75例新型冠状病毒肺炎患者中医证候与肺部CT影像相关性分析

Correlation between traditional Chinese medicine syndromes and CT imaging in 75 cases with COVID-19 pneumonia

关键词:  新型冠状病毒肺炎  中医证候  肺部CT  肺纤维化

Key words:  COVID-19  traditional Chinese medicine syndrome  lung CT  pulmonary fibrosis

摘要:

[目的] 对新型冠状病毒肺炎（简称新冠肺炎，COVID-19）患者中医证候与肺部计算机断层扫描（CT）影像的相关性进行分析，为中医药治疗提供参考。[方法] 对武汉市中医院2019年12月20日—2020年1月31日，收治的75例COVID-19患者信息进行整理，采用预先设置的数据提取表收集中医证型与肺部CT影像等信息，根据中医证型不同进行分组，评估不同证型、不同病情阶段的CT影像差异，探索中医证型与CT影像的关联性。[结果] 湿热并重型COVID-19患者肺部病变以单肺或双肺单发或者多发病灶为主，影像上表现为小斑片或大片状磨玻璃样密度影或结节影；寒湿内侵型、湿毒闭肺型肺部CT病灶变密实，可见空气支气管征，磨玻璃样密度影与实变影或条索影共存，部分患者出现少量胸腔积液；阴气耗伤型双肺呈弥漫性病变，严重时呈“白肺”，可见有肺纤维化。[结论] COVID-19患者的中医证候与肺部CT影像具有相关性，对中西医结合诊治COVID-19提供了新的思路。

Abstract:

[Objective] To explore the correlation between traditional Chinese medicine(TCM) syndromes of patients with COVID-19 pneumonia and CT images of lungs.[Methods] The information of 75 patients with new coronary pneumonia admitted to Wuhan Hospital of Traditional Chinese Medicine from December 20th,2019 to January 31st,2020 was sorted out,and the pre-set data extraction table was used to collect information such as TCM syndrome types and lung CT images. Different TCM syndromes were divided into groups to evaluate the differences in CT images of different syndromes and different stages of disease. A retrospective analysis was performed on the correlation between TCM syndromes and CT images of lungs in 75 patients with COVID-19 pneumonia.[Results] The lung lesions of patients with hot and severe COVID-19 pneumonia were mainly in the early stages of the lungs,with single or double lungs being single or multiple lesions,and the images showed small patches or large ground-glass densities or nodules. The lung lesions of the cold and wet internal invasion type and the wet-to-closed lung type are progressive,and the lung CT lesions become denser,air bronchus signs can be seen,and ground glass-like density shadows can be coexisted with consolidation or strip shadows. A small amount of pleural effusion was present in some patients CT of yin qi wearing lung showed diffuse lesions of both lungs in severe stage,and "white lung" in severe cases and pulmonary fibrosis.[Conclusion] TCM syndromes of COVID-19 pneumonia have correlation with CT images of the lungs,which provides new ideas for the diagnosis and treatment of COVID-19 with integrated traditional Chinese and Western medicine.