35例新型冠状病毒肺炎患者中医临床特征分析Analysis of Chinese Medical Characteristics of 35 Patients with Novel Coronavirus Pneumonia
黄晓青,聂玲辉,黎飞猛,王春,陈高,蔡可可,于超月,黎程
摘要(Abstract):
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。
关键词(KeyWords): 新型冠状病毒肺炎;中医辨证;特征分析
基金项目(Foundation): 广东省名中医传承工作建设项目[粤中医办函(2018)5号]
作者(Author): 黄晓青,聂玲辉,黎飞猛,王春,陈高,蔡可可,于超月,黎程
参考文献(References):
- [1] Zu ckerman AJ,Banatvala JE,Schoub BD,et al. Principles and Practice of Clinical Virology[M]. 6th edition. New Jersey:John Wiley&Sons,Ltd.,2019.
- [2] Ksiazek TG,Erdman D,Goldsmith CS,et al. A novel coronavirus associated with severe acute respiratory syndrome[J].New England Journal of Medicine,2003,348(20):1953-1966.
- [3] Kuiken T,Fouchier RAM,Schutten M,et al. Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome[J]. The Lancet,2003,362(9380):263-270.
- [4] Drosten C,Günther S,Preiser W,et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome[J]. New England Journal of Medicine,2003,348(20):1967-1976.
- [5] Groot RJ,Baker SC,Baric RS,et al. Commentary:Middle east respiratory syndrome coronavirus(MERS-CoV):announcement of the Coronavirus Study Group[J]. Journal of Virology,2013,87(14):7790-7792.
- [6] Zaki AM,Van Boheemen S,Bestebroer TM,et al. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia[J]. New England Journal of Medicine,2012,367(19):1814-1820.
- [7] Sampathkumar P,Temesgen Z,Smith TF,et al. SARS:epidemiology,clinical presentation,management,and infection control measures[C]. Mayo Clinic Proceedings. Elsevier,2003,78(7):882-890.
- [8] Cho SY,Kang JM,Ha YE,et al. MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea:an epidemiological outbreak study[J]. The Lancet,2016,388(10048):994-1001.
- [9] Hui DS,I Azhar E,Madani TA,et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-The latest 2019 novel coronavirus outbreak in Wuhan,China[J/OL]. International Journal of Infectious Diseases,2020,91:264-266.[2020-02-15].
- [10]国家卫生健康委员会.截至2月14日24时新型冠状病毒肺炎疫情最新情况[EB/OL].(2020-02-15)[2020-02-15].http/:/www.nhc.gov.cn/yjb/s7860/202002/0994e4df10c49c199ce6db07e196b61.shtml.
- [11]余学庆,李建生,王至婉,等.肺炎中医证型及症状特征的文献分析[J].上海中医药大学学报,2008,22(2):30-33.
- [12]广东省中医药局.关于印发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)的通知[EB/OL].(2020-1-25)[2020-02-15]. http://szyyj.gd.gov.cn/zwgk/gsgg/content/post_2879085.html
- [13]盛增秀,王英,江凌圳.运用中医温病瘟疫学说抗击非典型肺炎[J].浙江中医杂志,2003,38(6):231-232.
- [14]周铭心.从五运六气辨识与防治新型冠状病毒感染所致肺炎[J/OL].中医学报,2020,35(2):1-5[2020-02-03].https://kns8.cnki.net/KCMS/detail/41.1411.R.20200202.1043.001.html?uid=WEEvREcwSlJHSldTTEYzVTFPV2k1VVc0c0h1ZlpIVWNTdERocnFhQmUzaz0=$9A4hF_YAuvQ5obgVAqNKPCYcEjKensW4IQMovwHtwkF4VYPoHbKxJw!!&v=MTEyOTlscVdNMENMTDdSN3FkWitadEZ5M2xWYjdJSkYwPUxTUFJaYkc0SE5ITXJZOUhaT3NQWXc5TXptUm42ajU3VDNm.