摘要
【目的】观察惠州市中心人民医院收治的新型冠状病毒肺炎(COVID-19)确诊患者中医证型分布情况及使用中医药治疗的临床效果。【方法】对61例COVID-19确诊患者的临床症状、中医证型和舌象分布情况进行动态观察,并探讨在国家诊疗指南的基础上,根据中医疫病理论,给予个性化的中医辨证论治的临床效果。【结果】(1)中医证型方面,入院时(治疗前)以痰热蕴肺型为主,共35例(占57.38%),其次为风热犯肺型和气阴两虚型,分别为16例(占26.23%)和7例(占11.48%),而气阴两虚夹瘀型最少,只有3例(占4.92%)。治疗1个疗程后,中医证型仍以痰热蕴肺型为主,增加至48例(占78.69%),较治疗前明显增多,气阴两虚型亦增加至8例(占13.11%),而风热犯肺型和气阴两虚夹瘀型则分别减少至3例(占4.92%)和2例(3.28%)。(2)临床症状方面,入院时(治疗前)患者症状以发热、咳嗽、咳痰为主,其中发热45例(占73.77%),干咳36例(占59.02%),咳痰19例(占31.15%);治疗1个疗程后,患者发热、咳嗽、咳痰等症状明显改善,发热下降至22例(占36.07%),干咳下降至19例(占31.15%),咳痰下降至11例(占18.03%)。(3)舌象方面,入院时(治疗前)患者的舌质改变以舌质红、舌暗红为主,分别有20例(占32.79%)和19例(占31.15%),舌苔改变以舌苔腻、舌苔黄为主,分别有29例(占47.54%)和25例(占40.98%)。治疗1个疗程后,患者的舌象均有所改善。(4)中医药治疗方面,有58例患者坚持使用中医药治疗,中药治疗的接受率为95.08%(58/61),中药治疗总有效率为100.00%(58/58),无死亡病例,其中有2例重症患者转为普通型并治愈出院。【结论】本组病例辨证以痰热蕴肺、风热犯肺、气阴两虚为主,临床表现以发热、咳嗽、咳痰为主;舌质改变以舌质红、舌暗红为主,舌苔以舌苔黄、舌苔腻为主;采用个性化的中医辨证论治可以显著改善COVID-19确诊患者的临床症状。
Objective To observe the distribution of traditional Chinese medicine(TCM)syndrome types in the patients with confirmed coronavirus disease 2019(COVID-19)admitted to Huizhou Municipal Central People’s Hospital and to evaluate the clinical efficacy of TCM treatment.Methods The clinical symptoms,TCM syndrome types and tongue manifestations of 61 patients with confirmed COVID-19 were dynamically observed.Following the national diagnosis and treatment guidelines for COVID-19,the clinical efficacy of personalized TCM syndrome differentiation and treatment based on TCM theories of epidemic disease was evaluated.Results(1)In terms of TCM syndromes,at the time of admission(before treatment),phlegm-heat retention in lung type was predominant and was seen in 35 cases(57.38%),followed by wind-heat attacking lung type and deficiency of both qi and yin type,which were seen in 16 cases(26.23%)and 7 cases(11.48%),respectively.The syndrome type of deficiency of both qi and yin type interweaved with blood stasis was the least and was only seen in 3 cases(4.92%).After one course of treatment,the TCM syndrome type was still dominated by phlegm-heat retention in lung type,and the amount of the cases increased to 48 cases(78.69%),which was significantly more than that before treatment.The amount of the cases of deficiency of both qi and yin type also increased to 8 cases(13.11%),while the amount of the cases of wind-heat attacking lung type and the type of deficiency of both qi and yin interweaved with blood stasis decreased to 3 cases(4.92%)and 2 cases(3.28%),respectively.(2)In terms of clinical symptoms,at the time of admission(before treatment),the symptoms were mainly manifested as fever,cough(characterized by dry cough)and expectoration,which were seen in 45 cases(73.77%),36 cases(59.02%)and 19 cases(31.15%),respectively.After one course of treatment,the symptoms such as fever and cough were significantly improved,and the amount of the patients with fever decreased to 22 cases(36.07%),dry cough decreased to 19 cases(31.15%),and expectoration decreased to 11 cases(18.03%).(3)In terms of tongue manifestations,at the time of admission(before treatment),the tongue nature was characterized by being red or darkish red,which was seen in 20 cases(32.79%)and 19 cases(31.15%),respectively.The tongue coating was characterized by being greasy or yellow,which was seen in 29 cases(47.54%)and 25 cases(40.98%),respectively.After one course of treatment,the tongue manifestations of all patients were improved.(4)In terms of TCM treatment,58 patients adhered to TCM treatment,and the acceptance rate arrived to 95.08%(58/61).The total effective rate of TCM treatment was 100.00%(58/58).No death cases occurred during the treatment,and 2 severe cases were converted to common type and then were cured and discharged.Conclusion In the studied group of 61 cases,the syndrome types are predominated with phlegm-heat retention in lung type,wind-heat attacking lung type and deficiency of both qi and yin type,and the clinical manifestations are mainly manifested as fever,cough and expectoration.The tongue nature of the cases is characterized by being red and dark red,and the tongue coating is characterized by being yellow and greasy.The use of personalized TCM treatment based on syndrome differentiation could significantly improve the clinical symptoms of patients with confirmed diagnosis of COVID-19.
作者
李映姗
钟启腾
曾元桂
陈翠萍
孙惠华
LI Ying-Shan;ZHONG Qi-Teng;ZENG Yuan-Gui;CHEN Cui-Ping;SUN Hui-Hua(Huizhou Municipal Central People’s Hospital,Huizhou 516001 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第7期1466-1472,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
惠州市2020年新型冠状病毒防治专项资助项目(编号:2020SC0707007)。
关键词
惠州市
新型冠状病毒肺炎
疫病
痰热蕴肺
风热犯肺
气阴两虚
辨证论治
Huizhou city
coronavirus disease 2019(COVID-19)
epidemic disease
phlegm-heat retention in lung
wind-heat attacking lung
deficiency of both qi and yin
syndrome differentiation and treatment
