目的 研究2 型糖尿病(T2DM)4 种证素与血清C-反应蛋白(CRP)之间的相关性,为此病中医辨证客观化及中医药防治提供理论依据.方法 以197 例T2DM患者为研究对象,采用证素辨证方法进行四诊资料采集,并检测患者的炎症因子CRP,分析4 种主要病性证素与CRP的关系.结果 4 种主要病性证素为阴虚、热、气虚、痰.4 种证素与CRP的关系:气虚组CRP水平显著高于非气虚组(P<0.01);痰组CRP水平高于非痰组(P<0.05);与非热盛组相比,热盛组出现CRP升高的比例较高,差异有统计学意义(P<0.05);与非痰组相比,痰组出现CRP升高的比例较高,差异有统计学意义(P<0.05).结论 T2DM患者CRP水平升高可能与痰浊、气虚、热盛3 种病理因素有关联.
目的:探讨福建省厦门市新型冠状病毒Delta变异株感染患者的临床特征与中医体质分布规律,为早期干预及辨证论治提供参考依据.方法:采用真实世界研究方法,收集新型冠状病毒肺炎确诊患者基本信息,并以问卷星形式调查患者初始症状与中医体质情况,通过数据统计分析,探讨厦门地区新型冠状病毒肺炎患者症状特征、体质类型分布及两者之间的关联性.结果:此次纳入研究的183例新冠肺炎患者轻型36例,普通型141例,重型6例,平均核酸转阴天数为(15.39±8.95)天,整体预后较好.临床特征:厦门地区新型冠状病毒肺炎患者以咳嗽、发热、睡眠不佳、胃口差、咽干咽痒等为首发症状;其中恶心不适、咳嗽、咳痰、气喘、胃口差等症状持续天数较长;咽痛、恶心不适、大便不成形、周身酸痛、气喘等症状较为严重;体质类型发生前4位依次为平和质、痰湿质、阳虚质、湿热质,轻型以平和体质、痰湿质为主,普通型以平和质、痰湿质、阳虚质多见.结论:厦门地区感染新型冠状病毒的患者中,以湿为主要特征,偏于湿热;偏颇体质以痰湿质、阳虚质、湿热质多见.因此,对新冠病毒肺炎的防治可结合地域、饮食,在中医体质辨识的基础上,实行个体化诊疗.
目的:基于真实世界数据分析厦门地区境外输入新型冠状病毒肺炎患者内服中药的用药规律,以期为临床防治提供参考.方法:采用古今医案云平台(V2.2.1)对2021年4月至2021年10月于厦门大学附属第一医院杏林分院收住治疗的223例境外输入的新型冠状病毒肺炎患者的中药处方进行中药使用频次分析,中药性味、归经及功效分析,中药关联分析,中药聚类分析及中药复杂药理分析.结果:在223例患者的中药处方中,涉及156味中药,总用药频次3181次,药性以温、微寒为主,药味以苦、辛、甘为主,主要归肺经、脾经、胃经,药物主要功效为清热解毒、燥湿化痰、降逆止呕;柴胡-黄芩、半夏-柴胡、黄芩-甘草等为主要药对;复杂网络分析得出核心物组合为柴胡、黄芩、半夏、茯苓、陈皮、甘草、桔梗、贯众、北沙参、前胡;高频中药聚类分析可归纳为4个聚类方,主要为小柴胡汤、达原饮、麻黄汤及麻杏石甘汤等聚类方.结论:湿邪为此次境外输入新冠肺炎的核心病机,偏于湿热;治疗上当宣肺祛邪,清热燥湿,开达膜原,通利三焦;用药当寒温并举,以温为主,肺脾同治,间者并行.
COVID-19, referred to as new coronary pneumonia, is an acute infectious disease caused by a new type of coronavirus SARS-CoV-2. To evaluate the effect of integrated Chinese medicine and Western medicine in patients with COVID-19 from overseas. Data were collected from 178 COVID-19 patients overseas at First Affiliated Hospital of Xiamen University from April 1, 2021 to July 31, 2021. These patients received therapy of integrated Chinese medicine and western medicine. Demographic data and clinical characteristics were extracted and analyzed. In addition, the prescription which induced less length of PCR positive days and hospitalization days than the median value was obtained. The top 4 frequently used Chinese medicine and virus-related genes were analyzed by network pharmacology and bioinformatics analysis. According to the chest computed tomography (CT) measurement, abnormal lung findings were observed in 145 subjects. The median length of positive PCR/hospitalization days was 7/7 days for asymptomatic subjects, 14/24 days for mild subjects, 10/15 days for moderate subjects, and 14/20 days for severe subjects. The most frequently used Chinese medicine were Scutellaria baicalensis (Huangqin), Glycyrrhiza uralensis (Gancao), Bupleurum chinense (Chaihu), and Pinellia ternata (Banxia). The putative active ingredients were baicalin, stigmasterol, sigmoidin-B, cubebin, and troxerutin. ACE, SARS-CoV-2 3CL, SARS-CoV-2 Spike, SARS-CoV-2 ORF7a, and caspase-6 showed good binding properties to active ingredients. In conclusion, the clinical results showed that integrated Chinese medicine and Western medicine are effective in treating COVID-19 patients from overseas. Based on the clinical outcomes, the putative ingredients from Chinese medicine and the potential targets of SARS-CoV-2 were provided, which could provide a reference for the clinical application of Chinese medicine in treating COVID-19 worldwide.