北京中医药2025，Vol.44Issue(8)：961-966,6.DOI:10.16025/j.1674-1307.2025.08.003
新型冠状病毒感染后间质性肺疾病的中医证候分布与病机演变规律研究
TCM syndrome distribution and pathogenesis evolution of post-acute COVID-19 interstitial lung disease
摘要
Abstract
Objective To analyze the traditional Chinese medicine(TCM)symptoms and syndrome distribution characteristics of patients with post-acute COVID-19 interstitial lung disease(PC-ILD)and explore the pathogenesis and disease evolution.Methods A total of 103 patients diagnosed with PC-ILD from February 2023 to June 2024 at the outpatient and inpatient departments of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,were enrolled.Their medical information,including data from the four diagnostic methods and syndrome differentiation,was retrospectively analyzed.Results Among the 103 patients,20 symptoms were recorded,with pulmonary symptoms being the most common.Compared to patients with acute COVID-19 whose disease duration was≥3 months,those with a disease duration of<3 months had a higher proportion of thirst,half-body sweating,bitter taste,difficulty swallowing,and sticky mouth(P<0.05),and a lower proportion of aversion to cold and waist/knee soreness(P<0.05).Compared to mild and moderate COVID-19 patients,severe and critical patients had a higher proportion of shortness of breath,wheezing,fatigue,and night sweating(P<0.05).Compared to patients without underlying ILD,those with underlying ILD had a higher proportion of shortness of breath,wheezing,fatigue,lumbar and knee soreness,and aversion to cold(P<0.05).Among the 103 patients,there were 4 types of tongue texture,5 types of tongue coating,and 6 types of pulse.Compared to patients with acute COVID-19 whose disease duration was≥3 months,those with a disease duration of<3 months had a higher proportion of yellow greasy coating,slippery pulse,thready pulse,and soggy pulse(P<0.05).Compared to mild and moderate COVID-19 patients,severe and critical patients had a higher proportion of thready pulse(P<0.05).Compared to patients without ILD,those with underlying ILD had a higher proportion of deep pulse and thready pulse(P<0.05).Among the 103 patients,79(76.7%)had a mixed deficiency and excess syndrome,14(13.6%)had an excess syndrome,and 10(9.7%)had a deficiency syndrome.There were a total of 13 types of syndromes.Compared to patients with acute COVID-19 whose disease duration was≥3 months,those with a disease duration of<3 months had a higher proportion of lung yin deficiency,kidney yin deficiency,dampness-heat accumulation,and Shaoyang depression syndrome(P<0.05),and a lower proportion of kidney yang deficiency(P<0.05).Compared to mild and moderate COVID-19 patients,severe and critical patients had a higher proportion of lung qi deficiency,lung yin deficiency,and kidney yin deficiency(P<0.05).Compared to patients without ILD,those with ILD had a higher proportion of kidney qi deficiency and kidney yang deficiency(P<0.05).The overall disease distribution among the 103 patients was primarily in the lungs.Conclusion The clinical TCM symptoms of PC-ILD are mainly pulmonary symptoms.The pathogenesis involves both deficiency of healthy qi(lung qi deficiency)and excess pathogenic factors(turbidity-phlegm and dampness-stasis).The disease primarily affects the Taiyin lung,with severe/critical COVID-19 patients and those with underlying ILD more likely to involve the Shaoyin kidney.关键词
新型冠状病毒感染后/间质性肺疾病/证候/病因病机Key words
post-acute COVID-19/interstitial lung disease/syndrome/etiology and pathogenesis引用本文复制引用
李雪,周继朴,刘建,刘萌,王玉光..新型冠状病毒感染后间质性肺疾病的中医证候分布与病机演变规律研究[J].北京中医药,2025,44(8):961-966,6.基金项目
国家中医药管理局科技司中医药循证能力建设项目 （）
高层次公共卫生技术人才培养建设项目计划(学科带头人-01-16) （学科带头人-01-16）
