Study Of The Clinical Features And The Traditional Chinese Medicine Syndrome And Syndrome Types Of 42 Patients With COVID-19 In Chengdu

Objective: To analyze the clinical characteristics of patients with COVID-19 in Chengdu,to explore the characteristics of TCM syndrome in the early,middle and late stages of the course of COVID-19,to analyze the law of syndrome change,to analyze syndrome types,to establish dialectical standards,to provide reference for TCM syndrome differentiation and treatment.Methods:1.42 hospitalized cases were included in the diagnosis of COVID-19 in Chengdu public health clinical medical center,collecting,summarizing,analyzing and studying the features of COVID-19 epidemiology,clinical manifestations,auxiliary examination,etc;2.Consulting the literature and materials to develop the "COVID-19 statistical questionnaire of four diagnosis of traditional Chinese medicine",collecting the symptoms and signs of patients,and summarizing the characteristics of patients in different periods of disease by cluster analysis The characteristics of syndrome,and through cluster analysis for COVID-19 patients to establish TCM syndrome type,and finally set the syndrome differentiation standard.Conclusion: 1.Clinical features of COVID-19: 1.1 General situation:(1)There is no difference in the prevalence and severity of COVID-19 between men and women;(2)Elderly patients are more likely to suffer from severe disease than young patients;(3)73.8% of patients have contact history of epidemic area or confirmed cases;(4)Patients with basic medical history are more likely to suffer from severe disease;(5)11.9% of the patients discharged from the ` hospital were positive for nucleic acid retest,but there was no relationship between the retest and gender,age,history of allergy,basic disease and epidemic history.1.2 Clinical symptoms: The main symptoms were cough(85.7%),fever(83.3%),expectoration(57.1%),fatigue(52.4%),chest tightness(47.6%),systemic pain(45.2%),dizziness(45.2%),dry mouth(35.7%),nasal obstruction(31.0%),abdominal distention(31.0%).1.3 Laboratory examination :In most severe patients,the levels of IL-6,CRP and SAA were increased,and the numbers of CD3,CD4,CD8 and lymphocytes were decreased,indicating that there were inflammatory reaction and low cellular immune function at the same time;in most common patients,CRP was also increased,but the numbers of CD3,CD4,CD8 and lymphocytes were mostly normal,indicating that most common patients also had inflammatory reaction,but the cellular immune function had not been damaged.The total number of leukocytes and neutrophils in the whole sample were mostly normal.CD3,CD4,CD8 and lymphocytes were all negatively correlated with CRP,indicating that the more inflammatory reaction,the lower cellular immune function.1.4 Chest imaging: COVID-19 chest imaging showed changes in the shape of multiple lobes,segments and lesions,most of which were patchy and ground glass shadows,while flocculent shadows,nodular shadows,grid shadows and strip shadows were also seen.A few patients had enlarged mediastinal lymph nodes,a small amount of pleural effusion,subpleural ground glass shadow and pleural thickening.There was no obvious abnormality in chest imaging in a few patients;64.3% of the patients' lesions were mainly distributed in the extrapulmonary zone;78.6% of the patients' lesions were absorbed in the reexamination.2.COVID-19 TCM Syndrome Type: 2.1 TCM syndrome: In the early stage of the course of the disease,temperature,heat and dampness are the main manifestations,in the middle stage,phlegm dampness and damp heat are the main manifestations,and in the later stage,phlegm dampness and yin deficiency are the main manifestations.Evil Qi is transferred from Weifen and Shangjiao to Qifen and Zhongjiao.The early wet and turbid and warm heat are transferred into Zhongjiao in the middle period,or wet and heavy,or hot.If wet and heavy,it is difficult to get rid of the lingering Yin and evil.If hot and heavy,it is difficult to get rid of phlegm and dampness in the later period.2.2 TCM Syndrome Type: It is mainly divided into six syndrome types: dampness heat repressing Wei syndrome,dampness heat carrying wind syndrome,dampness heat internal knot syndrome,pathogenic heat damming lung syndrome,phlegm dampness stagnation lung syndrome,yin deficiency lung dryness syndrome.