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| 上海某方舱医院奥密克戎变异株感染者中医证候特点分析 |
| 修丽娟1,高松2,孙昱玮1,武峰1,覃光辉3,周冰华1,李培雯1,吴静静1,景华4* |
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(1. 海军军医大学(第二军医大学)第二附属医院中医科, 上海 200003;
2. 中国人民解放军联勤保障部队900医院中医科, 福州 350001;
3. 海军军医大学(第二军医大学)第三附属医院中医科, 上海 200438;
4. 海军军医大学(第二军医大学)海军特色医学中心中医科, 上海 200052
*通信作者) |
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| 摘要: |
| 目的 分析上海某方舱医院严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎变异株感染者的中医证候特点。方法 以2022年4月4日至5月24日上海某方舱医院收治的621例SARS-CoV-2奥密克戎变异株感染者作为研究对象，采用电子化的中医证候采集量表在入住方舱医院当天进行信息采集，包括患者的一般资料及常见的临床症状（如发热、头痛、鼻塞、流涕、咳嗽、咳痰等），根据各症状的占比分析核心证候特点。根据患者的症状评分划分证候，比较不同证候患者的病程差异。结果 621例奥密克戎变异株感染患者中30～49岁患者占比最高（49.76%，309/621）；症状以咳嗽、咳痰最为常见，分别占62.32%（387/621）和68.12%（423/621），其他症状包括咽痛、鼻塞、流涕、乏力、肌肉酸痛、头痛等。咳痰以白痰为主，流涕症状以流清鼻涕为主。从临床症状分析奥密克戎变异株感染患者核心的证候特点为寒疫袭肺夹湿夹毒。中医证候以瘟邪袭卫证占比最高，为40.10%（249/621）；其次为热毒犯肺型（29.95%，186/621）和湿邪内阻型（17.55%，109/621），而气阴两虚型占比最低（7.73%，48/621）。气阴两虚型患者的病程较其他3个证候更长（P<0.05）。结论 SARS-CoV-2奥密克戎变异株感染患者核心的中医证候特点为寒疫袭肺夹湿夹毒，以瘟邪袭卫证候最为常见，随着病程的延长有向气阴两虚型转化的趋势。 |
| 关键词: 严重急性呼吸综合征冠状病毒2 奥密克戎变异株 中医证候 方舱医院 新型冠状病毒肺炎 |
| DOI：10.16781/j.CN31-2187/R.20220527 |
| 投稿时间：2022-06-21修订日期：2022-10-04 |
| 基金项目:国家中医药管理局第五批新型冠状病毒肺炎中医药应急专项（2022ZYLCYJ05-8）. |
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| Analysis on traditional Chinese medicine syndrome characteristics of patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant in a shelter hospital in Shanghai |
| XIU Li-juan1,GAO Song2,SUN Yu-wei1,WU Feng1,QIN Guang-hui3,ZHOU Bing-hua1,LI Pei-wen1,WU Jing-jing1,JING Hua4* |
(1. Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200003, China;
2. Department of Traditional Chinese Medicine, No. 900 Hospital of Joint Logistics Support Force of PLA, Fuzhou 350001, Fujian, China;
3. Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200438, China;
4. Department of Traditional Chinese Medicine, Naval Medical Center, Naval Medical University (Second Military Medical University), Shanghai 200052, China
*Corresponding author) |
| Abstract: |
| Objective To analyze the characteristics of traditional Chinese medicine (TCM) syndromes of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in a shelter hospital in Shanghai. Methods A total of 621 patients infected with SARS-CoV-2 omicron variant from Apr. 4 to May 24, 2022 in a shelter hospital in Shanghai were enrolled. The data of the patients, including the general information and common clinical syndromes (such as fever, headache, stuffy nose, runny nose, cough, and sputum), were collected on admission by TCM syndrome electronic scale, and core syndrome characteristics were analyzed base on the proportion of each symptom. The syndromes were divided according to the symptom score of patients, and the differences of disease course among the syndromes were compared. Results The proportion of patients aged 30 to 49 years old was the highest among 621 patients infected with omicron variant (49.76%, 309/621). The most prominent symptoms were cough and expectoration, accounting for 62.32% (387/621) and 68.12% (423/621), respectively. The more common symptoms included sore throat, stuffy nose, runny nose, fatigue, muscle pain, and headache. White sputum was mostly seen in the expectoration and clear mucus was mostly seen in runny nose. According to the clinical symptoms, the core syndrome characteristic of patients infected with omicron variant was cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome was plague invading the defensive exterior, accounting for 40.10% (249/621). The second and third ones were heat toxin attacking the lung syndrome (29.95%, 186/621) and dampness obstructing (17.55%, 109/621), while the least common syndrome was deficiency of qi and yin (7.73%, 48/621). The course of qi and yin deficiency was longer than the other 3 syndromes (P<0.05). Conclusion The core TCM syndrome characteristic of patients infected with SARS-CoV-2 omicron variant is cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome is plague invading the defensive exterior. The pattern tends to convert into qi and yin deficiency along the long course. |
| Key words: severe acute respiratory syndrome coronavirus 2 omicron variant traditional Chinese medicine syndromes shelter hospital coronavirus disease 2019 |
