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1.湖北省中西医结合医院, 武汉 430021
2.中国中医科学院 西苑医院, 北京 100091
徐波,硕士,主治医师,从事中西医结合呼吸病研究,E-mail:1101979057@qq.com
张继先,硕士,主任医师,从事中西医结合呼吸病研究,E-mail:jxzhang1607@163.com
苗青,博士,主任医师,从事中西医结合呼吸病研究,E-mail:miaoqing55@sina.com
网络出版日期:2020-02-25,
纸质出版日期:2020-06-20
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徐波,范存愈,邹义龙等.46例新型冠状病毒病中医证候学分析[J].中国实验方剂学杂志,2020,26(12):14-17.
XU Bo,FAN Cun-yu,ZOU Yi-long,et al.Analysis of Traditional Chinese Medicine Syndromes of 46 Cases of COVID-19[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(12):14-17.
徐波,范存愈,邹义龙等.46例新型冠状病毒病中医证候学分析[J].中国实验方剂学杂志,2020,26(12):14-17. DOI: 10.13422/j.cnki.syfjx.20201029.
XU Bo,FAN Cun-yu,ZOU Yi-long,et al.Analysis of Traditional Chinese Medicine Syndromes of 46 Cases of COVID-19[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(12):14-17. DOI: 10.13422/j.cnki.syfjx.20201029.
目的
2
应用聚类分析方法对46例新型冠状病毒病(COVID-19)患者进行中医证候学分析。
方法
2
对46例COVID-19患者中医症状、体征、舌象、脉象四诊信息,进行频数分析及聚类分析,结合临床专业知识归类总结COVID-19患者的中医证型,并结合证候采集中位天数分析其演变规律。
结果
2
46例COVID-19患者主要症状和体征:发热(频次39,占比84.8%),纳差(频次44,占比95.7%),乏力(频次42,占比91.3%),喘息憋气(频次35,占比76.1%),口干渴(频次21,占比45.7%),胸闷气短(频次20,占比43.5%),大便溏(频次6,占比13%),舌红(频次30,占比65.2%),苔黄腻(频次27,占比58.7%),脉滑(频次30,占比62.5%)。中医证型分为湿热并重证(13例),湿毒闭肺证(10例),热郁胆经证(7例),湿重于热证(5例),阴伤气耗证(5例),寒湿内侵证(4例),湿毒血瘀证(2例)。按其发病时间依次为寒湿内侵证(中位天数6.5 d),湿重于热证(10 d),湿热并重证(10 d),湿毒闭肺证(11.5 d),热郁肝胆证(13 d),湿毒血瘀证(15 d),阴伤气耗证(16 d)。
结论
2
46例COVID-19患者中,湿热证最为常见,其后为热郁肝胆证、阴伤气耗证,寒湿内侵证,湿毒血瘀证。病机演变为湿邪向热、毒进展,后期出现耗伤气阴表现。
Objective
2
To analyze the traditional Chinese medicine(TCM) syndromes of 46 patients with coronavirus disease-2019 (COVID-19) by cluster analysis method.
Method
2
The 46 COVID-19 patients with TCM symptoms
signs
tongue and pulse were analyzed by frequency analysis and clustering analysis
and the TCM syndrome types of COVID-19 patients were classified and summarized by combining clinical expertise
and the evolution law was analyzed by combining the median days of the syndrome collection.
Result
2
The major signs and symptoms of the 46 patients with COVID-19: fever (frequency of 39
accounted for 84.8%)
poor appetite (frequency of 44
95.7%)
fatigue (frequency of 42
91.3%)
wheezing breath (frequency of 35
76.1%)
dry mouth (frequency of 21
45.7%)
lung condition short (frequency of 20
43.5%)
defecate pond (frequency of 15
32.6%)
red tongue (frequency 30
accounting for 65.2%)
yellowish moss (frequency 27
accounting for 58.7%)
and slimy pulse (frequency 30
accounting for 62.5%). TCM syndromes were divided into seven types
i.e. dampness and heat syndrome (13 cases)
dampness and toxin syndrome (10 cases)
heat stasis syndrome (7 cases)
dampness and heat syndrome (5 cases)
cold dampness internal invasion syndrome (4 cases)
dampness poison blood stasis syndrome (2 cases).According to the time of onset
there were cold and dampness syndrome (median days 6.5 days)
dampness was heavier than heat syndrome (10 days)
dampness and heat syndrome (10 days)
dampness and heat syndrome (11.5 days)
heat stagnation of liver and gallbladder syndrome (13 days)
dampness and blood stasis syndrome (15 days)
and Yin injury syndrome (16 days).
Conclusion
2
Among the 46 cases of COVID -19
damp-heat syndrome was the most common
followed by heat stagnation of liver and gallbladder syndrome
Yin injury and gas consumption syndrome
cold and damp internal invasion syndrome
and dampness and blood stasis syndrome. The pathogenesis of the disease evolved into heat and poison
and later appeared to consume Qi Yin performance.
国家卫生健康委员会 . 关于印发新型冠状病毒感染的肺炎诊疗方案(试行第五版)的通知 [EB/OL]. http//www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtml http//www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtml , 2020-02-05 / 2020-02-05 .
苗青 , 丛晓东 , 王冰 , 等 . 新型冠状病毒肺炎的中医认识与思考 [J]. 中医杂志 , 2020 , doi: 10.13288/j.11-2166/r.2020.04.003 http://dx.doi.org/10.13288/j.11-2166/r.2020.04.003 .
国家技术监督局 . 中医临床诊疗术语·证候部分 [M]. 北京 : 中国标准出版社 , 1997 .
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