摘要
目的:探讨2023年春季流行性感冒的中医证候及体质分布特点.方法:收集2023年3月8日-3月21日北京中医药大学东方医院就诊的345例流行性感冒患者进行中医证候学调查,通过分析患者的一般资料、流行病学史、症状、体质及实验室检查等,归纳总结其中医证候及体质分布特点.结果:345例患者中男性161例,女性184例,症状以发热、咳嗽、周身疼痛、乏力、头痛、口干、流涕、咳痰等最为常见,亦可见消化道症状[26.38％(91/345)].舌象以舌淡红或红,苔黄腻或白腻多见;脉象以脉数或滑为多.中医证型可分为风热犯卫证[57.10％(197/345)]、风寒束表证[26.67％(92/345)]、表寒里热证[16.23％(56/345)];兼夹证以湿热证[8.12％(28/345)]、气虚证[6.96％(24/345)]、寒湿证[6.38％(22/345)]多见.体质类型以平和质[31.88％(110/345)]、阳虚质[18.55％(64/345)]、气虚质[12.46％(43/345)]、阴虚质[12.46％(43/345)]为多.实验室检查以淋巴细胞计数降低为主;淋巴细胞绝对值在各证型之间存在显著性差异(P＜0.05),由高到低顺序为风热犯卫证＞风寒束表证＞表寒里热证.结论:2023年春季流行性感冒以全身症状、呼吸道症状为主,并见消化道症状;中医证型以风热犯卫证最为常见,并见湿热证、气虚证、寒湿证兼夹;体质在一定程度上决定流感中医证型的传变和转归,阳虚体质更易出现寒化,阴虚体质更易出现热化,气虚体质更易向湿热、寒湿转化;淋巴细胞绝对值的高低可能与流感中医证候的演变及病情进展相关.
Abstract
Objective:To investigate the characteristics of traditional Chinese medicine(TCM)syndromes and constitution distribution of influenza in the spring of 2023.Methods:A total of 345 cases of influenza diagnosed at the Dongfang Hospital,Beijing University of Chinese Medicine from 8,March,2023 to 21,March,2023 were collected for investigation of Chinese medicine evidence.By analyzing the general data,epidemiological history,symptoms,constitution of the patients,and laboratory examination,the characteristics of TCM symptoms and constitution distribution of influenza were summarized.Results:Among 345 patients with influenza,161 were males and 184 were females.The most common symptoms were fever,cough,body aches,malaise,headache,dry mouth,runny nose,coughing up sputum,etc..Gastrointestinal symptoms could also be seen[26.38％(91/345)].The tongue was mostly light red or red with yellow or white greasy moss,the pulse was mostly counted or slippery.The types of TCM symptoms could be categorized as wind-heat offending the guard[57.10％(197/345)],wind-cold binding the surface[26.67％(92/345)],and exterior cold and interior heat[16.23％(56/345)].The concurrent TCM syndrome was commonly characterized as damp-heat syndrome[8.12％(28/345)],qi deficiency syndrome[6.96％(24/345)],and cold-damp syndrome[6.38％(22/345)].The types of constitution were mostly balance[31.88％(110/345)],yang deficiency[18.55％(64/345)],qi deficiency[12.46％(43/345)]and yin deficiency[12.46％(43/345)].Laboratory examination were dominated by decreased lymphocyte counts,and absolute lymphocyte values differed between the syndrome types(P＜0.05),in descending order:wind-heat offending the guard syndrome＞wind-cold binding the surface syndrome＞exterior cold and interior heat syndrome.Conclusion:Influenza in the spring of 2023 are dominated by systemic and respiratory symptoms,while gastrointestinal symptoms are also seen.The most common TCM syndrome type is wind-heat offending the guard,and the combination of damp-heat syndrome,qi deficiency syndrome and cold-dampness syndrome can also be seen.To some extent,constitution determines the transmission of TCM symptoms of influenza.Yang deficiency is more prone to cold,yin deficiency is more prone to heat,and qi deficiency is more prone to dampness-heat and cold-dampness.The level of absolute lymphocyte values may be associated with the evolution of influenza TCM syndromes and disease progression.
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