天津市32例新型冠状病毒肺炎（奥密克戎）成人患者中医临床特征分析

Analysis on traditional Chinese medicine clinical characteristics of 32 patients with common type COVID-19 (Omicron) in Tianjin

关键词:  新型冠状病毒肺炎（奥密克戎）  普通型  临床特征  中医证候

Key words:  COVID-19 (Omicron)  common type  clinical characteristics  traditional Chinese medicine syndrom

摘要:

[目的] 分析天津市新型冠状病毒肺炎（奥密克戎）成人普通型患者一般情况及中医临床特征。[方法] 选取2022年1月27日—2月5日于天津海河医院中医病区收治的本土新型冠状病毒肺炎（奥密克戎）成人普通型患者32例，入院后采集流行病学资料及血常规、C反应蛋白、白细胞介素-6（IL-6）、降钙素原、首发症状、舌象等信息并进行辨证。[结果] 研究共纳入32例新型冠状病毒肺炎（奥密克戎）成人普通型患者，包括男13例，女19例，年龄21～71岁，平均年龄（49.34±15.00）岁，其中9例（28.13%）存在基础疾病。流行病学调查发现发热门诊筛查病例1例（3.12%），新型冠状病毒肺炎患者密切接触史12例（37.5%），家庭聚集性发病19例（59.38%）。7例患者（21.87%）白细胞计数、淋巴细胞计数、C反应蛋白和IL-6正常；17例患者（53.12%）出现淋巴细胞计数下降，6例患者（18.75%）淋巴细胞合并白细胞计数减少。首发症状：1例患者（3.13%）无症状，31例患者（96.87%）首发症状为咽干，23例患者（71.88%）有咳嗽症状，9例患者出现发热，1例患者（3.13%）伴味觉、嗅觉减退。舌象：淡红舌25例（78.12%）、红舌7例（28.88%），2例患者（6.25%）舌体胖大有齿痕；黄苔21例（65.63%），其中薄黄苔9例（28.13%）、黄腻苔12例（37.5%）；白苔10例（31.25%），其中薄白苔6例（18.75%）、白腻苔4例（12.5%）；中医证型：湿邪困表证3例（9.37%），瘟热犯卫证24例（75%），热毒袭肺证3例（9.37%），湿蕴脾胃证2例（6.25%）。[结论] 经过研究分析32例新型冠状病毒肺炎（奥密克戎）成人普通型患者中医临床特点，认为温热蕴结，肺气不宣为主要病机，治疗宜以宣肺化湿、清热透邪为主。

Abstract:

[Objective] To investigate the general conditions and traditional Chinese medicine (TCM) clinical features of local common type COVID-19(Omicron) patients in Tianjin.[Methods] A total of 32 common type COVID-19 patients treated in the Tianjin Haihe Hospital from January 27th to February 5th, 2022 were enrolled. The epidemiological data, including blood routine, C-reactive protein, Interleukin-6(IL-6), procalcitonin, initial symptoms and tongue manifestations were collected on admission and differentiated according to TCM diagnosis and treatment of COVID-19.[Results] A total of the 32 adult patients with common-type COVID-19 patients included in the study, including 13 males and 19 females, aged 21 to 71 years, mean age (49.34±15.00), and 9 cases (28.13%) had an underlying disease. Epidemiological investigation found that 1 case(3.12%) was from the fever outpatient department. 12 cases (37.5%) were close contacts of confirmed patients, and 19 cases (59.38%) were family cluster cases. 7 cases(21.87%) had a normal value of white blood cell count, lymphocyte count CRP and IL-6, 17 cases(53.12%) had a decreased lymphocyte count, and 6 cases(18.75%) had a decrease of white blood cell count and lymphocyte count. Initial symptoms:one patient (3.12%) was asymptomatic, 31 patients (96.87%) had dry throat, 23 patients (71.88%) had cough, 9 patients (28.13%) had fever, and one patient (3.12%) was accompanied by decreased taste and smell. The appearance of tongue:there were 25 cases (78.12%) with red tongue, seven cases (21.88%) with red tongue, and 2 cases (6.24%) with big and fat tongue with teeth marks. There were 21 cases (65.63%) with yellow fur, including 9 cases (28.13%) with thin yellow fur and 12 cases (37.5%) with yellow greasy fur. There were 10 cases of white fur (31.25%), including 6 cases of thin white fur (18.75%) and 4 cases of white greasy fur (12.5%). TCM syndrome:there were 3 cases with pathogenic dampness attacking body fur, 24 cases (75%) with heat pestilence attacking body fur, 3 cases (9.37%) with heat pestilence attacking lung, and 2 cases (6.24%) with dampness accumulation in the spleen and stomach.[Conclusion] In this study, the main types of TCM syndrome of COVID-19 is heat pestilence attacking body fur, accompanied with pathogenic dampness. The treatment should be mainly to removing dampness with dispersing lung qi and clearing heat for expulsing pathogen.