178例SARS恢复期患者中医证候观察

目的探讨SARS恢复期患者中医证候特点以指导临床辨证.方法在小汤山SARS定点医院观察总结了178例SARS恢复期患者中医证候.并进行归纳、总结出恢复期证候特点以指导临床辨证.结果 SARS恢复期患者中医辨证属肺脾气虚,夹湿夹热.舌脉体现为气虚湿阻,夹热夹瘀.恢复期患者以肺脾气虚、余邪未尽,夹湿夹热为病机特征.主症表现为乏力、咳嗽、气短、汗出、食欲不振、尿黄、口渴不欲饮,部分患者伴有低热.舌象以淡黯舌、黯红舌,白腻苔、黄腻苔多见.结论热毒、湿浊是SARS的主要发病因素.从症状舌脉观察,伤阴症状不典型,而气虚症状多见.气虚运化无力,湿热瘀滞,故舌象可见瘀点瘀斑,提示瘀也是恢复期的重要病理因素.故恢复期治疗一方面益气扶正,一方面注意余邪未尽,湿热瘀滞,治当清热利湿、活血化瘀,有助于患者的早日康复并防止病情反复.

Study on TCM Characteristics of Symptom Complex Law of 178 Sufferers in Convalescence Period of SARS

Objective Inquiry into the characteristics of symptom complex law of the sufferers in convalescence period of SARS to guide the clinic dialectical. Methods In Xiaotangshan fixed-point hospital, we observed 178 cases' symptom complex law in convalescent period and summarized the TCM characteristic of SARS. Results The sufferers' symptom complex law in convalescence period belongs to deficiency of lung qi, spleen qi and internal accumulation of damp heat. Tongue and pulse show qi deficiency with damp stagnancy, heat and blood stasis. The characteristics of pathological mechanism are deficiency of lung qi and spleen qi, remained evil and damp-heat. The main performance is: tired, cough, shortness of breath, sweating, poor appetite, yellowish urine, thirsty but without desire of drinking, parts of sufferers' companions is low fever. Pale dark tongue, white coating and yellow coating can always be observed in tongue manifestation. Conclusion Hot poison and damp stagnancy are the main factors. Damp has the characteristics of glue which causes the state of the illness lingers, the hot poison not exhausted, heat and damp intertexture, then the conditions relapse easily again and again. Observing from the symptoms, tongue and pulse, yin deficiency is atypical, however qi deficiency can always be observed, which causes damp-heat stagnancy and blood stasis, then ecchymosis can be observed in tongue manifestation, which tell us blood stasis is also an important pathologic factor. So we should invigorate qi and clear away damp-heat and promote blood circulation by removing stasis at the same time, that is beneficial to the sufferer to get over soon and prevent the relapse of illness.