64例新型冠状病毒肺炎普通型患者中医临床特征分析

目的：分析新型冠状病毒肺炎普通型患者一般情况及中医临床特征。方法：选取2020年2月5日至2月20日温州医科大学附属第二医院收治的新型冠状病毒肺炎普通型患者64例，于入院第1天采集流行病学资料及血常规、C反应蛋白、首发症状、舌象等信息，依据《新型冠状病毒肺炎中医诊疗手册》进行辨证。结果：新型冠状病毒肺炎普通型患者年龄（48.8±12.9）岁，男女比为1.56:1；14例（占21.88%）有武汉/湖北旅居史，38例（占59.38%）有确诊患者密切接触史；15例（占23.44%）患者白细胞计数下降，17例（占26.56%）患者淋巴细胞计数下降，35例（占54.69%）患者Ｃ反应蛋白升高；首发症状以发热（42例，占65.63%）、咳嗽（9例，占14.06%）多见，6例（占9.38%）患者无症状；舌象以舌质红黄腻苔（14例，占21.88%）、舌质淡红薄白腻苔（8例，占12.50%）、舌质红白腻苔（8例，占12.50%）多见；中医证型分为寒湿疫毒袭肺证6例（占9.38%）、湿热疫毒蕴肺证58例（占90.62%），湿热疫毒蕴肺证中热重于湿型20例（占34.48%）、湿重于热型38例（占65.52%）。结论：新型冠状病毒肺炎普通型的证型以湿热疫毒蕴肺证为主，涉及病理因素包括寒、热、湿、毒、虚，湿毒是核心病机。

Analysis on Chinese medical clinical characteristics of 64 patients with common type COVID-19

Objective: To investigate the general features and distribution of Chinese medical syndrome of common type COVID-19 patients. Methods: A total of 64 common type COVID-19 patients from the Second Affiliated Hospital of Wenzhou Medical University during February 5 to February 20 2020 were enrolled. The epidemiological date, including blood routine, C-reactive protein, initial symptom and tongue image were collected on the first day of admission, and analyzed and differentiated according to traditional Chinese medicine diagnosis and treatment of COVID-19. Results: The average age of common type COVID-19 patients was (48.8±12.9), the ratio of male to female was 1.56:1. Of all patients, 14 cases (21.88%) had the history of visiting or living in Wuhan/Hubei, 38 cases (59.38%) had the history of close contact with the confirmed patients, 15 cases (23.44%) had decreased count of leukocyte, 17 cases (26.56%) had decreased lymphocyte count and 35 cases (54.69%) had increased C reactive protein. Most of the initial symptoms were fever (42 cases, 65.63%) and cough (9 cases, 14.06%), but 6 cases (9.38%) had no symptoms. The main tongue features were red tongue with yellow greasy coat (14 cases, 21.88%), light red with white thin and greasy coat (8 cases, 12.50%), red tongue with white greasy coat (8 cases, 12.50%). The Chinese medical syndrome were present in 6 cases with dampness-cod pestilence attack lung (9.38%), and dampness-heat pestilence accumulate lung in 58 cases (90.62%). Dampness-heat pestilence accumulate lung included 20 cases (34.48%) of heat predominating over dampness and 38 cases (65.52%) of dampness predominating over heat. Conclusion: The main type of the Chinese medical syndrome of COVID-19 is dampness-heat pestilence accumulate lung with the pathological factors all related to cold, heat, dampness, toxicity and deficiency, and “damp-toxicity” is the its critical pathology.