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| 天津市746例新型冠狀病毒感染患者“長新冠”特征和中醫證候學特點分析 |
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王凱1, 姜楠1, 孫雪2, 倪道艷1, 田盈1, 孫小茁1, 昝樹杰2, 張碩1, 周勝元1, 封繼宏1, 付鯤1, 雒明池1
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1.天津中醫藥大學第二附屬醫院, 天津 300250;2.天津中醫藥大學, 天津 301617
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| 摘要: |
| [目的] 研究天津市新型冠狀病毒感染患者出院后“長新冠”發生情況和臨床特點，以及中醫證候學特征，為恢復期患者的康復治療提供參考。[方法] 以2022年1—3月感染奧密克戎的746例患者為研究對象，分別于出院后3、6個月進行隨訪調查，于出院3個月時系統查體，進行血常規、生化指標、胸部計算機斷層掃描（CT）等檢查。[結果] 746例患者中符合“長新冠”定義的有58例（7.8%），“長新冠”癥狀主要表現為乏力、易疲勞、記憶力減退、入睡困難或多夢易醒、活動后氣短等；實驗室檢查基本趨于正常；36例胸部CT檢查顯示：肺紋理增多25例，無明顯臨床意義；索條影11例，肺纖維化2例，提示為陳舊性損傷；肺氣腫2例，為基礎??；肺結節9例，磨玻璃影1例，提示炎癥可能。中醫證候學調查發現，最常見的病位證素為脾、心、肺和腎，最常見的病性證素為氣虛、陰虛、濕、熱。[結論] 奧密克戎感染患者在出院后“長新冠”發生率、肺部影像學損傷較既往毒株發生率低，但乏力、記憶力減退、睡眠障礙等癥狀需引起關注，中醫證候學表現為以氣陰兩虛證為主，兼有濕（熱）、氣滯、血瘀諸證。 |
| 關鍵詞: 新型冠狀病毒感染 奧密克戎 “長新冠” 中醫證候 康復 |
| DOI：10.11656/j.issn.1672-1519.2023.05.03 |
| 分類號:R511 |
| 基金項目:現代中醫藥海河實驗室科技項目（22HHZYJC00001）；天津市中醫藥重點領域科技項目（2021008，2021009，2022002）。 |
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| Characteristics and traditional Chinese medicine syndrome of “long-COVID” of 746 COVID-19 patients in Tianjin |
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WANG Kai1, JIANG Nan1, SUN Xue2, Ni Daoyan1, TIAN Ying1, SUN Xiaozhuo1, ZAN Shujie2, ZHANG Shuo1, ZHOU Shengyuan1, FENG Jihong1, FU Kun1, LUO Mingchi1
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1.Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China;2.Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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| Abstract: |
| [Objective] To study the occurrence，clinical characteristics and the syndrome of traditional Chinese medicine（TCM） of COVID-19 patients in Tianjin after discharge，so as to provide evidence for the rehabilitation treatment of convalescent patients. [Methods] A total of 746 patients infected with Omicron between January and March in 2022 were followed up 3 and 6 months after discharge，and they were systematically examined at 3 months after the discharge，for blood routine，biochemical indexes，chest computed tomography （CT）. [Results] Among the 746 patients，58（7.8%） met the definition of long-COVID. The symptoms of long-COVID mainly manifested as fatigue，memory loss，difficulty to fall asleep or wake up from dreams，shortness of breath after activity，etc. Laboratory tests were basically normal. Chest CT examination of 36 people showed that 25 cases of showed increased lung texture，without obvious clinical significance；11 cases of fibrous stripes and 2 cases of pulmonary fibrosis，suggesting old injury；2 cases of emphysema which was underlying disease；9 cases of lung nodules and 1 case of ground-glass opacities，suggesting possible inflammation. The investigation of TCM syndrome found that the most common syndrome elements are spleen，heart，lung and kidney，the most common disease symptoms qi deficiency，yin deficiency，humidity，and heat. [Conclusion] The incidence of long-COVID and lung imaging damage in patients with Omicron infection after discharge is lower than that of previous strains，but the symptoms such as fatigue，memory loss，and sleep disorders still need attention. Qi and yin deficiency，accompanied with humidity（heat），qi stasis and blood stagnation is the most common TCM syndrome. |
| Key words: COVID-19 Omicron long-COVID traditional Chinese medicine syndrome rehabilitation |
