摘要
目的分析认识46例首都医科大学附属北京佑安医院收治的新型冠状病毒肺炎确诊病例的中医临床特征。方法采集患者的病史、中医证候及诊疗过程资料,分析不同分型患者证候演变及转归。结果46例患者中疫毒袭肺证(普通型)27例,湿毒郁肺证(普通型)13例,疫毒闭肺证(重型)6例,所有患者均接受中药治疗,中成药26例,中药汤剂20例。早期(0~3 d)症状相对较少,但已表现出特征性舌质红或暗红、苔黄腻或白腻的特点,进展期(4~14 d)半数以上患者出现发热(89.13%)、咳嗽咳痰(71.40%)、口干口渴(68.60%)、乏力(60%)、咽干或咽痛(57.10%)、纳呆(54.30%),重症患者舌腻而干或少苔。恢复期(>15 d)多数患者症状明显缓解,咳嗽咳痰(72.20%)、口干口渴(66.70%)、汗出(50%)仍较突出,舌苔由厚转薄,苔腻的程度有所改善、苔色由黄逐渐转白,舌象改变较为缓慢。普通型与重型的中位病程分别为16.5 d(14~26 d)和25 d(21~27 d),平均住院天数分别为(13.24±4.36)d、(19.73±2.33)d。病毒核酸中位转阴时间分别为11.41 d(4~22 d)、14.5 d(9~24 d),肺部电子计算机断层扫描(computed tomography,CT)检查病灶开始吸收的中位时间分别为10 d(5~19 d)、15.5 d(8~21 d)。结论本病湿热证候突出,病程长,对中医不同证型特征的认识有助于指导中医辨证施治。
Objective To analyze and understand the traditional Chinese medicine(TCM)characteristics of 46 confirmed cases with COVID-19 in Beijing Youan Hospital,Capital Medical University.Methods Data were collected and analyzed about the history of patients,TCM syndrome characteristics,the diagnosis and treatment process,evolution of the symptoms,and outcomes of the cases.The clinical characteristics of different types of cases were compared with each other.Results Among the 46 patients,27 cases were epidemic toxin attacking lung syndrome(common type),13 cases were dampness toxin depression lung syndrome(common type),6 cases were retention of epidemic toxin in the lung(severe type).All patients received Chinese medicine treatment,26 cases of which were treated with proprietary Chinese medicine and 20 cases with traditional Chinese medicine decoction.In the early stage(0-3 days),the symptoms were relatively alleviated,yet with the characteristics of red or dark red tongue,yellow greasy tongue coating or white greasy coating.In the advanced stage(4-14 days),more than half of the patients had fever(89.13%),cough and expectoration(71.40%),dry mouth and thirst(68.60%),fatigue(60%),dry throat or sore throat(57.10%),and lack of appetite(54.30%).For the severe patients,the tongue coating was greasy and dry or less.In the recovery stage(>15 d),most of the symptoms were relieved,but with cough and expectoration(72.20%),dry mouth and thirst(66.70%),sweating(50%)remained.Meanwhile tongue coating changed from thick to thin,the degree of greasy coating improved with the color of coating changed from yellow to white,although the changes of tongue manifestation occurred slowly.For cases with common type and severe type,the median course of the disease of were respectively 16.5 d(14-26 d)and 25 d(21-27 d),the average days of hospital stay were(13.24±4.36)d and(19.73±2.33)d,the median time for viral nucleic acid test turning negative was respectively 11.41 d(4-22 d)and 14.5 d(9-24 d),and the median time for pulmonary computed tomography(CT)lesions to start absorption was respectively 10 d(5-19 d),15.5 d(8-21 d).Conclusion The syndrome with damp and heat are prominent in COVID-19 and the course of the disease is relatively long.The understanding of the characteristics of different TCM syndrome types and the evolution is helpful to guide the syndrome differentiation and treatment with TCM.
作者
李丽
杨华升
勾春燕
汪晓军
罗晓岚
张佳莹
李红艳
李侗曾
梁连春
李秀惠
Li Li;Yang Huasheng;Gou Chunyan;Wang Xiaojun;Luo Xiaolan;Zhang Jiaying;Li Hongyan;Li Tongzeng;Liang Lianchun;Li Xiuhui(Center for Integrated Chinese and Western Medicine, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China;Department of Infectious Disease, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China)
出处
《首都医科大学学报》
CAS
北大核心
2020年第2期155-160,共6页
Journal of Capital Medical University
基金
国家重大科研专项(2017ZX10305501)
北京市中医管理局课题(YJ2020-02)。
关键词
新型冠状病毒肺炎
中医证候
证候演变
COVID-19
syndrome of traditional Chinese medicine
syndrome evolution
作者简介
Corresponding author:梁连春,E-mail:llc671215@sohu.com;Corresponding author:李秀惠,lixiuhui@sohu.com。
