曾国飞,杨荟平,张晓宇,李雪娇,杨华

• 1:重庆市中医院

摘要(Abstract)：

目的分析重庆市中医医疗机构新型冠状病毒肺炎(Novel Coronavirus Pneumonia,NCP)的临床及影像特征,以期为中医辨证施治提供参考。方法对重庆市中医医疗机构2019年12月19日至2020年2月2日收治的18例新型冠状病毒肺炎的临床及胸部CT影像资料进行总结分析,包括流行病学史、临床表现、中医辨证、影像特征等。结果 18例患者中,发病前14 d内与疫区相关人员有密切接触史者15例,1例来自武汉;18例中发热15例,以中、低热为主;中医辨证分型以湿邪郁肺证和邪热壅肺证为主,分别为8例和7例;16例为双肺受累,以多个肺段受累为主要表现,18例患者共计91个肺段受累,主要位于肺段外带或内、外带同时受累,无单独肺段内带受累患者;CT上以磨玻璃影为主要表现,共67个肺段(73.63%),辅以间质改变和实变。结论重庆市中医医疗机构收治的新型冠状病毒肺炎患者具有起病隐匿、临床症状轻等特点,胸部CT表现具有一定的特征,可以作为中医辨证施治的重要参考。

关键词(KeyWords)： 新型冠状病毒肺炎;中医;诊断;CT

Abstract:

Keywords:

基金项目(Foundation): 重庆市科研院所绩效激励引导专项项目(cstc2018jxjl130078);; 成都中医药大学医院专项课题(YYZX20180051);; 重庆市科卫联合医学科研项目(2019QNXM010)

作者(Author): 曾国飞,杨荟平,张晓宇,李雪娇,杨华

参考文献(References)：

• [1] Lu R,Zhao X,Li J,Niu P,et al. Genomic characterisation and epidemiology of 2019 novel coronavirus:implications for virus origins and receptor binding[J]. Y Lancet,2020(20):30251-30258.
• [2]国家卫生健康委办公厅，国家中医药管理局办公室.新型冠状病毒感染的肺炎诊疗方案(试行第四版)[EB/OL].(2020-01-27)[2020-02-04]. http：//www.nhc.gov.cn/yzygj/s7653p/202001/4294563ed35b43209b31739bd0785e67/files/a9309111267475a99d4306962c8bf78.pdf
• [3] Kloth C,Thaiss WM,Beck R,et al. Potential role of CT-textural features for differentiation between viral interstitial pneumonias,pneumocystis jirovecii pneumonia and diffuse alveolar hemorrhage in early stages of disease:a proof of principle[J]. BMC Med Imaging,2019,19(1):39.
• [4] Chan FYY,Lui CT,Tse CF,Poon KM. Decision rule to predict pneumonia in children presented with acute febrile respiratory illness[J]. Am J Emerg Med,2020(19):30848-30851.
• [5]刘国华，文洁珍.自拟清热平喘汤对小儿重症病毒性肺炎(风热闭肺证)免疫功能、炎症因子和中医证候积分的影响[J].中国中医急症，2016,23(10):1952-1954.
• [6]范逸品，王燕平，张华敏，等.试析从寒疫论治新型冠状病毒(2019-nCoV)感染的肺炎[J/OL].中医杂志，2020:1-6[2020-02-06]. http：//kns.cnki.net/kcms/detail/11.2166.R.20200206.1519.007.html.
• [7] Afadzi M,Foss?K,Andersen HK,et al. Image quality measured from ultra-low dose chest computed tomography examination protocols using 6 different iterative reconstructions from 4 vendors,a phantom study[J]. J Comput Assist Tomogr,2020,44(1):95-101.
• [8] Kunihiro Y,Tanaka N,Kawano R,et al. Differential diagnosis of pulmonary infections in immunocompromised patients using high-resolution computed tomography[J]. Eur Radiol,2019,29(11):6089-6099.
• [9]国家卫生健康委办公厅，国家中医药管理局办公室.新型冠状病毒感染的肺炎诊疗方案(试行第五版)[EB/OL].(2020-02-05)[2020-02-05]. http：//www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440/files/260301a393845fc87fcf6dd52965ecb.pdf
• [10] Chen N,Zhou M,Dong X,et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan,China:a descriptive study[J]. Lancet,2020(20):30211-30217.
• [11]李太生，曹玮，翁利，等.北京协和医院关于“新型冠状病毒感染的肺炎”诊疗建议方案(V2.0)[J/OL].协和医学杂志，2020:1-5[2020-02-04]. http：//kns.cnki.net/kcms/detail/11.5882.r.20200130.1430.002.html.
• [12]谷孝芝，陈剑坤，李际强.呼吸道病毒检测阳性老年肺炎患者中医证候研究[J].中国中医急症，2018,237(1):13-15.
• [13] Thomas J,Pociute A,Kevalas R,et al. Blood biomarkers differentiating viral versus bacterial pneumonia aetiology:a literature review[J]. Ital J Pediatr,2020,46(1):4.
• [14] Carmen LC,Esther B,Christine CG,et al. Practical Guidance for Clinical Microbiology Laboratories:Viruses Causing Acute Respiratory Tract Infections[J]. Clin Microbiol Rev,2019,32(1):e00042-18.
• [15]靳英辉，蔡林，程真顺，等.新型冠状病毒(2019-nCoV)感染的肺炎诊疗快速建议指南(标准版)[J/OL].解放军医学杂志，2020:1-20[2020-02-04]. http：//kns.cnki.net/kcms/detail/11.1056.r.20200201.1338.003.html.
• [16]管汉雄，熊颖，申楠茜，等. 2019新型冠状病毒(2019-nCoV)肺炎的临床影像学特征初探[J/OL].放射学实践，2020:1-6[2020-02-04]. https：//doi.org/10.13609/j.cnki.1000-0313.2020.02.001.
• [17] Ishiguro T,Kobayashi Y,Uozumi R,et al. Viral pneumonia requiring differentiation from acute and progressive diffuse interstitial lung diseases[J]. Intern Med,2019,58(24):3509-3519.