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1.中国中医科学院中医临床基础医学研究所,北京市东城区东直门内南小街16号,100700
2.中国中医科学院广安门医院
3.中国中医科学院中医药信息研究所
4.陕西省西安市第八医院
5.山西省太原市第四人民医院
6.广西壮族自治区人民医院邕武医院
7.西南医科大学附属中医医院
8.中国中医科学院中药研究所
Received:21 April 2021,
Revised:2021-08-22,
Published:17 October 2021
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范逸品,马艳,焦丽雯等.清肺排毒汤联合西医常规治疗对不同分型新型冠状病毒肺炎患者舌象特征的影响[J].中医杂志,2021,62(20):1806-1813.
[J]. Journal of Traditional Chinese Medicine, 2021, 62(20): 1806-1813.
范逸品,马艳,焦丽雯等.清肺排毒汤联合西医常规治疗对不同分型新型冠状病毒肺炎患者舌象特征的影响[J].中医杂志,2021,62(20):1806-1813. DOI: 10.13288/j.11-2166/r.2021.20.011.
[J]. Journal of Traditional Chinese Medicine, 2021, 62(20): 1806-1813. DOI: 10.13288/j.11-2166/r.2021.20.011.
目的
2
探讨清肺排毒汤联合西医常规治疗对不同分型新型冠状病毒肺炎(新冠肺炎)患者舌象变化特征的影响。
方法
2
回顾性收集2020年1月28日至3月30日4个省(自治区)4家医院新冠肺炎确诊病例,比较不同临床分型患者在服用清肺排毒汤前及服用1个疗程(3天)、2个疗程(6天)的舌象变化。
结果
2
共纳入82例新冠肺炎病例,其中男43例(52.4%)、女39例(47.6%);患者中位年龄42岁;轻型15例(18.3%),普通型54例(65.9%),重型12例(14.6%),危重型1例(1.2%)。舌质颜色方面,淡红舌所占比例最高,为37.8%(31/82),其次为红舌35.4%(29/82);舌苔颜色方面,黄苔所占比例最高,为35.4%(29/82),其次为白苔29.3%(24/82),白黄苔25.6%(21/82);苔质方面,以滑腻苔最多,占39.0%(32/82),其次为浊腻与干燥并见苔,占23.2%(19/82)。从六经舌象分析,轻型患者以太阳所占比例最高,为26.7%(4/15),普通型以少阳阳明所占比例最高,为25.9%(14/54),重型以阳明少阴所占比例最高,为33.3%(4/12)。与服药前比较,服用清肺排毒汤3天、6天后,舌象总体好转率分别为58.5%(48/82)、78.0%(64/82)。
结论
2
新冠肺炎患者服用清肺排毒汤后与服药前相比舌象总体好转,具体表现为服药前后舌象显示虽然疾病还属于原六经病变,但舌苔从厚转薄比例增加,兼见或由燥转润,或由浊转净,或由紧腻转疏松;苔色由焦黄转为正黄,或由正黄转为淡黄,或由淡黄转白等表现;舌象显示疾病的六经病机转归表现为从阴经向阳经转化、或从阳经之里向阳经之表转化。
Objective
2
To explore the effect of
Qingfei Paidu Decoction
(清肺排毒汤) combined with western medicine routine treatment on tongue manifestations in patients with coronavirus disease 2019 (COVID-19).
Methods
2
Data was retrospectively collected from the confirmed cases of COVID-19 who were admitted from four hospitals in four provinces (autonomous regions) from January 28 to March 30, 2020. The changes of tongue manifestations were observed before and after one course (three days) and two courses (six days), and were compared among different clinical types including mild, moderate, severe and critically ill.
Results
2
A total of 82 cases were included, involving 43(52.4%) males and 39 (47.6%) females. The median age of patients was 42 years old. The number of mild, moderate, severe, and critically ill cases was 15 (18.3%), 54 (65.9%), 12 (14.6%), and 1 (1.2%), respectively. In terms of the color of the tongue body, light red tongue (31/82, 37.8%) and red tongue (29/82, 35.4%) were most frequently seen. The top three color of tongue coating was yellow (29/82, 35.4%), white (24/82, 29.3%) and white-yellow (21/82, 25.6%). For coating texture, glossy and greasy coating was mostly seen (32/82, 39.0%), followed by turbid, greasy and dry coating (19/82, 23.2%). From the perspective of six-channel pattern differentiation,
taiyang
(太阳) pattern accounted for the highest proportion (4/15, 26.7%) in mild cases;
shaoyang
to
yangming
(少阳阳明) pattern was the highest (14/54, 25.9%) in moderate cases; and
yangming
to
shaoyin
(阳明少阴) pattern was most frequent (4/12, 33.3%) in severe cases. After 3 days and 6 days of administration of
Qingfei Detoxifying Decoction
, the overall improvement rate of tongue manifestations was 58.5% (48/82) and 78.0% (64/82), respectively
.
Conclusion
2
The tongue manifestations are improved after taking
Qingfei Detu Decoction
. Although the six-channel pattern of the disease keeps the same as before treatment, the tongue coating gradually changes from thick to thin, and simultaneously from rough to moist, or from turbid to clear,or from greasy to loose; the tongue coating color becomes yellow from burnt yellow, or becomes light yellow from yellow, or white from light yellow. From the perspective of six-channel pattern differentiation, there is a tendency of tongue manifestations transforming from
yin
(阴) channel to
yang
(阳) channel, or from the interior to exterior of the
yang
channel.
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Effect of Qingfei Paidu Decoction(清肺排毒汤)combined with Western Medicine Routine Treatment on Tongue Manifestations in Patients with Coronavirus Disease 2019
FAN Yipin 1 , MA Yan 1 , JIAO Liwen 1 , GE Youwen 1 , SHI Nannan 1 , LUAN Xiangjia 2 , CHEN Renbo 1 , CHEN Guangkun 3 , YANG Mingbo 4 , YANG Puye 4 , HOU Yanling 5 , HUANG Jin 6 , HUANG Qiuhua 6 , ZHANG Linsong 7 , BAI Weiguo 1 , ZHANG Huamin 8 , WANG Yanping 1 , WANG Yongyan 1
Institute of Basic Research in Clinical Medicine , China Academy of Chinese Medical Sciences , Beijing , 10070 ; 2 . Guang' anmen Hospital , China Academy of Chinese Medical Sciences;3. Institute of Traditional Chinese Medicine Information, China Academy of Chinese Medical Sciences;4. Xi'an Eighth Hospital, Shaanxi Province;5. The Fourth People's Hospital of Taiyuan, Shanxi Province;6. Yongwu Hospital, Peoples Hospital of Guangxi Zhuang Autonomous Region;7. The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University; 8.Institute of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences
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