辽宁省集中收治新型冠状病毒肺炎的中医临床特点浅析  

Analysis of clinical characteristics of traditional Chinese medicine of novel coronavirus pneumonia centralized treatment in Liaoning Province

作　　者：田霞[1] 李鲁平[1] 王岩[1] 李伯君 于成文[1] 郭晓苇 郑佳连[2] 卢秉久[2] TIAN Xia;LI Luping;WANG Yan;LI Bojun;YU Chengwen;GUO Xiaowei;ZHENG Jialian;LU Bingjiu(Shenyang Sixth People's Hospital,Shenyang,Liaoning,110006,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning,110032,China)

机构地区：[1]沈阳市第六人民医院中医康复科,辽宁沈阳110006 [2]辽宁中医药大学附属医院门诊,辽宁沈阳110032

出　　处：《当代医学》2022年第3期81-84,共4页Contemporary Medicine

基　　金：国家重大科技专项(2017Z10305501);沈阳市科技计划项目(YJ2020-9-009);北京市科技计划项目(Z20110005420009);沈阳市卫生健康委科研课题项目(2021046)。

摘　　要：目的对"辽宁新型冠状病毒感染肺炎集中收治中心(沈阳)"(沈阳中心)收治的新型冠状病毒肺炎(新冠肺炎)的临床资料进行分析,初探辽沈地区新冠肺炎的中医病因病机、证候特征,及其与西医指标的相关性,以期为新冠肺炎的中西医诊疗提供参考。方法对沈阳中心2020年1—2月收治的57例新冠肺炎的流行病学、中医症状等数据进行统计,对其中51例中西医结合治疗的患者进行中医症状、舌象信息、肺部影像学等数据采集,归纳出中医证候特点及其与西医相关性。结果 57例新冠肺炎患者中,有湖北旅居史25例,占43.9%,本地病例32例,占56.1%;人群普遍易感,以家族聚集发病为主。中医症状主要以发热(34例,59.6%)和呼吸道症状(31例,54.4%)为主,其中25例出现咳嗽且多为干咳,仅有10例咳痰,多为咳少量白痰;有消化道症状者19例(33.3%),主要以腹泻13例(22.8%)为主。舌象上以舌红24例(47.1%),舌淡21例(41.2%),舌苔腻40例(78.4%)为主要特征。中医证型分为湿邪郁肺、脾虚湿盛、邪热壅肺、气阴两虚、疫毒闭肺5个证型,以湿邪郁肺和脾虚湿盛为主,部分病例病机演变会向气阴两虚、脾虚湿盛转化。脾虚湿盛和湿邪郁肺型以轻型和普通型为主,湿邪郁肺和脾虚湿盛退热较快,湿邪郁肺平均热度最低。结论辽沈地区新冠肺炎中医病因为外感疫戾之气夹湿浊,引动肺内伏热而发病。致病因素为"湿"邪,并会因湿生瘀热、痰浊。病位在肺脾,证型以脾虚湿盛和湿邪郁肺为主,并因人体正气而致虚实转化,影响疾病转归。Objective To analyze the clinical data of novel coronavirus(referred as COVID-19 Pneumonia) admitted to "Liaoning novel coronavirus Centralized Treatment Center for Infected Pneumonia(Shenyang)" referred as Shenyang center in order to explore the TCM etiology, pathogenesis, syndrome characteristics and correlation with western medicine indexes of COVID-19 Pneumonia in Liaoshen region, so as to provide reference for the diagnosis and treatment of COVID-19 Pneumonia. Methods The epidemiological and TCM symptoms data of 57 patients with newly diagnosed pneumonia admitted to Shenyang Center from January to February 2020 were collected. Among them, 51 patients treated with integrated traditional Chinese and western medicine were collected with TCM symptoms, tongue image information, lung imaging and other data, and the TCM syndrome characteristics and their correlation with western medicine were summarized. Results Of the 57 cases of COVID-19 Pneumonia patients, 25 cases(43.9%) had a history of living in Hubei, while 32 cases(56.1%) were local cases. The population was generally susceptible, with familial aggregation as the main cause. The main TCM symptoms were fever(34, 59.6%) and respiratory symptoms(31, 54.4%), of which 25 cases have cough and mostly dry cough, only 10 had expectoration, mostly cough with a small amount of white sputum. 19(33.3%) cases had digestive tract symptoms, mainly diarrhea 13(22.8%) cases. The main features of tongue picture are red tongue in 24 cases(47.1%), pale tongue in 21 cases(41.2%),greasy tongue coating in 40 cases(78.4%). The TCM syndrome types were divided into five types, damp-evil stagnation of the lung, spleen deficiency and dampness-excess, pathogenic heat obstructing the lung, deficiency of both Qi and Yin, and pestilence and toxin blocking the lung. Damp-evil stagnation of the lung and spleen deficiency and dampness-excess were the main types. The pathogenesis evolution of some cases will change to deficiency of both qi and yin and spleen deficiency and dampness-excess. Lig

关 键 词：新冠肺炎 流行病学 中医证候 中医症状 临床表现 

分 类 号：R259[医药卫生—中西医结合]