关键词: 新型冠状病毒肺炎, 中医证候, 证候演变

Abstract: Objective To analyze and understand the traditional Chinese medicine (TCM) characteristics of 46 confirmed cases with COVID-19 in Beijing Youan Hospital, Capital Medical University.Methods Data were collected and analyzed about the history of patients, TCM syndrome characteristics, the diagnosis and treatment process, evolution of the symptoms, and outcomes of the cases. The clinical characteristics of different types of cases were compared with each other. Results Among the 46 patients, 27 cases were epidemic toxin attacking lung syndrome (common type), 13 cases were dampness toxin depression lung syndrome (common type), 6 cases were retention of epidemic toxin in the lung (severe type). All patients received Chinese medicine treatment, 26 cases of which were treated with proprietary Chinese medicine and 20 cases with traditional Chinese medicine decoction. In the early stage (0-3 days), the symptoms were relatively alleviated, yet with the characteristics of red or dark red tongue, yellow greasy tongue coating or white greasy coating. In the advanced stage (4-14 days), more than half of the patients had fever (89.13%), cough and expectoration (71.40%), dry mouth and thirst (68.60%), fatigue (60%), dry throat or sore throat (57.10%), and lack of appetite (54.30%). For the severe patients, the tongue coating was greasy and dry or less. In the recovery stage (>15 d), most of the symptoms were relieved, but with cough and expectoration (72.20%), dry mouth and thirst (66.70%), sweating (50%) remained. Meanwhile tongue coating changed from thick to thin, the degree of greasy coating improved with the color of coating changed from yellow to white, although the changes of tongue manifestation occurred slowly. For cases with common type and severe type, the median course of the disease of were respectively 16.5 d (14-26 d) and 25 d (21-27 d), the average days of hospital stay were (13.24±4.36) d and (19.73±2.33) d, the median time for viral nucleic acid test turning negative was respectively 11.41 d (4-22 d) and 14.5 d (9-24 d), and the median time for pulmonary computed tomography(CT) lesions to start absorption was respectively 10 d (5-19 d), 15.5 d (8-21 d). Conclusion The syndrome with damp and heat are prominent in COVID-19 and the course of the disease is relatively long. The understanding of the characteristics of different TCM syndrome types and the evolution is helpful to guide the syndrome differentiation and treatment with TCM.

Key words: COVID-19, syndrome of traditional Chinese medicine, syndrome evolution