基于中医临床证候探讨新型冠状病毒肺炎在岭南地区的疫性特点

目的:通过分析广东省第二人民医院收治的新型冠状病毒肺炎(以下简称新冠肺炎)患者的临床资料,从中医临床证候探讨该病在岭南地区的疫性特点,更好地指导临床辨证治疗。方法:收集广东省第二人民医院收治的36例新冠肺炎患者的临床资料,其中输入病例20例,本地病例16例,分析全部病例、输入病例和本地病例的临床资料和证候特点。结果:新冠肺炎患者年龄分布较广,平均年龄45岁,以男性居多,55.56%的患者为外地输入病例,44.44%的患者为本地感染病例。全部病例证型以湿邪郁肺型和邪热壅肺型为主,分别占44.44%和38.89%;91.67%的患者呈现“湿”的病理特点,72.22%的患者呈现“热”的病理特点。其中输入病例证型以湿邪郁肺型为主,占65.00%,100%的患者呈现“湿”的病理特点,55.00%呈现“热”的病理特点;本地病例证型以邪热壅肺为主,占56.25%,93.75%的患者呈现“热”的病理特点,81.25%呈现“湿”的病理特点。结论:本次疫病在岭南地区的疫性属于以湿邪和热邪为主导的“湿热疫”,病机特点为湿热并重;输入性病例多表现为以湿邪为患的“湿疫”,有化热的趋势和倾向,病机特点为湿重于热;本地病例多表现为以热邪为主的“温热疫”,病机特点为热重于湿。此次新冠肺炎不同地区存在不同疫性的可能,辨证和治疗要遵守三因制宜的原则。

Exploring the Epidemic Situation of Corona Virus Disease in Lingnan Area Based on Clinical Syndrome of Traditional Chinese Medicine

Objective:To explore the nature of Cor-ona Virus Disease 2019(COVID-19)in the Lingnan area from the characteristics of clinical syndromes in traditional Chinese medicine by analyzing the clinical data of patients with COVID-19 treated in Guangdong Second Provincial General Hospital so as to better guide clinical syndrome differentiation and treatment.Methods:The clinical data of 36 patients with COVID-19 admitted to the Guangdong Second Provincial General Hospital were collected,including 20 imported cases and 16 local cases.The clinical data and syndrome characteristics of all cases,imported cases and local cases were analyzed.Results:The age distribution of patients with COVID-19 was relatively wide,with an average age of 45 years.Most of the patients were male.Imported cases and local infected cases account for 55.56%and 44.44%respectively.Syndrome types of all cases are mainly damp pathogen stagnating lung type and heat pathogen stagnating lung type,accounting for 44.44%and 38.89%respectively.The pathological characteristics of dampness presented in 91.67%of patients and the pathological characteristics of heat presented in 71.22%of patients.Among the imported cases,damp pathogen stagnating lung type is the main type,accounting for 65.00%;the pathological characteristics of dampness presented in 100%of patients while the pathological characteristics of heat presented in 55.00%of them.Among the local infected cases,heat pathogen stagnating lung type is the main type,accounting for 56.25%;the pathological characteristics of heat presented in 93.75%of patients while the pathological characteristics of dampness presented in 81.25%of them.Conclusions:The epidemic situation in the Lingnan area is dampness-heat epidemics dominated by damp pathogen and heat pathogen with the pathogenesis characterized by emphasis on both dampness and heat.Imported cases are mostly manifested as“damp epidemics”caused by damp pathogen with the trend and tendency of transforming into heat,the pathogenesis is characterized by dampness-heat syndrome with predominant dampness;local cases are mostly manifested as“warm heat epidemics”caused by heat pathogen with the pathogenesis characterized by dampness-heat syndrome with predominant heat.Different regions may have different epidemic potentials,and the principle of adaptation to different situations should be followed for syndrome differentiation and treatment.