南京地区42例新型冠状病毒肺炎临床特征及中医证候初探

目的?分析南京地区新型冠状病毒肺炎确诊患者的临床特征及中医证候特点，为临床诊疗提供依据。方法?对符合新型冠状病毒肺炎诊断标准的42例患者（2020年1月21日至2月5日，南京中医药大学附属南京医院），采集人口学资料、流行病学资料、中医证候信息、血液检查数据及胸部CT平扫报告等进行研究分析。结果?南京地区新型冠状病毒肺炎确诊患者平均年龄（43.02±16.80）岁，男性居多，95%有确诊患者密切接触史或湖北地区旅居史，40%为家庭聚集性病例。临床分型以普通型居多（93%）。患者外周血白细胞总数正常或减少，多数患者出现C-反应蛋白和红细胞沉降率增高，93%患者见有病毒性肺炎胸部影像学特征改变。主要症状为咳嗽、发热、肌肉酸痛、咯痰、汗出、口渴、疲劳乏力等；舌象以红舌为主，薄、白、腻苔多见。中医证型主要为初期的湿困肺卫证（69%）和热毒郁肺证（31%）。不同证型的发病人群性别、平均年龄分布情况无统计学差异，不同证型的发病人群发热等级有统计学差异（P<0.05）。结论?南京地区新型冠状病毒肺炎初步分析以湿困肺卫证为主，病理因素与湿、热、毒、虚相关，湿毒是其病理核心。 

A Preliminary Study on the Clinical Characteristics and Chinese Medical Syndrome of 42 Cases of COVID-19 in Nanjing

OBJECTIVE?To investigate the clinical characteristics and TCM syndrome features of COVID-19 patients in Nanjing area， so as to provide basis for clinical diagnosis and treatment. METHODS?The demographic data， epidemiological data， TCM syndrome information， blood examination data and chest CT plain scan reports of 42 patients who met the diagnostic criteria of COVID-19 (Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine， from January 21 to February 5， 2020) were collected and analyzed. RESULTS?The average age of COVID-19 patients in Nanjing was about 43 years old， most of them were male， 95% of them had the history of close contact with the confirmed patients or a history of travelling and living in Hubei， 40% of them were familial aggregation cases. Most of the clinical types were ordinary type (93%). The total number of leukocytes in peripheral blood of patients was normal or decreased， C-reactive protein and erythrocyte sedimentation rate increased in most patients， and 93% of patients had chest imaging features of viral pneumonia. The main symptoms were cough， fever， muscle soreness， expectoration， sweating， thirst， fatigue. The main tongue features were red tongue， thin， white and greasy coat. The main Chinese medical syndromes were dampness trapped in lung (69%) and heat-toxicity stagnation in lung (31%). There was no significant difference in gender and average age distribution among different syndrome types， but there was statistical difference in fever grade among different syndrome types. CONCLSION?The preliminary analysis of COVID-19 in Nanjing is mainly based on the syndrome of dampness trapped in lung， the pathological factors are all related to dampness， heat， toxicity and deficiency， and the core of its pathology is "damp-toxicity".