新型冠状病毒奥密克戎变异株感染者核酸转阴后中医证候分布与演变规律研究

Study on the distribution and evolution of traditional Chinese medicine syndromes in patients infected with the SARS-CoV-2 Omicron variant after nucleic acid turned negative

关键词:  奥密克戎变异株  核酸转阴后  证候  演变规律  清金益气颗粒

Key words:  Omicron variant  after nucleic acid turned negative  syndrome  evolution law  Qingjin Yiqi Granule

摘要:

[目的]归纳总结新型冠状病毒奥密克戎变异株感染者核酸转阴后的中医证候分布及演变规律。[方法]收集天津首轮新型冠状病毒奥密克戎疫情全部430例感染者核酸转阴后的中医临床症状、舌象、理化检查等信息，统计在观察的第1、7、14天各临床症状、舌象因子、病位证素、病性证素的频数和频率，分析证候分布特征及变化情况，归纳核酸转阴后的核心证候，并观察应用中药清金益气颗粒治疗对证候演变的影响。[结果]在感染者核酸转阴后，咳嗽、咽部不适、咯痰等呼吸道症状仍是最主要的症状，至第14天时乏力成为出现频率最高的症状，仍有超过10%的感染者遗留呼吸道及消化系统症状；核酸转阴后最常见的病位证素为脾和肺，最常见的病性证素为气虚、热、湿、痰、阴虚，归纳核酸转阴后普遍存在的核心证候为气阴两虚，兼夹痰湿郁热；根据应用中药清金益气颗粒的情况，将感染者分为用药组（178例）和非用药组（252例），对两组各证素的转变情况进行统计分析，观察到第7天时与非用药组相比，用药组的病位证素脾、肺，病性证素热、湿、痰、阴虚、气滞、血虚的频数下降，差异有统计学意义（P＜0.05或P＜0.01），第14天时与非用药组比较，用药组的病位证素脾、肺，病性证素气虚、热、湿、痰、阴虚的频数下降，差异有统计学意义（P＜0.05或P＜0.01）。[结论]气阴两虚，余邪未尽是新型冠状病毒奥密克戎变异株感染者核酸转阴后普遍存在的核心证候，清金益气颗粒能够显著改善其证候，在核酸转阴后及时应用可以促进其康复。

Abstract:

[Objective] To summarize the distribution and evolution of traditional Chinese medicine(TCM) syndromes in patients that were infected by the SARS-CoV-2 Omicron variant after nucleic acid turned negative.[Methods] The information of TCM clinical symptoms, tongue images,physical and chemical examinations of all 430 patients that were infected by the first round of SARS-CoV-2 Omicron epidemic in Tianjin were collected after nucleic acid turned negative. The frequency and ratio of clinical symptoms,tongue image factors,syndrome elements on the 1st,7th and 14th day of observations were counted,and the distribution characteristics and changes of syndromes were analyzed. The core syndromes of the patients after nucleic acid turned negative were summarized,and the effects of Qingjin Yiqi Granules treatment on the evolution of syndromes were observed.[Results] After the nucleic acid of the infected person turns negative,cough,pharyngeal discomfort,phlegm and other respiratory symptoms were still the most important and primary symptoms. By day 14,fatigue was the most frequent symptom,and more than 10% of patients still had respiratory and digestive symptoms. The most common syndrome elements after nucleic acid turned negative were spleen,lung,qi deficiency,heat,dampness,phlegm and yin deficiency. The common core syndromes of patients after nucleic acid turned negative are deficiency of both qi and yin,with phlegm dampness and heat stasis. Depending on the application of traditional Chinese medicine Qingjin Yiqi Granules,divided the patients into the treatment group(178 cases) and the non-treatment group(252 cases). Statistical analysis was made on the transformation of each syndrome element in the two groups,found that compared with the non-treatment group on the 7th day,the frequency of syndrome elements of the treatment group including spleen,lung,dampness,phlegm heat,yin deficiency,qi stagnation and blood deficiency decreased obviously. The differences were statistically significant (P＜0.05 or P＜0.01). On the 14th day,compared with the non-treatment group,the syndrome elements including spleen,lung,qi deficiency,heat,dampness,phlegm and yin deficiency in the treatment group were significantly decreased (P＜0.05 or P＜0.01).[Conclusion] Deficiency of both qi and yin,the remaining evil spirit has not been eliminated,which are the common core syndromes after nucleic acid turned negative of patients with SARS-CoV-2 Omicron infection. Qingjin Yiqi Granules can significantly improve the TCM syndromes of patients,and timely application after nucleic acid turned negative can promote the recovery of patients.