2020年沈阳地区两次新型冠状病毒肺炎疫情的中医临床特点比较  

Comparison of Clinical Characteristics between Two Outbreaks of Coronavirus Disease 2019 in Shenyang in 2020

作　　者：田霞[1] 王岩[1] 于红[1] 王静波[1] 王妍[1] 权冬梅 孙胜男[1] 张伟[2] 苏芮 刘清泉[3] TIAN Xia;WANG Yan;YU Hong;WANG Jingbo;WANG Yan;QUAN Dongmei;SUN Shengnan;ZHANG Wei;SU Rui;LIU Qingquan(The Sixth Peopled Hospital of Shenyang,Shenyang,110006;Beijing Ditan Hospital,Capital Medical University;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University)

机构地区：[1]沈阳市第六人民医院,辽宁省沈阳市110006 [2]首都医科大学附属北京地坛医院 [3]首都医科大学附属北京中医医院

出　　处：《中医杂志》2021年第17期1522-1525,共4页Journal of Traditional Chinese Medicine

基　　金：国家科技重大专项(2017ZX10305501);新型冠状病毒感染肺炎重症、危重症病例的早期预警及转归预测因素的研究(YJ2020-9-009);中医针药联合治疗轻型及普通型新型冠状病毒肺炎前瞻性队列研究(62041701)。

摘　　要：目的分析沈阳地区2020年两次新型冠状病毒肺炎(简称新冠肺炎)疫情的异同,总结病情演变规律。方法纳入沈阳地区2020年1月至2020年2月收治的57例患者(简称年初收治患者)及2020年12月至2021年1月收治的38例患者(简称年末收治患者)。提取两次收治患者的临床资料,包括流行病学特征、基本人口特征、疾病分型及进展特征、中医症状及证候分布情况并进行统计分析。结果两次收治患者的性别、年龄、合并疾病分布比较差异均有统计学意义(P<0.05或P<0.01)。两次收治患者均以普通型为主,年初收治患者入院后有3例(5.3%)病情进展,其中2例(3.5%)转为重型、危重型;年末收治患者入院后有14例(36.8%)病情进展,其中9例(23.7%)转为重型、危重型。年初收治患者中发热者34例(59.6%),持续时间平均(11.41±4.41)天;年末收治患者中发热32例(84.2%),持续时间平均(8.06±3.84)天,两次收治患者的发热例数、持续时间比较差异均有统计学意义(P<0.01)。年初收治患者中医症状以中低热、干咳、咯痰、腹泻为主要表现,中医证型以脾虚湿盛者为多;年末收治患者以高热、干咳、便秘为主要表现,中医证型以湿邪郁肺者为多。结论沈阳地区2020年2次疫情中,年初患者病情轻,湿邪透表而愈,病情变化不大,治疗相对简单;年末患者以老年人为主,基础病多,湿邪入里化热快,疾病进展快,重症多,治疗相对复杂。Objective To analyze the similarities and differences between the two outbreaks of coronavirus disease 2019(COVID-19)in Shenyang in 2020,and to summarize the evolution law of the disease.Methods Fifty-seven patients admitted from January to February 2020 in Shenyang(year-beginning admission patients)and 38 patients admitted from December 2020 to January 2021(year-end admission patients)were included,and clinical data including epidemiological and demographic characteristics,disease types,progression status,traditional Chinese medicine(TCM)symptoms and syndromes were collected and analyzed.Results There were statistically significant differences between year-beginning and year-end admission patients group in the gender,age,and combined diseases(P<0.05 or P<0.01).Patients in both group were mainly moderate cases;three of year-beginning admission patients(5.3%)progressed after hospitalization,of which 2(3.5%)progressed into severe or critically ill cases,while 14 of year-end admission patients(36.8%)progressed after hospitalization,of which 9(23.7%)became severe or critically ill cases.Thirty-four of year-beginning admission patients(59.6%)had fever lasting for an average of 11.41±4.41 days,while there were 32 fever cases(84.2%)among year-end admission patients,lasting for 8.06±3.84 days;statistically significant differences were found in fever case numbers and lasting time between two patients groups(P<0.01).The major TCM symptoms in year-beginning admission patients were manifested as low or medium fever,dry cough,expectoration,and diarrhea,and the predominant syndrome was spleen deficiency and dampness excess syndrome;for year-end admission patients,the major symptoms and syndromes were high fever,dry cough,constipation,and pathogenic dampness constraining the lung syndrome.Conclusion During the two epidemics in Shenyang in 2020,the patients admitted at the beginning of the year are mildly ill;the pathogenic dampness vents the exterior and can be eliminated;the condition has not changed much,and therefore the t

关 键 词：新型冠状病毒肺炎 中医证候 沈阳地区 

分 类 号：R259[医药卫生—中西医结合]