Journal of Traditional Chinese Medicine ›› 2024, Vol. 44 ›› Issue (4): 822-829.DOI: 10.19852/j.cnki.jtcm.2024.04.004
• Original articles • Previous Articles Next Articles
SU Rui, SU Youzhu, WANG Shuo, FAN Jie, LIU Qingquan(), LIU Mifeng()
Received:
2023-04-22
Accepted:
2023-08-03
Online:
2024-08-15
Published:
2024-07-15
Contact:
Prof. LIU Qingquan, Department of infectious diseases, Capital Medical University Beijing Hospital of Traditional Chinese Medicine, Beijing 100010, China. Supported by:
SU Rui, SU Youzhu, WANG Shuo, FAN Jie, LIU Qingquan, LIU Mifeng. A real-world study of the differences in Traditional Chinese Medicine diagnosis and treatment rules for coronavirus disease 2019 between Northern and Southern China[J]. Journal of Traditional Chinese Medicine, 2024, 44(4): 822-829.
Item | Total cases (n = 982) | Northern group (n = 211) | Southern group (n = 771) | P value |
---|---|---|---|---|
Age (years) | 41.30±16.15 | 46.64±17.77 | 39.74±15.31a | <0.001 |
Female [n (%)] | 533 (54.28) | 97 (45.98) | 436 (56.55) a | <0.001 |
Male [n (%)] | 449 (45.73) | 114 (54.02) | 335 (43.45)a | <0.001 |
BMI (kg/m2) | 23.63±3.28 | 23.92±3.69 | 23.55±3.04 | 0.161 |
Smokers [n (%)] | 81 (8.25) | 22 (10.43) | 59 (7.65) | 0.194 |
14-day contact history [n (%)] | 242 (24.64) | 131 (62.09) | 111 (14.40)a | <0.001 |
Overseas Travel [n (%)] | 455 (46.33) | 17 (8.06) | 438 (56.81)a | <0.001 |
Asymptomatic [n (%)] | 111 (11.30) | 62 (29.38) | 49 (6.36)a | <0.001 |
Mild [n (%)] | 112 (11.41) | 11 (5.21) | 101 (13.10)a | <0.001 |
Moderate [n (%)] | 716 (72.91) | 118 (55.92) | 598 (77.56)a | <0.001 |
Serious [n (%)] | 40 (4.07) | 17 (8.06) | 23 (2.98)a | <0.001 |
Critical [n (%)] | 3 (0.31) | 3 (1.42) | 0 (0.0)a | <0.001 |
Diabetes [n (%)] | 48 (4.89) | 21 (1.00) | 27 (3.50)a | <0.001 |
Chronic lung disease [n (%)] | 28 (2.85) | 8 (3.79) | 20 (2.59) | 0.295 |
Cardiovascular disease (including high blood pressure) [n (%)] | 95 (9.67) | 46 (21.80) | 49 (6.46)a | <0.001 |
Digestive system disease [n (%)] | 8 (0.81) | 0 (0.0) | 8 (1.04) | 0.137 |
Nervous system disease [n (%)] | 5 (0.51) | 2 (0.95) | 3 (0.39) | 0.312 |
Chronic liver disease [n (%)] | 16 (1.63) | 2 (0.95) | 14 (1.86) | 0.242 |
Fever [n (%)] | 122 (12.42) | 31 (14.69) | 91 (11.80) | 0.260 |
<37.4 ℃[n (%)] | 860 (87.58) | 184 (87.20) | 676 (87.68) | 0.853 |
37.4 ℃-38.0 ℃ [n (%)] | 84 (8.56) | 23 (10.90) | 65 (8.43) | 0.266 |
>38 ℃ [n (%)] | 38 (3.87) | 10 (4.74) | 28 (3.63) | 0.460 |
Cough [n (%)] | 335 (34.11) | 101 (47.87) | 234 (30.35)a | <0.001 |
Fatigue [n (%)] | 164 (16.70) | 32 (15.17) | 132 (17.12) | 0.500 |
Myalgia [n (%)] | 32 (3.26) | 5 (0.24) | 27 (3.50) | 0.412 |
Irritability [n (%)] | 33 (3.36) | 4 (1.90) | 29 (3.76) | 0.183 |
Diarrhea [n (%)] | 37 (3.77) | 6 (2.84) | 31 (4.02) | 0.426 |
Runny nose [n (%)] | 36 (3.67) | 9 (4.27) | 27 (3.50) | 0.601 |
Expectoration [n (%)] | 216 (22.00) | 59 (27.96) | 157 (20.36)b | 0.018 |
Sore throat [n (%)] | 81 (8.25) | 12 (5.69) | 69 (8.95) | 0.127 |
Dyspnea [n (%)] | 95 (9.67) | 41 (19.43) | 54 (7.00)a | <0.001 |
Abdominal pain [n (%)] | 31 (3.16) | 6 (2.84) | 25 (3.24) | 0.769 |
Dry mouth [n (%)] | 158 (16.09) | 44 (20.85) | 114 (14.79)b | 0.034 |
Days from onset to admission (d) | 4.64±5.88 | 4.72±4.58 | 4.62±6.19 | 0.062 |
Hospital length of stay (d) | 16.98±8.48 | 17.31±6.63 | 16.90±8.90c | 0.014 |
Course of disease (d) | 20.70±10.19 | 21.26±7.94 | 20.55±10.69 | 0.083 |
ICU admission [n (%)] | 33(3.36) | 22(10.43) | 11(1.43)a | <0.001 |
ICU length of stay (d) | 15.57±8.35 | 13.91±6.58 | 33.00±1.41b | 0.022 |
Viral shedding duration (d) | 12.12±7.74 | 12.38±5.82 | 12.04±8.25 | 0.064 |
Duration of antibiotic treatment (d) | 9.91±5.12 | 6.89±4.30 | 10.16±5.11b | 0.005 |
Duration of corticosteroid treatment (d) | 6.40±5.03 | 7.48±7.32 | 6.00±3.86 | 0.609 |
Duration of oxygenation by nasal cannula or face mask (d) | 2.12±1.69 | 2.05±2.01 | 2.13±1.63 | 0.061 |
Cases of noninvasive mechanical ventilation [n (%)] | 9(0.92) | 3(1.42) | 6(0.78) | 0.385 |
Cases of traumatic mechanical ventilation [n (%)] | 6(0.61) | 3(1.42) | 3(0.39) | <0.088 |
ECMO [n (%)] | 2(0.20) | 2(0.95) | 0(0.0)a | 0.007 |
Admission days of first TCM use (d) | 2.77±4.18 | 1.78±2.27 | 2.63±1.53b | 0.015 |
Table 1 Clinical features and treatment of the two cohorts
Item | Total cases (n = 982) | Northern group (n = 211) | Southern group (n = 771) | P value |
---|---|---|---|---|
Age (years) | 41.30±16.15 | 46.64±17.77 | 39.74±15.31a | <0.001 |
Female [n (%)] | 533 (54.28) | 97 (45.98) | 436 (56.55) a | <0.001 |
Male [n (%)] | 449 (45.73) | 114 (54.02) | 335 (43.45)a | <0.001 |
BMI (kg/m2) | 23.63±3.28 | 23.92±3.69 | 23.55±3.04 | 0.161 |
Smokers [n (%)] | 81 (8.25) | 22 (10.43) | 59 (7.65) | 0.194 |
14-day contact history [n (%)] | 242 (24.64) | 131 (62.09) | 111 (14.40)a | <0.001 |
Overseas Travel [n (%)] | 455 (46.33) | 17 (8.06) | 438 (56.81)a | <0.001 |
Asymptomatic [n (%)] | 111 (11.30) | 62 (29.38) | 49 (6.36)a | <0.001 |
Mild [n (%)] | 112 (11.41) | 11 (5.21) | 101 (13.10)a | <0.001 |
Moderate [n (%)] | 716 (72.91) | 118 (55.92) | 598 (77.56)a | <0.001 |
Serious [n (%)] | 40 (4.07) | 17 (8.06) | 23 (2.98)a | <0.001 |
Critical [n (%)] | 3 (0.31) | 3 (1.42) | 0 (0.0)a | <0.001 |
Diabetes [n (%)] | 48 (4.89) | 21 (1.00) | 27 (3.50)a | <0.001 |
Chronic lung disease [n (%)] | 28 (2.85) | 8 (3.79) | 20 (2.59) | 0.295 |
Cardiovascular disease (including high blood pressure) [n (%)] | 95 (9.67) | 46 (21.80) | 49 (6.46)a | <0.001 |
Digestive system disease [n (%)] | 8 (0.81) | 0 (0.0) | 8 (1.04) | 0.137 |
Nervous system disease [n (%)] | 5 (0.51) | 2 (0.95) | 3 (0.39) | 0.312 |
Chronic liver disease [n (%)] | 16 (1.63) | 2 (0.95) | 14 (1.86) | 0.242 |
Fever [n (%)] | 122 (12.42) | 31 (14.69) | 91 (11.80) | 0.260 |
<37.4 ℃[n (%)] | 860 (87.58) | 184 (87.20) | 676 (87.68) | 0.853 |
37.4 ℃-38.0 ℃ [n (%)] | 84 (8.56) | 23 (10.90) | 65 (8.43) | 0.266 |
>38 ℃ [n (%)] | 38 (3.87) | 10 (4.74) | 28 (3.63) | 0.460 |
Cough [n (%)] | 335 (34.11) | 101 (47.87) | 234 (30.35)a | <0.001 |
Fatigue [n (%)] | 164 (16.70) | 32 (15.17) | 132 (17.12) | 0.500 |
Myalgia [n (%)] | 32 (3.26) | 5 (0.24) | 27 (3.50) | 0.412 |
Irritability [n (%)] | 33 (3.36) | 4 (1.90) | 29 (3.76) | 0.183 |
Diarrhea [n (%)] | 37 (3.77) | 6 (2.84) | 31 (4.02) | 0.426 |
Runny nose [n (%)] | 36 (3.67) | 9 (4.27) | 27 (3.50) | 0.601 |
Expectoration [n (%)] | 216 (22.00) | 59 (27.96) | 157 (20.36)b | 0.018 |
Sore throat [n (%)] | 81 (8.25) | 12 (5.69) | 69 (8.95) | 0.127 |
Dyspnea [n (%)] | 95 (9.67) | 41 (19.43) | 54 (7.00)a | <0.001 |
Abdominal pain [n (%)] | 31 (3.16) | 6 (2.84) | 25 (3.24) | 0.769 |
Dry mouth [n (%)] | 158 (16.09) | 44 (20.85) | 114 (14.79)b | 0.034 |
Days from onset to admission (d) | 4.64±5.88 | 4.72±4.58 | 4.62±6.19 | 0.062 |
Hospital length of stay (d) | 16.98±8.48 | 17.31±6.63 | 16.90±8.90c | 0.014 |
Course of disease (d) | 20.70±10.19 | 21.26±7.94 | 20.55±10.69 | 0.083 |
ICU admission [n (%)] | 33(3.36) | 22(10.43) | 11(1.43)a | <0.001 |
ICU length of stay (d) | 15.57±8.35 | 13.91±6.58 | 33.00±1.41b | 0.022 |
Viral shedding duration (d) | 12.12±7.74 | 12.38±5.82 | 12.04±8.25 | 0.064 |
Duration of antibiotic treatment (d) | 9.91±5.12 | 6.89±4.30 | 10.16±5.11b | 0.005 |
Duration of corticosteroid treatment (d) | 6.40±5.03 | 7.48±7.32 | 6.00±3.86 | 0.609 |
Duration of oxygenation by nasal cannula or face mask (d) | 2.12±1.69 | 2.05±2.01 | 2.13±1.63 | 0.061 |
Cases of noninvasive mechanical ventilation [n (%)] | 9(0.92) | 3(1.42) | 6(0.78) | 0.385 |
Cases of traumatic mechanical ventilation [n (%)] | 6(0.61) | 3(1.42) | 3(0.39) | <0.088 |
ECMO [n (%)] | 2(0.20) | 2(0.95) | 0(0.0)a | 0.007 |
Admission days of first TCM use (d) | 2.77±4.18 | 1.78±2.27 | 2.63±1.53b | 0.015 |
Northern group (n = 211) | Southern group (n = 771) | ||||
---|---|---|---|---|---|
Syndrome elements | Frequency | Proportion (%) | Syndrome elements | Frequency | Proportion (%) |
Toxin | 86 | 40.76 | Heat | 620 | 80.42 |
Dampness | 74 | 35.07 | Wind | 349 | 45.27 |
Lung | 68 | 32.23 | Lung | 81 | 10.51 |
Spleen | 50 | 23.70 | Dampness | 65 | 8.43 |
Deficiency | 39 | 18.48 | Phlegm | 48 | 6.23 |
Heat | 9 | 4.27 | Toxin | 26 | 0.37 |
Wind | 7 | 3.12 | Cold | 13 | 1.69 |
Phlegm | 7 | 3.12 | Fire | 11 | 1.43 |
Exterior | 4 | 1.90 | Spleen | 4 | 0.52 |
Blood stasis | 4 | 1.90 | Deficiency | 3 | 0.39 |
Table 2 Frequency distribution of syndrome elements in the Northern and Southern groups
Northern group (n = 211) | Southern group (n = 771) | ||||
---|---|---|---|---|---|
Syndrome elements | Frequency | Proportion (%) | Syndrome elements | Frequency | Proportion (%) |
Toxin | 86 | 40.76 | Heat | 620 | 80.42 |
Dampness | 74 | 35.07 | Wind | 349 | 45.27 |
Lung | 68 | 32.23 | Lung | 81 | 10.51 |
Spleen | 50 | 23.70 | Dampness | 65 | 8.43 |
Deficiency | 39 | 18.48 | Phlegm | 48 | 6.23 |
Heat | 9 | 4.27 | Toxin | 26 | 0.37 |
Wind | 7 | 3.12 | Cold | 13 | 1.69 |
Phlegm | 7 | 3.12 | Fire | 11 | 1.43 |
Exterior | 4 | 1.90 | Spleen | 4 | 0.52 |
Blood stasis | 4 | 1.90 | Deficiency | 3 | 0.39 |
Northern group (n = 211) | Southern group (n = 771) | ||||
---|---|---|---|---|---|
Patterns | Frequency | Proportion (%) | Patterns | Frequency | Proportion (%) |
Dampness-toxin stagnating in the lung | 94 | 44.55 | Heat dampness accumulating in the lung | 429 | 55.65 |
Deficiency of lung and spleen Qi | 38 | 18.01 | Dampness-toxin stagnating in the lung | 123 | 15.96 |
Heat dampness accumulating in the lung | 38 | 18.01 | Wind heat attacking the lung | 41 | 5.32 |
Qi and Yin deficiency | 21 | 9.52 | Epidemic toxin blocking the lung | 31 | 4.02 |
Epidemic toxin blocking the lung | 19 | 9.00 | Cold dampness stagnating in the lung | 14 | 1.82 |
Cold dampness obstructing the lung | 5 | 2.37 | Deficiency of lung and spleen Qi | 14 | 1.82 |
Table 3 The top 6 frequencies of syndrome distribution in the Northern and Southern groups
Northern group (n = 211) | Southern group (n = 771) | ||||
---|---|---|---|---|---|
Patterns | Frequency | Proportion (%) | Patterns | Frequency | Proportion (%) |
Dampness-toxin stagnating in the lung | 94 | 44.55 | Heat dampness accumulating in the lung | 429 | 55.65 |
Deficiency of lung and spleen Qi | 38 | 18.01 | Dampness-toxin stagnating in the lung | 123 | 15.96 |
Heat dampness accumulating in the lung | 38 | 18.01 | Wind heat attacking the lung | 41 | 5.32 |
Qi and Yin deficiency | 21 | 9.52 | Epidemic toxin blocking the lung | 31 | 4.02 |
Epidemic toxin blocking the lung | 19 | 9.00 | Cold dampness stagnating in the lung | 14 | 1.82 |
Cold dampness obstructing the lung | 5 | 2.37 | Deficiency of lung and spleen Qi | 14 | 1.82 |
Northern group (n = 211) | Southern group (n = 771) | ||||
---|---|---|---|---|---|
Herbal | Frequency | Proportion (%) | Herbal | Frequency | Proportion (%) |
Chaihu (Radix Bupleuri Chinensis) | 122 | 57.82 | Fuling (Poria) | 187 | 24.25 |
Huangqin (Radix Scutellariae Baicalensis) | 121 | 57.35 | Lianqiao (Fructus Forsythiae Suspensae) | 174 | 22.56 |
Gancao (Radix Glycyrrhizae) | 120 | 56.87 | Gancao (Radix Glycyrrhizae) | 168 | 21.79 |
Cangzhu (Rhizoma Atractylodis Lanceae) | 110 | 52.13 | Chenpi (Pericarpium Citri Reticulatae) | 165 | 21.40 |
Huoxiang (Herba Agastaches Rugosa) | 107 | 50.71 | Jinyinhua (Flos Lonicerae) | 131 | 16.99 |
Jinyinhua (Flos Lonicerae) | 100 | 47.39 | Huangqi (Radix Astragali Mongolici) | 120 | 15.56 |
Fuling (Poria) | 100 | 47.39 | Huangqin (Radix Scutellariae Baicalensis) | 119 | 15.43 |
Chenpi (Pericarpium Citri Reticulatae) | 94 | 44.55 | Baizhu (Rhizoma Atractylodis Macrocephalae) | 112 | 14.53 |
Baizhu (Rhizoma Atractylodis Macrocephalae) | 89 | 42.18 | Dangshen (Radix Codonopsis) | 92 | 11.94 |
Kuxingren (Semen Armeniacae Amarum) | 85 | 40.28 | Dahuang (Radix Et Rhizoma Rhei Palmati) | 87 | 11.28 |
Table 4 Frequency of use of Chinese Herbal Medicine (top 10) in the Northern and Southern groups
Northern group (n = 211) | Southern group (n = 771) | ||||
---|---|---|---|---|---|
Herbal | Frequency | Proportion (%) | Herbal | Frequency | Proportion (%) |
Chaihu (Radix Bupleuri Chinensis) | 122 | 57.82 | Fuling (Poria) | 187 | 24.25 |
Huangqin (Radix Scutellariae Baicalensis) | 121 | 57.35 | Lianqiao (Fructus Forsythiae Suspensae) | 174 | 22.56 |
Gancao (Radix Glycyrrhizae) | 120 | 56.87 | Gancao (Radix Glycyrrhizae) | 168 | 21.79 |
Cangzhu (Rhizoma Atractylodis Lanceae) | 110 | 52.13 | Chenpi (Pericarpium Citri Reticulatae) | 165 | 21.40 |
Huoxiang (Herba Agastaches Rugosa) | 107 | 50.71 | Jinyinhua (Flos Lonicerae) | 131 | 16.99 |
Jinyinhua (Flos Lonicerae) | 100 | 47.39 | Huangqi (Radix Astragali Mongolici) | 120 | 15.56 |
Fuling (Poria) | 100 | 47.39 | Huangqin (Radix Scutellariae Baicalensis) | 119 | 15.43 |
Chenpi (Pericarpium Citri Reticulatae) | 94 | 44.55 | Baizhu (Rhizoma Atractylodis Macrocephalae) | 112 | 14.53 |
Baizhu (Rhizoma Atractylodis Macrocephalae) | 89 | 42.18 | Dangshen (Radix Codonopsis) | 92 | 11.94 |
Kuxingren (Semen Armeniacae Amarum) | 85 | 40.28 | Dahuang (Radix Et Rhizoma Rhei Palmati) | 87 | 11.28 |
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