新型冠状病毒肺炎的中医证型分析

目的:分析新型冠状病毒肺炎(COVID-19)患者的中医证型分布特点,为临床进一步救治COVID-19患者提供参考。方法:纳入2020年2月1日至2月14日湖北和四川两地多家医院收集的COVID-19确诊病例,收集其基本特征(年龄、性别、来源)、临床分型及中医证型,分析不同临床分型患者的中医证型分布特点。使用SPSS 26. 0统计软件进行数据分析。结果:共收集138例COVID-19患者,来自湖北/四川的各120/18例,男女比例为0. 86∶1,平均年龄为(53. 2±14. 9)岁,60岁以下的患者有86例(62. 3%),其中普通型80例、重型58例,重型组患者发病[(57. 7±14. 67)岁]年龄较普通组患者[(49. 9±14. 4)岁]高。中医证型分布以湿遏卫阳证44例(31. 9%),湿遏热伏证28例(20. 3%),湿热袭肺、肺失宣降证36例(26. 1%)为主,其他尚有湿热袭肺、阳气虚馁、肺气欲绝证19例(13. 8%),湿热袭肺、气阴两伤、肺气欲绝证11例(8%),且各种证型在COVID-19患者中的分布不均匀(χ^2=0. 202,P <0. 05)。进一步分层分析发现:普通组患者中医证型以湿遏卫阳证(48. 8%),湿遏热伏证(26. 3%),湿热袭肺、肺失宣降证(17. 5%)为主;重型组患者以湿热袭肺、肺失宣降证(37. 9%),湿热袭肺、阳气虚馁、肺气欲绝证(25. 9%)为主,各证型在普通组和重型组患者间的分布有差异(Z=6. 452,P <0. 05)。结论:COVID-19患者的中医证型以湿遏卫阳证,湿遏热伏证,湿热袭肺、肺失宣降证为主,但应警惕避免疾病向肺气欲绝的危候方向发展。

Analysis on Syndrome in Traditional Chinese Medicine of COVID-19

Objective: To analyze the characteristics of TCM syndromes in patients with Novel Coronavirus Pneumonia( COVID-19),and to provide reference for further clinical treatment of COVID-19 patients. Methods: Confirmed NPC cases collected from several hospitals in Hubei and Sichuan from February 1 to February 14,2020 were included,then the basic characteristics( age,gender,source),clinical classification and TCM syndrome types were collected. The distribution characteristics of TCM syndromes in patients with different clinical types were analyzed by SPSS 26. 0 statistical software. Results: A total of 138 COVID-19 patients were collected,120/18 from Hubei/Sichuan,with a male-to-female ratio of 0. 86: 1 and an average age of 53. 2 ± 14. 9 years. 86 patients( 62. 3%) were under 60 years of age. There were 80 cases of general type and 58 cases of severe type. The morbidity age in severe type group( 57. 7 ± 14. 6) was higher than that in the general group( 49. 9 ± 14. 4). TCM syndromes are mainly distributed in 44 cases( 31. 9%) of " Shieweiyang" syndrome,28 cases( 20. 3%)of " Shierefu" syndrome,36 cases( 26. 1%) of " Shirexifei,Feishixuanjiang" syndrome,and others 19 cases( 13. 8%) of " Shirexufei,Yangqixunei,Feiqiyujue" Syndrome,11 cases( 8%) of " Shirexifei,Qiyinliangshang,Feiqiyujue" Syndrome. It was observed that distribution of various types of syndromes was not uniform( X^2= 0. 202,P < 0. 05). Further analysis showed that: In general group, " Shieweiyag"( 48. 8%), " Shierefu"( 26. 3%) and " Shirexifei,Feishixuanjiang"( 17. 5%) were the main syndromes. In severe group, " Shirexifei,Feishixuanjiang"( 37. 9%) and " Shirexifei,Yangqixunei,Feiqiyujue"( 25. 9%) were the main syndromes,and the distribution of each syndrome was different between the general group and the severe group( Z = 6. 452,P < 0. 05). Conclusion: TCM Syndromes of COVID-19 patients are mainly " Shieweiyang", " Shierefu", " Shirexifei,Feishixuanjiang" Syndromes,but we should be alert to prevent the disease from developing to " Feiqiyujue" syndrome.