摘要
目的从中西医学视角观察中国北方和南方地区新型冠状病毒肺炎(COVID-19)症状描述的异同性,为疾病的中西医结合防治提供参考。方法检索我国科技部、国家卫生健康委、中国科协、中华医学会联合共建"新型冠状病毒肺炎科研成果学术交流平台"和中国知网(新型冠状病毒肺炎OA)两种数据库(检索时间为2020年2月26日),下载文中有中医学四诊信息和(或)现代医学症状描述的文章,利用SPSS 17.0对文中提取的症状等信息进行统计分析。结果 (1)现代医学视角下COVID-19排名前10的症状依次是发热、咳嗽、乏力、咳痰、肌肉酸痛、干咳、胸闷、呼吸困难、头痛和腹泻,其中胸闷和呼吸困难出现频率南方多于北方(P<0.05),头痛则少于北方(P<0.01)。(2)中医学视角下COVID-19排名前10的症状依次是发热、咳嗽、乏力、肌肉酸痛、纳差、咳痰、胸闷、口干、恶寒和头痛。其中咳嗽、干咳、乏力、肌肉酸痛、咳痰、头痛、胸闷和腹泻等症状出现频率南方高于北方(P<0.05,P<0.01),咽痛则低于北方(P<0.01);(3)两种医学综合来看,COVID-19排名前10的症状依次是发热、咳嗽、乏力、咳痰、肌肉酸痛、胸闷、纳差、干咳、呼吸困难和头痛。其中咳嗽、胸闷、纳差、干咳、呼吸困难等症状的出现频率南方高于北方(P<0.01),咽痛则低于北方(P<0.01)。(4)中医学视角下的COVID-19症状中发热、干咳和呼吸困难出现频率低于现代医学(P<0.05,P<0.01),乏力、肌肉酸痛、头痛、胸闷和纳差等症状的出现频率则高于现代医学(P<0.05,P<0.01)。结论 (1)除发热、咳嗽、乏力作为COVID-19的主要症状外,肌肉酸痛也可能是其主要症状之一;(2)COVID-19发病特征中国南北方基本一致,但也有差别,而"胸闷"可能是体现这种差别的症状之一。(3)现代医学视角下作为COVID-19主要症状的发热、干咳出现频率高于中医学,一定程度体现了在该病发生流行的初期阶段,部分地区中医学和现代医学的介入时点可能稍有区别。(4)推进中西医结合的第一步则是规范中西医的疾病症状辨识和记录,推进中西医症状描述名词的通用性,实现中西医症状采集方面的一致性。
Objective To reveal the similarities and differences of the Corona Virus Disease 2019(COVID-19) symptoms in North and South China, and to promote the prevention and treatment of COVID-19 with integrated Chinese and Western medicine(ICWM). Methods Retrieved were the papers published before Feb 26, 2020, which contained the diagnoses of COVID-19 with traditional Chinese medicine(TCM) and/or symptoms description of modern medicine in the academic exchange platform(co-established by Ministry of Science and Technology, National Health Commission, China Association for Science and Technology, and China Medical Association) for novel coronavirus pneumonia research achievements and CNKI(novel coronavirus pneumonia OA). SPSS 17.0 was used to analyze the symptoms and other information extracted from these papers. Results(1) From the perspective of modern medicine, the top 10 symptoms of COVID-19 were fever, cough, fatigue, expectoration, muscle pain, dry cough, chest distress, dyspnea, headache, and diarrhea, among which the frequencies of chest distress and dyspnea were higher in South China than in North China(P<0.05), while headache was less in North China(P<0.01).(2) From the perspective of TCM, the top 10 symptoms of COVID-19 were fever, cough, fatigue, muscle pain, poor appetite, expectoration, chest distress, dry mouth, aversion to cold, and headache, in which the frequencies of cough, dry cough, fatigue, muscle pain, expectoration, headache, chest distress, and diarrhea were higher in South China than in North China(P<0.05, P<0.01), while the incidence of pharyngeal pain was lower in South China than in North China(P<0.01).(3) From the perspective of two medicines, the top 10 symptoms of COVID-19 were fever, cough, fatigue, expectoration, muscle pain, chest distress, poor appetite, dry cough, dyspnea, and headache. The frequencies of cough, chest distress, dyspnea, dry cough, and dyspnea were higher in South China than in North China(P<0.01), while the incidence of pharyngeal pain was lower in South China than in North China(P<0.01).(4) The frequencies of fever, dry cough, and dyspnea in the symptoms of COVID-19 from the perspective of TCM were lower than those of modern medicine(P<0.05, P<0.01), while the frequencies of fatigue, muscle pain, headache, chest distress, and poor appetite were higher than those of modern medicine(P<0.05, P<0.01). Conclusions(1) In addition to fever, cough, and fatigue as the main symptoms of COVID-19, muscle soreness may also be one of main symptoms.(2) The characteristics of COVID-19 in North China and South China were almost the same, but there were also differences, and chest distress may be one of the symptoms reflecting this difference.(3) From the perspective of modern medicine, the main symptoms of COVID-19, fever and dry cough occur more frequently than that of TCM. To some extent, it showed that in its early stage the interventions of TCM and modern medicine may be slightly different.(4) The first step to promote the integration of TCM and modern medicine is to standardize the identification and recording of symptoms in TCM and modern medicine, to promote the universality of symptoms description in TCM and modern medicine, and to achieve the consistency of symptoms collection in TCM and modern medicine.
作者
高振
刘莹莹
董竞成
GAO Zhen;LIU Ying-ying;DONG Jing-cheng(Department of Integrated Traditional Chinese and Western Medicine,Huashan Hospital Affiliated to Fudan University,Institutes of Integrative Medicine,Fudan University,Shanghai,200040)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2020年第4期439-445,共7页
Chinese Journal of Integrated Traditional and Western Medicine
基金
中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者(董竞成)资助项目(No.国中医药人教函[2018]284号)。
关键词
新型冠状病毒肺炎
症状
中国南方和北方
中医学
现代医学
Corona Virus Disease 2019
symptoms
South and North China
traditional Chinese medicine
modern medicine
