ordinary type,22 cases(73.3%)of severe type;main underlying diseases:14 cases were of hypertension(46.6%),6 cases of diabetes(20.0%),5 cases of coronary heart disease(16.7%);the main symptoms at the initial onset including fever(20 cases,66.7%),wheezing(10 cases,33.3%),cough(7 cases,23.3%);throat swab nucleic acid repeated positive 24 times(80.0%),sputum nucleic acid repeated positive 16 times(53.3%);24 cases received antibiotic treatment(80.0%),16 cases(53.4%)received antiviral drug treatment,25 cases(83.3%)received traditional Chinese medicine treatment;19 cases(63.3%)had dull tongue,11 cases(36.7%)had red tongue;21 cases(70.0%)with greasy tongue coating,5 cases(16.7%)with less tongue coating,4 cases(13.3%)with thin and white coating;12 cases(40.0%)were of phlegm constitution,8 cases of qi depression constitution(26.7%),5 cases(16.6%)of qi deficiency constitution,3 cases(10.0%)of damp-heat constitution,2 cases(6.7%)of yin deficiency constitution.Conclusion There are relatively more patients with persistently positive nucleic acid of the novel coronavirus in the elderly and those w

关 键 词：新型冠状病毒肺炎 新型冠状病毒核酸 核酸持续阳性 临床特征 中医体质 

分 类 号：R563.1[医药卫生—呼吸系统]