摘要
【目的】总结儿童新型冠状病毒奥密克戎(Omicron)BA.2.38变异株感染的中医证候特征,客观评价中医药疗效。【方法】对2022年7月8日~2022年8月4日期间甘肃省兰州市第二人民医院雁滩分院收治的251例新型冠状病毒Omicron BA.2.38变异株感染患儿进行调查,内容主要包括患儿基本信息、发病情况、入院时临床症状以及舌象、临床分型等,同时总结中医证候特点及证型分布规律,并以热程、治疗后退热时间、核酸转阴时间、病情由轻转重等为指标,评价中医药疗效。【结果】(1)症状、体征方面,251例患儿中,主要症状表现为发热者120例(占47.8%),且以中、高热为主,体温≥38.1℃者94例[占78.3%(94/120)],平均热程为(2.0±1.1)d;出现咳嗽者112例(占44.6%);部分患儿还出现咽痛、鼻塞、流涕、纳差、眠差、乏力、便秘等症状。舌象方面,舌质多红[占70.9%(178/251)],舌苔多腻[占72.5%(182/251)]。(2)治疗上以清热透邪、化湿解毒为法,结合儿童生理病理特点,兼以健脾消食以顾护脾胃。全程使用中药治疗的患儿有248例(占98.8%),其中,单纯中药治疗245例(占97.6%),中西医结合治疗3例(占1.2%)。(3)治疗后,所有患儿预后良好,无患儿出现病情加重。平均住院时间为(10.8±3.9)d,核酸转阴时间为(12.0±3.4)d;症状缓解最快的是“发热”,服药后热退时间为(1.4±0.7)d;其次为咳嗽,平均咳嗽缓解时间为(2.1±1.0)d;重复测量方差分析结果表明,治疗3 d和7 d后的中医证候积分均较治疗前降低,且治疗7 d后又较治疗3 d后降低,差异均有统计学意义(P<0.001)。(4)所有服用中药的患儿均未出现消化道不适、胸闷心悸、皮疹、肝肾功能损害等不良反应或不良事件。【结论】本轮疫情的Omicron BA.2.38变异株感染患儿的核心病机为疫毒侵肺、夹以暑湿,治疗上以清热透邪、化湿解毒为法;应用中药治疗能够明显改善患儿发热、咳嗽等症状,阻止病�
Objective To analyze the characteristics of traditional Chinese medicine(TCM)syndromes in children infected with the Omicron sub-variant BA.2.38 of coronavirus disease 2019(COVID-19),and to objectively assess the efficacy of Chinese medicine.Methods A cross-sectional study was conducted among 251 children(<18 years old)infected with the Omicron variant BA.2.38 admitted in the Yantan Branch of Lanzhou Second People’s Hospital of Gansu Province from July 8,2022 to August 4,2022.We collected the data of basic information,incidence of the infection,symptoms at admission,tongue manifestations,clinical classification,etc.,analyzed the characterisation of TCM syndromes and the distribtuion of syndrome types,and evaluated the Chinese medicine efficacy with the indicators of the duration of fever,antipyretic time after treatment,nucleic acid negative-conversion time,and the relief of the illness.Results(1)The cardinal symptom of the 251 children was fever(47.8%),especially a moderated and high fever(≥38.1℃)with the percentage of 78.3%(94/120),and the average fever duration was(2.0±1.1)days.Cough was also commonly seen in 112 children(44.6%),and other cardinal symptoms involved sore throat,nasal congestion,runny nose,poor appetite,bad sleep,fatigue,and constipation.As for tongue manifestations,most patients had red tougue(178/251,70.9%)and greasy coating(182/251,72.5%).(2)The treatment for the infected children was based on the method of clearing heat and expelling pathogens,and resolving dampness and removing toxin,as well as invigorating spleen and promoting the digestion to protect the spleen and stomach for considering the physiopathological characteristics of the children.Actually,248 children(248/251,98.8%)were treated with Chinese medicine throughout the course,of whom 97.6%(245/251)were treated with Chinese medicine alone,and 1.2%(3/251)were treated with integrative medicine.(3)After treatment,the prognosis of all children was good,and none of them got worse.The average duration of in-hospital was(10.8±3.9)
作者
杨京华
李玉霞
郭建文
陈芯莹
任耀全
韩娟
李冬梅
丁霞
洪俊彬
张忠德
YANG Jing-Hua;LI Yu-Xia;GUO Jian-Wen;CHEN Xin-Ying;REN Yao-Quan;HAN Juan;LI Dong-Mei;DING Xia;HONG Jun-Bin;ZHANG Zhong-De(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;LYU Ying’s Famous Physician Studio,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China;The Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou 730000 Gansu,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050 Gansu,China;The Second Hospital of Lanzhou University,Lanzhou 730030 Gansu,China;Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2023年第5期1053-1059,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家重点研发计划项目(编号:2022YFC0867400)
国家中医药管理局中医药防治新型冠状病毒感染肺炎应急研究专项课题(编号:2022ZYLCYJ07-3)
广东省中医院院内项目吕英学术经验传承工作室建设项目(编号:E43729)。
关键词
新型冠状病毒
Omicron
BA.2.38变异株
中医证候
清热透邪
化湿解毒
中医药疗效
儿童
novel coronavirus
Omicron sub-variant BA.2.38
traditional Chinese medicine(TCM)syndromes
clearing heat and expelling pathogens
resolving dampness and removing toxin
Chinese medicine efficacy
children
