Theoretical System Of Yellow Fur And Its Application In Corona Virus Disease 2019

ObjectiveThis study systematically analyzes Chinese medical literature to construct a diagnosis and treatment system for yellow fur.The study is based on medical records of traditional Chinese medicine to verify the theory of yellow fur and analyze its application.The study collects tongue photographs from patients with Corona Virus Disease 2019 to analyze the distribution of pathological tongue manifestations and explore the characteristics of yellow fur.Methods1.Theoretical construction of yellow fur:Statements of yellow fur in Chinese medical literature were collected and refined from the perspectives of history,composition,etiology,theoretical basis,guidance of treatment,prognosis assessment,and tongue image,so as to build a theoretical system.2.Medical record study of yellow fur:The Chinese Medical Dictionary was searched for medical records with yellow fur.A database of yellow fur based on ancient Chinese medical records was constructed.Practical applications of the yellow fur(including disease distribution,tongue recording,factors,treatments,and prognostic assessment)were studied to validate the theory.3.Tongue manifestation study of COVID-19:Retrospective and prospective studies were combined to collect tongue photographs of COVID-19 from Wuhan,Xingtai,Ruili,Guangzhou,Xiamen,Hong Kong,Gansu,and Sanya.A combination of manual recognition and machine recognition was applied to extract pathological tongue features.The distribution characteristics of the tongue manifestation in different regions were analyzed,and the factors related to yellow fur were explored.Results1.Theoretical construction of yellow fur:The yellow fur system comes under the category of tongue diagnosis and has gone through a long period of time,from epiphenomenal recognition to theoretical sublimation.The yellow fur appears mostly in the middle stage of the disease,and is an important distinguishing sign for the heat syndrome and the internal syndrome.Clinical assessment requires a combination of tongue color,fur color,tongue texture,fur texture,as well as symptoms and pulse diagnosis.The theory of yellow fur is promoted by the theory of Shanghan and Wenbing.The yellow fur has guiding significance to the common treatment methods such as heat-clearing and purgation method.Yellow fur helps to assess disease changes.2.Medical record study of yellow fur:The study included 2195 medical cases containing records of yellow fur.The 1915 medical record study of yellow fur were categorized as external records(1345,70.23%)and internal records(570,29.77%).There were 557 medical records with a single factor,847 medical records with two factors,454 medical records with three factors,144 medical records with four factors,43 medical records with more than four factors,and 150 medical records with no valid factors.The common exogenous factors are heat,dampness,and the common internal factors are phlegm,Yin deficiency,food-accumulation."Phlegm-heat","dampness-heat","phlegm-dampness" are the common combinations of factors.Simple recording method was used in 42 3(19.27%)medical cases and comprehensive recording method was used in 1772(80.73%)medical cases for the description of yellow fur.The high-frequency prescriptions were Baihu decoction,Chengqi decoction,Yiyuan powder,Liuyi powder,Xianxiong decoction,Zuojin pill,Wendan decoction,and Chaihu decoction.High-frequency medicines in yellow fur medical records included Radix Glycyrrhizae,Poria,Rhizoma Pinelliae,Semen Armeniacae Amarum,Bulbus Fritillaria,Fructus Forsythiae,Fructus Gardeniae,and Radix Scutellariae.Two hundred medical cases correlated yellow fur changes with disease prognosis,including 68 cases of disease exacerbation,73 cases of disease remission,and 59 cases of disease persistence.3.Tongue manifestation study of COVID-19:The study finally included 5777 tongue photos,involving 2341 cases of COVID-19 patients.There were differences in the distribution of tongue by length of hospitalization.In the overall distribution,greasy fur,thick fur,dentate fur,fat tongue,dark white fur,and light yellow fur were the common pathologic tongue features.The differences between different pathologic tongue features in terms of regional distribution were statistically significant(P<0.05).A study of the yellow fur revealed that the differences between the yellow fur group and the non-yellow fur group were statistically significant in terms of viral strains,regions,and clinical subtypes(P<0.05),and that patients in the yellow fur group were more likely to have fever,chest tightness,nausea and vomiting,fatigue,and loss of appetite.Logistic regression suggested that virulent strain,,clinical types,and region were risk factors for yellow fur.ConclusionThis study systematically collated medical literature and initially constructed a theoretical system of yellow fur to provide theoretical guidance for modern TCM clinical diagnosis.The study analyzed the records of yellow fur in Chinese medical records to further verify the practical application of the theory of yellow fur and to achieve the purpose of "theory-practice" to corroborate each other.The study on the distribution of pathological tongue manifestations in COVID-19 provided more evidence to support the theory of"treatment individualized to patient,season and locality" in Chinese medicine.In COVID-19,yellow fur may be accompanied by heavier clinical types,more clinical symptoms.The occurrence of yellow fur may be related to COVID-19 strain,region and clinical types.