35例新型冠状病毒肺炎患者中医临床特征分析

目的分析广东省新型冠状病毒肺炎患者临床资料及中医证候,为该病的防治提供科学依据。方法将2020年1月23日至2020年2月14日本院收治的35例新型冠状病毒肺炎患者纳为研究对象,收集患者的基本情况、流行病学史及疾病史,通过血液生化分析及胸部CT检查患者临床情况,由5名高级职称中医师对患者舌象进行诊断,并根据《广东省新型冠状病毒感染的肺炎中医药治疗方案(试行第一版)》进行辨证。结果新型冠状病毒肺炎患者年龄分布较广,平均年龄为(44.00±15.17)岁,以男性居多,57.14%的患者有武汉及周边地区旅居史,42.86%的患者有确诊患者接触史;50%以上的患者淋巴细胞绝对值降低,CD3、CD4和、CD8降低以及C反应蛋白增加;胸部CT显示,80%以上的患者出现肺部病变,其中双肺病变占60%,病变类型以斑块状阴影居多;多数患者伴有发热(85.71%)、咳嗽(80.00%)、肌肉酸痛(42.86%)、乏力(40.00%)等临床症状;患者的证型主要是湿邪郁肺(45.71%),其次为邪热壅肺(37.14%),病机特点以湿为主,其次为热;舌苔以腻苔为主,舌质以红和淡红为主。结论新型冠状病毒肺炎患者的中医证型以湿邪郁肺为主,致病特点以"湿"为主,可针对性地采取中医治疗。

Analysis of Chinese Medical Characteristics of 35 Patients with Novel Coronavirus Pneumonia

Objective:To analyze the clinical data and Chinese medical syndromes of Novel coronavirus pneumonia(NCP)patients in Guangdong province,providing scientific basis for its prevention and treatment. Methods:35 patients from January 23 rd,2020 to February 14 th,2020 were taken as the research object. Their basic situation,epidemiological history and disease history were collected,and the patients were examined in blood biochemical analysis and chest CT. In the clinical situation,5 Chinese medicine doctors diagnosed the tongue picture of the patient,and conducted a dialectical diagnosis based on Traditional Chinese Medicine Treatment Scheme for Pneumonia Infected by New Coronavirus in Guangdong Province(Trial Implementation). Results:The age of patients was widely distributed,with an average age of(44.00±15.17) years old. Most of them were male. 57.14%of patients had a history of living in Wuhan and/or other area of Hubei;42.86% of these cases had a history of contact with confirmed patients. In more than half of the patients,the absolute value of lymphocytes,CD3,CD4 and CD8 decreased,and C-reactive protein increased. Chest CT showed that more than 80% of patients had lung disease,of which 60% were bilateral lung disease,most of them with plaque-shaped shadows. Most patients were associated with clinical symptoms,such as fever(85.71%),cough(80.00%),muscle soreness(42.86%),fatigue(40.00%). The patients′ syndrome types were mainly the damp-stagnation lung type(45.71%),followed by the type of accumulation of pathogenic heat in the lung(37.14%). The pathological features were mainly wet,followed by heat. The tongue coating was mainly greasy and the tongue quality was mainly red and light red. Conclusions:TCM syndrome of NCP is mainly wet and stagnation lung type. The pathogenic characteristic is mainly dampness,which can be treated by traditional Chinese medicine.