新型冠状病毒感染恢复期合并冠心病中医证候特征分析及机制探索  

TCM Syndrome Characteristics Analysis and Mechanism Exploration of COVID-19 in the Recovery Period Combined with Coronary Heart Disease

作　　者：王凤鑫 李平 王成祥 于会勇 陈卫衡 曹鸿云 聂天旸 郭雨菲 薛贝 李绪贵 周诗晶 卢江云 何江城 WANG Fengxin;LI Ping;WANG Chengxiang;YU Huiyong;CHEN Weiheng;CAO Hongyun;NIE Tianyang;GUO Yufei;XUE Bei;LI Xugui;ZHOU Shijing;LU Jiangyun;HE Jiangcheng(Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Wuhan Orthopedic Hospital of Integrated Chinese and Western Medicine,Wuhan 430079,Hubei,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学东直门医院,北京100700 [3]武汉中西医结合骨科医院,湖北武汉430079

出　　处：《辽宁中医药大学学报》2025年第5期52-57,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074389);北京中医药科技发展资金项目(YJ2020-05);北京中医药大学新冠肺炎防控应急专项(2020-JYB-YJ-023)。

摘　　要：目的探讨新型冠状病毒感染(简称新冠感染)恢复期合并冠心病的证候特征及通路机制。方法多中心收集武汉新冠感染恢复期合并冠心病患者共60例,收集中医四诊资料,分析其主要症状及中医证候分布,以症状为切入点,得出疾病各证型中医证候表型靶点,进一步用R语言进行KEGG通路富集分析。结果中医症状以喘促气短、胸闷、咳嗽、乏力、咳痰、心悸、神疲、自汗、少气、睡眠障碍为主,舌象以舌胖大、舌淡白、苔白腻或黄腻为主,脉象以脉沉、脉细、脉弱等沉脉类、虚脉类多见。病位证素主要为肺、脾、心,病性证素主要是气虚。中医证型主证型为肺脾气虚证、心气虚证。新冠感染恢复期合并冠心病肺脾气虚证与心气虚证的临床表型相关靶点分别为1482、1392个。KEGG通路富集结果表明各证型对应通路大致相似,但具体通路的富集程度表现出一定的差异。结论新冠感染恢复期合并冠心病的中医证候分散性良好,病机特点为邪气未尽、正气未复,信号通路主要与病毒感染、炎症反应、免疫应答、脂质代谢相关。同时,应格外注意精神情志方面的调护,促进患者生理及心理的全面康复。Objective To explore the characteristics of TCM syndromes and pathway mechanisms of patients with coronary heart disease during the recovery period of corona virus disease 2019(COVID-19).Methods A total of 60 patients with coronary heart disease during the recovery period of COVID-19 in Wuhan from multiple centers were included in the study.The data of four TCM consultations was collected to analyze the main symptoms and distribution of TCM syndromes.Taking the symptoms as the breakthrough point,the phenotypic targets of TCM syndrome types of diseases were obtained,and the KEGG pathway enrichment analysis was further conducted with R.Results TCM symptoms are mainly shortness of breath,chest tightness,cough,fatigue,expectoration,palpitation,exhaustion,spontaneous sweating,sleep disorders.The tongue picture is mainly fat tongue,pale tongue,and white or yellow greasy fur.The pulse image is heavy pulse,weak pulse and thin pulse.The disease location syndromes are mainly lung,spleen and heart.And the disease syndromes are mainly Qi deficiency.The main syndroms of TCM are deficiency of lung and spleen Qi,deficiency of heart Qi.There were 1482 and 1392 clinical phenotypic targets of lung and spleen Qi deficiency syndrome and heart-Qi deficiency syndrome combined with coronary heart disease during the convalescence of COVID-19 infection.The enrichment results of KEGG pathway showed that the corresponding pathway of each syndrome type was roughly similar,but the enrichment degree of specific pathway showed some differences.Conclusion The TCM syndromes of COVID-19 during the recovery period combined with coronary heart disease are well dispersed.The pathogenesis is manifested as the pathogenic Qi is not exhausted,the vital Qi is not restored.The signaling pathway is mainly related to viral infection,inflammation,immune response and lipid metabolism.Meanwhile,the special attention should be paid to the mental and emotional care to promote the comprehensive physical and psychological rehabilitation of patients.

关 键 词：新冠感染恢复期 冠心病 中医证候特征 通路机制 

分 类 号：R254[医药卫生—中医内科学] R259[医药卫生—中医学]