1.北京中医药大学东直门医院 北京 100700
2.北京中医药大学
吕明圣,男,博士,在站博士后
# 王洪武,男,博士,教授,主任医师,博士生导师,博士后合作导师,主要研究方向:中西医结合呼吸系统疾病及肿瘤研究,E-mail:wanghongwu2015@126.com
纸质出版日期:2023-05-30,
网络出版日期:2023-02-16,
收稿日期:2023-01-26,
移动端阅览
吕明圣, 王洪武, 班承钧, 等. 2022年冬季京冀鲁地区196例新型冠状病毒奥密克戎变异株感染者临床表现及中医证候分析[J]. 北京中医药大学学报, 2023,46(5):644-650.
LYU Mingsheng, WANG Hongwu, BAN Chengjun, et al. Clinical manifestations and traditional Chinese medicine pattern analysis of patients infected with SARS-CoV-2 Omicron variant in Beijing, Hebei, and Shandong in winter 2022[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(5):644-650.
吕明圣, 王洪武, 班承钧, 等. 2022年冬季京冀鲁地区196例新型冠状病毒奥密克戎变异株感染者临床表现及中医证候分析[J]. 北京中医药大学学报, 2023,46(5):644-650. DOI: 10.3969/j.issn.1006-2157.2023.05.009.
LYU Mingsheng, WANG Hongwu, BAN Chengjun, et al. Clinical manifestations and traditional Chinese medicine pattern analysis of patients infected with SARS-CoV-2 Omicron variant in Beijing, Hebei, and Shandong in winter 2022[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(5):644-650. DOI: 10.3969/j.issn.1006-2157.2023.05.009.
目的
2
归纳总结2022年冬季京冀鲁地区新型冠状病毒(简称“新冠病毒”)奥密克戎变异株感染者临床表现及中医证候。
方法
2
对新冠病毒感染阳性成人患者进行“问卷星”在线调查,统计人口学信息、既往病史及临床症状,采用系统聚类法和因子分析法归纳总结中医证候特点。
结果
2
共纳入196例有效病例,以中青年为主,医务工作者人数超过40%,既往高频使用药物包括连花清瘟、布洛芬及对乙酰氨基酚。患者发病早期表现为发热、恶寒、头痛及肌肉关节酸痛;发病中期咽痛及痰少质黏难咳出比例增加;发病后期咳嗽、胸闷憋气、便溏症状凸显。因子分析及聚类分析显示,本病病位主要在卫表及肺,与脾有关,病性多为虚实夹杂,主要证候为湿毒夹寒束表、湿热内蕴及脾虚湿困。
结论
2
新冠病毒奥密克戎变异株感染者起病病机为湿毒疫邪郁闭卫阳,兼有风寒邪气致病特点,随病情进展可出现热化、燥化及脾虚湿困等转归,但也有部分患者起病即为湿热内蕴之证。
Objective
2
We aimed to summarize the clinical manifestations and traditional Chinese medicine (TCM) patterns of infected patients with SARS-CoV-2 Omicron variant(hereinafter called "COVID-19" ) in Beijing
Hebei
and Shandong in the winter of 2022.
Methods
2
A questionnaire survey was carried out with the "Questionnaire Star" online service among adult COVID-19 patients
and the demographic information
medical history
and clinical symptoms were recorded. The characteristics of TCM patterns were summarized by systematic clustering analysis and factor analysis.
Results
2
A total of 196 cases were included. Most of the patients were young or middle-aged. More than 40% of the patients were healthcare workers. The most frequently used medicines were
Lianhua Qingwen
(a traditional Chinese patent medicine and simple preparation)
ibuprofen
and acetaminophen. The early symptoms of COVID-19 patients were fever
chilliness
headache
and muscle/joint pain. In the middle stage of COVID-19
the proportion of sore throat and sputum increased. The incidence of cough
chest tightness
and loose stool increased at the late stage of the disease. Factor analysis and cluster analysis showed that COVID-19 was mainly located in the defensive exterior and lung
related to spleen. The nature of the disease was mostly intermingled deficiency and excess. The main patterns were dampness toxin with pathogenic cold on the exterior
internal retention of damp-heat
dampness stagnancy due to spleen deficiency.
Conclusion
2
The pathogenesis of COVID-19 is obstruction of defense yang by dampness-toxin pestilence
with exogenous pathogenic wind cold. With disease progression
the dampness toxin pestilence might transform into heat and dryness or into spleen deficiency with dampness stagnancy. However
some patients show the pattern of internal damp-heat at the beginning of the disease.
新型冠状病毒感染奥密克戎变异株证候因子分析聚类分析
coronavirus disease 2019Omicron variantTCM patternfactor analysiscluster analysis
WANG C, HORBY PW, HAYDEN FG, et al. A novel coronavirus outbreak of global health concern[J]. Lancet, 2020,395(10223):470-473.
HU B, GUO H, ZHOU P, et al. Characteristics of SARS-CoV-2 and COVID-19[J]. Nat Rev Microbiol, 2021,19(3):141-154.
PULLIAM J, VAN SCHALKWYK C, GOVENDER N, et al. Increased risk of SARS-CoV-2 reinfection associated with emergence of Omicron in South Africa[J/OL]. Science, 2022,376(6593):eabn4947 [2022-12-04]. https://www.science.org/doi/10.1126/science.abn4947https://www.science.org/doi/10.1126/science.abn4947.
方辉,王玉光,张宁,等. 奥密克戎变异株所致新型冠状病毒感染轻症患者中医证候学调查研究[J]. 北京中医药,2023,42(1):19-23.
周毅骏,荀运浩,金巧菲,等. 杭州地区114例奥密克戎株新型冠状病毒肺炎中医证候初探[J]. 浙江中西医结合杂志,2022,32(9):816-819.
张金荣,闵翼,时翠林,等. 144例奥密克戎新型冠状病毒感染患者发病初期中医证候特征探讨[J]. 中国中医急症,2022,31(8):1156-1158.
季绍良,成肇智.中医诊断学[M].北京:人民卫生出版社,2011:114-134.
UGBOLUE UC, DUCLOS M, URZEALA C, et al. An Assessment of the Novel COVISTRESS Questionnaire:COVID-19 Impact on Physical Activity, Sedentary Action and Psychological Emotion[J/OL]. J Clin Med, 2020,9(10):3352[2022-12-04]. https://www.mdpi.com/2077-0383/9/10/3352https://www.mdpi.com/2077-0383/9/10/3352.
LESAGE FX, BERJOT S, DESCHAMPS F. Clinical stress assessment using a visual analogue scale[J/OL]. Occup Med (Lond), 2012,62(8):600-605.
YESUDHAS D, SRIVASTAVA A, GROMIHA MM. COVID-19 outbreak: history, mechanism, transmission, structural studies and therapeutics[J]. Infection, 2021,49(2):199-213.
YAN RH, ZHANG YY, LI YN, et al. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2[J]. Science, 2020, 367(6485): 1444-1448.
北京市中医管理局. 北京市新型冠状病毒感染中医药诊疗方案(试行第七版)[EB/OL]. (2023-01-09)[2023-01-16]. http://zyj.beijing.gov.cn/sy/tzgg/202301/t20230116_2901712.htmlhttp://zyj.beijing.gov.cn/sy/tzgg/202301/t20230116_2901712.html.
CAROD-ARTAL FJ. Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved[J]. Rev Neurol, 2021,72(11):384-396.
WIECH M, CHROSCICKI P, SWATLER J, et al. Remodeling of T Cell Dynamics During Long COVID Is Dependent on Severity of SARS-CoV-2 Infection[J/OL]. Front Immunol, 2022,13:886431[2022-12-04]. https://www.frontiersin.org/articles/10.3389/fimmu.2022.886431https://www.frontiersin.org/articles/10.3389/fimmu.2022.886431.
田发念,柯佳,陈俊,等. 新型冠状病毒肺炎患者恢复期中医症状调查与分析[J]. 医药导报,2020,39(5):637-639.
福建省中医药学会感染病分会,福建省中医药学会呼吸病分会.福建省新型冠状病毒感染者恢复期中医康复指导建议(2022年版)[J]. 福建中医药,2022,53(4):1-3.
北京市中医管理局.新型冠状病毒感染恢复期中医药综合干预方案(试行第二版)[J]. 北京中医药,2023,42(1):40-43.
上海市新型冠状病毒感染恢复期中医康复方案专家共识撰写组. 上海市新型冠状病毒感染恢复期中医康复方案专家共识(2022年第2版)[J]. 上海中医药杂志,2022,56(8):1-3.
天津市卫生健康委员会. 天津市新型冠状病毒肺炎恢复期中西医结合康复方案(试行)[J]. 天津中医药,2022,39(3):275-277.
谷晓红. 中西医协同模式下的疫病康复策略:以新型冠状病毒肺炎后综合征为例[J]. 北京中医药大学学报,2022,45(8):757-763.
孙宪泓,史锁芳,王博寒,等. 中医药综合康复方案治疗新型冠状病毒肺炎恢复期不同证型患者的临床研究[J]. 中华中医药杂志,2022,37(7):4181-4185.
0
浏览量
8
下载量
2
CSCD
关联资源
相关文章
相关作者
相关机构