TCM pattern analysis of interstitial lung disease with COVID-19

LI Xue; WANG Yuguang; ZHOU Jipu; LIU Meng; LIU Jian; MA Jiaju; GUO Yali

doi:10.3969/j.issn.2095-6606.2023.04.005

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TCM pattern analysis of interstitial lung disease with COVID-19

COVID-19 | 更新时间：2023-08-07

- TCM pattern analysis of interstitial lung disease with COVID-19
- Modern Chinese Clinical Medicine Vol. 30, Issue 4, Pages: 21-27(2023)
- 作者机构：
  
  首都医科大学附属北京中医医院呼吸科　北京　100010
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2095-6606.2023.04.005
  CLC： R259
- Published：30 July 2023，
  
  Received：03 April 2023，
- 稿件说明：
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LI Xue, WANG Yuguang, ZHOU Jipu, et al. TCM pattern analysis of interstitial lung disease with COVID-19. [J]. Modern Chinese Clinical Medicine 30(4):21-27(2023)
DOI：

LI Xue, WANG Yuguang, ZHOU Jipu, et al. TCM pattern analysis of interstitial lung disease with COVID-19. [J]. Modern Chinese Clinical Medicine 30(4):21-27(2023) DOI： 10.3969/j.issn.2095-6606.2023.04.005.

摘要

目的

分析间质性肺疾病(ILD)合并新型冠状病毒感染(简称“新冠感染”)患者的中医症状、证候分布特点，并探究其病因病机。

方法

采用横断面调查研究，选取69例2022年12月—2023年1月在我院门诊和病房诊断为新冠感染的ILD患者，收集门诊首诊或入院第一天的中医四诊信息、一般情况及西医临床资料。

结果

69例患者首发症状以肺卫症状多见，同时兼有脾系症状。69例患者共涉及23种症状。与轻、中型患者相比，重型、危重型患者中喘、胸闷、排便不爽、畏寒、恶风和痰中带血的比例较高(

0.05)；而头痛的比例较低(

0.05)。69例患者中，舌质共3种，舌苔和脉象分别为6种。与轻型及中型患者相比，重型及危重型患者中燥苔和细脉比例较高(

0.05)。69例患者中有50例(72.5%)为虚实夹杂证，19例(27.5%)为实证。结合脏腑辨证，证候类型共计12个。与轻型和中型患者相比，重型及危重型患者中肾气虚证、肾阴阳两虚、热入营血证和疫毒闭肺证比例较高(

0.05)，寒湿郁肺证的比例较低(

0.05)。69例患者总体病位分布主要在肺和脾。与轻型和中型患者相比，重型及危重型患者中病位在肾和营血分的比例较高(

0.05)。

结论

新冠感染系感受疫疠之气所致，ILD患者感染新冠病毒可表现为湿毒为胜，病机涉及正虚(肺、脾、肾)和邪实(湿热邪毒)两部分，病程初起病位在肺卫，进展期以肺脾多见，重型和危重型累及肾及营血。

Abstract

Objective

To analyze the TCM patterns of interstitial lung disease (ILD) with corona virus disease 2019

and explore its etiology and pathogenesis.

Methods

A cross-sectional study was conducted

in which 69 ILD patients diagnosed with COVID-19 in our hospital’s outpatient and wards from December 2022 to January 2023 were included. Their four TCM diagnostic information

general conditions and clinical data of western medicine were collected on the first visit or the day of admission.

Results

Among the 69 patients

the initial manifestation was predominantly lung-

wei

syndrome

accompanied by spleen syndromes. 23 symptoms were recorded from the 69 patients. Compared with the mild and moderate cases

the proportion of dyspnea

chest tightness

incomplete defecation

fear of cold

aversion of wind

blood in sputum

dry coating on the tongue and thready pulse in severe and critical patients was significantly higher (

0.05); while the proportion of headaches was significantly low (

0.05). Among the 69 patients

there were 3 types of tongue body

and 6 types of tongue coating and pulse pattern

respectively. Compared with mild and moderate patients

the proportion of dry coating on the tongue and thready pulse was higher in severe and critical patients (

0.05). Among the 69 patients

50 (72.5%) had a mixture of deficiency and excess

while 19 (27.5%) had excess patterns. From the perspective of

zang

organ syndrome differentiation

there were a total of 12 syndrome types. Compared with the mild and moderate patients

the proportion of kidney-qi deficiency

kidney-yin and yang deficiency

heat entering

ying

-blood and pestilence blocking the lung in severe and critical patients was significantly higher (

0.05). The proportion of cold-dampness stagnation in the lung was significantly lower (

0.05). The affected area of the 69 patients is mainly located in the lung and spleen. Compared with the mild and moderate patients

the proportion of affected area in the kidney and

ying

-blood level is higher in severe and critical patients (

0.05).

Conclusion

COVID-19 is caused by the contraction of pestilence qi. COVID-19 in ILD patients can be manifested as the predominance of dampness toxin. The pathogenesis involves two parts: deficiency of healthy qi (in the lung

spleen

kidney) and excess of evil qi (damp heat toxin). The onset of the disease is in the lung

wei

and it common moves to the lung and spleen in the progressive stage. In severe and critical cases

the kidney and

ying

-blood may also be involved.

关键词

间质性肺疾病新型冠状病毒症状证候病因病机

Keywords

ILDCOVID-19symptomsTCM patternsetiology and pathogenesis

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