Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions”

Xiao-hua XU; Heng WENG; Ze-hui HE; Huai-ti WANG; Li LI; Yun-tao LIU; Li-juan TANG; Xin YIN; Bang-han DING; Jian-wen GUO; Zhong-de ZHANG

doi:10.13422/j.cnki.syfjx.20220112

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Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions”

更新时间：2022-01-13

- Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions”
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 28, Issue 4, Pages: 172-180(2022)
- 作者机构：
  
  1.广州中医药大学第二临床医学院，广州 510006
  2.广州中医药大学第二附属医院，广州 510120
  3.瑞丽市中医傣医医院，云南瑞丽 678699
  4.邢台市中医院，河北邢台 054001
  5.广东省中医急症研究重点实验室，广州 510120
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20220112
  CLC： R285;R289;R22;R2-031;R33
- Received：23 August 2021，
  
  Published Online：14 December 2021，
  
  Published：20 February 2022
- 稿件说明：
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徐晓花,翁衡,何泽慧等.基于“三因制宜”理论探讨两地COVID-19的中医证治特点[J].中国实验方剂学杂志,2022,28(04):172-180.

XU Xiao-hua,WENG Heng,HE Ze-hui,et al.Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions”[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(04):172-180.
徐晓花,翁衡,何泽慧等.基于“三因制宜”理论探讨两地COVID-19的中医证治特点[J].中国实验方剂学杂志,2022,28(04):172-180. DOI： 10.13422/j.cnki.syfjx.20220112.

XU Xiao-hua,WENG Heng,HE Ze-hui,et al.Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions”[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(04):172-180. DOI： 10.13422/j.cnki.syfjx.20220112.

摘要

目的

通过分析河北邢台及云南瑞丽新型冠状病毒肺炎（COVID-19）患者中医证治的异同，探讨三因制宜理论在COVID-19防治中的指导价值，对其在新突发传染病防治中的指导意义展开思考。

方法

通过电子病历系统（HIS）回顾性收集两家医院COVID-19患者一般资料及中医四诊信息，获得中药处方信息，采用SPSS 18.0对一般信息及证候资料进行描述性统计；使用广东省中医院大数据智能处理与知识服务系统对中药进行频数统计及关联规则分析，并对症-药进行热图-层次聚类分析。

结果

共纳入COVID-19患者175人，其中河北邢台70人，以中青年男性为主，临床多见发热、汗出异常、疲倦乏力等表现，主要病机为寒湿困表、郁热伤阴，寒、湿、虚征象明显，治疗上以宣表化湿为主，兼泻郁热，核心方药包括茯苓、苦杏仁、石膏、陈皮、藿香等。云南瑞丽105人，以青年女性为主，临床症状不明显，多为无症状或轻型患者，湿阻肺胃为其主要病机，湿、热征象明显，治疗上以健脾化湿、轻清宣肺为主，核心方药包括茯苓、白术、甘草、薏苡仁、桔梗、金银花、藿香等。

结论

两地病例临床特征、中医证候特点及处方用药存在差异，与COVID-19发生的时间、地域及人群特征可能存在内在联系，三因制宜理论有助于理解其内在关联，并在临床论治中发挥理论指导作用。

Abstract

Objective

To explore the guidance value of “treatment of disease in accordance with three conditions” theory in the prevention and treatment of corona virus disease 2019（COVID-19） based on the differences of syndromes and traditional Chinese medicine（TCM） treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases.

Method

Demographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system （HIS） of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas.

Result

A total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai，dominated by young and middle-aged males，had clinical symptoms of fever， abnormal sweating，and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat， with manifest cold， dampness， and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness， accompanied by draining depressed heat. The core Chinese medicines used are Poria，Armeniacae Semen Amarum，Gypsum Fibrosum，Citri Reticulatae Pericarpium，and Pogostemonis Herba. By contrast，the 105 patients in Ruili， dominated by young females， had atypical clinical symptoms， and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach， with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen， resolving dampness， and dispersing Qi with light drugs. The core Chinese medicines used are Poria，Atractylodis Macrocephalae Rhizoma，Glycyrrhizae Radix et Rhizoma，Coicis Semen，Platycodonis Radix，Lonicerae Japonicae Flos， and Pogostemonis Herba.

Conclusion

The differences in clinical characteristics， TCM syndromes， and medication of COVID-19 patients from the two places may result from different regions，population characteristics， and the time point of the COVID-19 outbreak. The “treatment of disease in accordance with three conditions” theory can help to understand the internal correlation and guide the treatments.

关键词

Keywords

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