[1]曹雪,刘小莹,郭团茂,等.陕西咸阳地区新型冠状病毒肺炎中医证候特征及其分析[J].西部中医药,2021,34(03):7-10.[doi:10.12174/j.issn.2096-9600.2021.03.02]
 CAO Xue,LIU Xiaoying,GUO Tuanmao,et al.The Characteristics of TCM Syndrome of COVID-19 in Xianyang District and Its Analysis[J].Western Journal of Traditional Chinese Medicine,2021,34(03):7-10.[doi:10.12174/j.issn.2096-9600.2021.03.02]
点击复制

陕西咸阳地区新型冠状病毒肺炎中医证候特征及其分析
分享到:

《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
34
期数:
2021年03期
页码:
7-10
栏目:
出版日期:
2021-03-15

文章信息/Info

Title:
The Characteristics of TCM Syndrome of COVID-19 in Xianyang District and Its Analysis
作者:
曹雪, 刘小莹, 郭团茂, 蒲秀玲, 庞乐, 苏海生, 袁军民
咸阳市中心医院,陕西 咸阳 712000
Author(s):
CAO Xue, LIU Xiaoying, GUO Tuanmao, PU Xiuling, PANG Le, SU Haisheng, YUAN Junmin
Xianyang City Central Hospital, Xianyang 712000, China
关键词:
新型冠状病毒肺炎中医证候辨证论治咸阳地区
Keywords:
COVID-19TCM syndromesyndrome differentiation and treatmentdistrict
分类号:
R285
DOI:
10.12174/j.issn.2096-9600.2021.03.02
摘要:
目的通过17例新型冠状病毒肺炎(简称“新冠肺炎”)确诊患者的临床资料,分析咸阳地区新冠肺炎患者的中医证候特征,为今后临床辨证治疗新冠肺炎提供依据。 方法分析2020年1月20日至2月10日我院收住确诊的17例新冠肺炎患者的一般情况、主要症状和舌脉在初期、中期、重症期和恢复期的特征。 结果1)本地区确诊的17例患者均为湿热疫毒所致;男性居多(10例),平均年龄(39.70±11.16)岁,发病到确诊时间平均为(4.4±3.6)d,有基础疾病者占23.5%(4/17),病发前2周有湖北地区旅居史者占82.4%(14/17),与确诊患者有密切接触史者占52.9%(9/17);呈家庭聚集性发病者占47.1%(8/17);普通型居多82.4%(14/17)。2)首发发热者占76.5%(13/17);发热患者体温范围37.4~39.0℃,平均体温(38.01±0.44)℃;发热持续时间1~15天不等,平均(6.01±0.33)d。3)初期17例寒湿郁肺型排在前6位的症状是发热、咽干、咳嗽、倦怠乏力、咳痰、恶心呕吐;舌质多淡红56.3%(9/16)、苔多白腻81.3%(13/16);以濡脉为主68.8%(11/16);中期11例疫毒闭肺型排前6位症状是倦怠乏力、胸闷、咳痰、脘痞、气短及发热、喘息、纳差(后3个并列);舌质多红54.5%(6/11)、苔黄腻或黄燥63.6%(7/11);以滑数脉为主63.6%(7/11);重症期2例内闭外脱型均有神志异常、咳痰、气短、大便干症状;均表现为舌质紫暗、苔厚腻;脉浮大无根或滑数。恢复期共16例,其症状排前5位的是倦怠乏力、纳差、气短、大便异常和咽干;舌质淡62.5%(10/16)、苔白腻75.0%(12/16);脉细弱87.5%(14/16)。 结论咸阳地区新冠肺炎病性属湿热疫毒;病位在上焦肺脏,可及中焦脾胃;临床分为寒湿郁肺、疫毒闭肺、内闭外脱和脾肺气弱4型进行辨证治疗。
Abstract:
ObjectiveTo analyze the characteristics of TCM syndromes of COVID-19 in Xianyang district and provide the reference for clinical syndrome differentiation and treatment through analyzing clinical data of 17 cases of confirmed COVID-19. MethodsGeneral conditions, main symptoms, the characteristics of tongues and pulses at the primary, moderate, severe and the rehabilitation stages of 17 confirmed COVID-19 patients who were hospilized from January 20, 2020 to February 10, 2020 were analyzed. Results1)All 17 patients confirmed in the district were caused by damp-heat epidemic toxin; most of the patients were male (ten cases), average ages (39.70±11.16) years, average time from attacking to confirming(4.4±3.6)d, the patients with basic diseases held 23.5%(4/17), the ones who have travelled to Hubei district two weeks before the attacking occupied 82.4%(14/17), these who had close contact with the confirmed patients held 52.9% (9/17); these showed family aggregation held 47.1%(8/17); most of them were common type in clinic and they held 82.4% (14/17). 2)These who started with fever held 76.5% (13/17); the temperature of fever patients ranged between 37.4 and 39.0℃, average body temperature(38.01±0.44)℃; the duration of fever ranged from one to 15 days, average (6.01±0.33)d; 3)The symptoms ranked in the first six positions of 17 patients of cold-dampness and stagnation of lung pattern were fever, dry throat, cough, fatigue, expectoration, nausea and vomiting; tongues were of light red 56.3% (9/16), most of tongue coating were white and greasy, 81.3% (13/16); mainly soft pulse, 68.8% (11/16). The top six symptoms of 11 patients of epidemic toxin closing lung pattern were fatigue, choking sensation in chest, expectoration, gastric blockage, being short of breath, fever, panting and poor appetite; most of the tongues were red, 54.5% (6/11), tongue coating yellow and greasy or yellow and drying, 63.6%(7/11); smooth and rapid pulse, 63.6% (7/11), Two patients of unconsciousness and collapse patten manifested abnormal consciousness, expectoration, being short of breath and dry stool; they manifested purple and dark tongue, thick and greasy tongue coating; floating and rootless pulse or smooth and rapid pulse. 16 patients were at rehabilitation stage, the top five symptoms were fatigue, poor appetite, being short of breath, abnormal stool and dry throat; the tongue was light, 62.5% (10/16), white and greasy tongue coating mainly, 75.0% (12/16); thin and weak pulse, 87.5% (14/16). ConclusionThe nature of COVID-19 is of cold-dampness epidemic toxin in Xianyang district; located at lung in upper energizer, it could involve spleen and stomach in the middle energizer; it could be divided into cold-dampness and stagnation of lung pattern, epidemic toxin closing lung pattern, unconsciousness and collapse patten, Qi deficiency of spleen and lung pattern, which are differentiated and treated in clinic.

相似文献/References:

[1]周涛,何彪,霍利,等.不同证型冠心病患者螺旋CT冠状动脉CTA影像分析[J].西部中医药,2015,28(02):130.
[2]玛丽亚,孙学健,严兴海.新疆昌吉地区238例支气管哮喘发作期患者中医证型分布[J].西部中医药,2013,26(12):63.
 MA Liya,SUN Xuejian,YAN Xinghai.TCM Patterns Distribution of 238 Cases of Bronchial Asthma at Exacerbation Stage in Changji of XinJiang[J].Western Journal of Traditional Chinese Medicine,2013,26(03):63.
[3]丁然,陆小左△.慢性乙型肝炎中医证候与舌象客观量化指标相关性的临床研究*[J].西部中医药,2015,28(01):56.
[4]吴强.芍连胃乐片治疗肝郁气滞型慢性萎缩性胃炎32例[J].西部中医药,2017,30(10):77.
 WU Qiang.ShaoLian WeiLe Tablets in Treating 32 Cases of Chronic Atrophic Gastritis of Liver-depression Qi-stagnation Pattern[J].Western Journal of Traditional Chinese Medicine,2017,30(03):77.
[5]陈慕芝,孙红艳,照日格图△.223例类风湿关节炎患者中医证候及实验室指标分析[J].西部中医药,2016,29(05):67.
 CHEN Muzhi,SUN Hongyan,ZHAORI Getu.The Analysis of Lab Indicators and TCM Patterns of 223 Patients with Rheumatoid Arthritis[J].Western Journal of Traditional Chinese Medicine,2016,29(03):67.
[6]王庆,李天一,陈忆莲,等.基于证素探析干燥综合征的中医证候分布规律[J].西部中医药,2018,31(09):81.
 WANG Qing,LI Tianyi,CHEN Yilian,et al.Exploration into TCM Syndrome Distribution Laws of Sjogren′s Syndrome Based on Syndrome Elements[J].Western Journal of Traditional Chinese Medicine,2018,31(03):81.
[7]马云飞,孙旭,杨永,等.乳腺癌的中医证型及用药规律研究[J].西部中医药,2017,30(01):46.
 MA Yunfei,SUN Xu,YANG Yong,et al.Study on TCM Syndrome and Medication Rule of Breast Cancer[J].Western Journal of Traditional Chinese Medicine,2017,30(03):46.
[8]李宁,李应福,谢兴文,等.兰州地区膝关节骨性关节炎的中医证候分布特点[J].西部中医药,2016,29(02):95.
 LI Ning,LI Yingfu,XIE Xingwen,et al.Distribution Features of TCM Syndromes of Knee Osteoarthritis in Lanzhou City[J].Western Journal of Traditional Chinese Medicine,2016,29(03):95.
[9]党民卿,导:王道坤.萎胃灵1号对慢性萎缩性胃炎癌前病变患者中医证候及病理组织学的影响[J].西部中医药,2016,29(07):1.
 DANG Minqing,Director: WANG Daokun.Effects of WeiWeiLing No.1 on TCM Syndromes and Histopathology of the Patients with Precancerous Lesions of Chronic Atrophic Gastritis[J].Western Journal of Traditional Chinese Medicine,2016,29(03):1.
[10]孔咏霞.乳腺癌中医证型与证候要素分布规律文献研究[J].西部中医药,2018,31(03):68.
 KONG Yongxia.Literature Research on Distribution Laws of Syndrome Elements and TCM Patterns of Breast Cancer[J].Western Journal of Traditional Chinese Medicine,2018,31(03):68.
[11]丁潇,邹忆怀△,辛大永,等.北京顺义地区新型冠状病毒肺炎的中医临床证候与CT表现[J].西部中医药,2020,33(S1):16.
 DING Xiao,ZOU Yihuai,XIN Dayong,et al.TCM Clinical Syndromes and CT Manifestations of COVID-19 in Shunyi District of Beijing[J].Western Journal of Traditional Chinese Medicine,2020,33(03):16.
[12]闫向勇,李 俊,燕忠生△.武汉地区新型冠状病毒肺炎中医证候及病机特点[J].西部中医药,2020,33(S1):20.
 YAN Xiangyong,LI Jun,YAN Zhongsheng.On the Characteristics of TCM Patterns and the Pathogenesis of COVID-19 in Wuhan Region[J].Western Journal of Traditional Chinese Medicine,2020,33(03):20.
[13]丁潇,邹忆怀,辛大永,等.北京顺义地区新型冠状病毒肺炎的中医临床证候与CT表现[J].西部中医药,2020,33(04):1.[doi:10.12174/j.issn.1004-6852.2020.04.01]
 DING Xiao,ZOU Yihuai,XIN Dayong,et al.TCM Clinical Syndromes and CT Manifestations of COVID-19 in Shunyi District of Beijing[J].Western Journal of Traditional Chinese Medicine,2020,33(03):1.[doi:10.12174/j.issn.1004-6852.2020.04.01]
[14]闫向勇,李俊,燕忠生.武汉地区新型冠状病毒肺炎中医证候及病机特点[J].西部中医药,2020,33(04):25.[doi:10.12174/j.issn.1004-6852.2020.04.08]
 YAN Xiangyong,LI Jun,YAN Zhongsheng.On the Characteristics of TCM Patterns and the Pathogenesis of COVID-19 in Wuhan Region[J].Western Journal of Traditional Chinese Medicine,2020,33(03):25.[doi:10.12174/j.issn.1004-6852.2020.04.08]
[15]曹雪,刘小莹,郭团茂,等.陕西咸阳地区新型冠状病毒肺炎中医证候特征及其分析[J].西部中医药,2020,33(S1):76.[doi:org /10.1101 /2020.02.06.20020974]
 CAO Xue,LIU Xiaoying,GUO Tuanmao,et al.The Characteristics of TCM Syndrome of COVID-19 in Xianyang District and Its Analysis[J].Western Journal of Traditional Chinese Medicine,2020,33(03):76.[doi:org /10.1101 /2020.02.06.20020974]
[16]鞠娅,浦明之,周运海.从卫气营血理论探讨武汉地区69例新型冠状病毒肺炎患者中医证候[J].西部中医药,2022,35(12):15.[doi:10.12174/j.issn.2096-9600.2022.12.04]
 JU Ya,PU Mingzhi,ZHOU Yunhai.TCM Syndromes of 69 COVID-19 Patients in Wuhan from the Perspective of Defensive Qi and Nutrient Blood Theory[J].Western Journal of Traditional Chinese Medicine,2022,35(03):15.[doi:10.12174/j.issn.2096-9600.2022.12.04]

备注/Memo

备注/Memo:
曹雪(1989—),女,硕士学位,主治医师。研究方向:中医临床症候及规范化研究。陕西省2020年度中医药防治新冠肺炎项目(2020-YJ004)。
更新日期/Last Update: 2021-03-05