TCM syndrome distribution and pathogenesis evolution of post-acute COVID-19 interstitial lung disease

LI Xue; ZHOU Jipu; LIU Jian; LIU Meng; WANG Yuguang

doi:10.16025/j.1674-1307.2025.08.003

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TCM syndrome distribution and pathogenesis evolution of post-acute COVID-19 interstitial lung disease

更新时间：2025-10-10

- TCM syndrome distribution and pathogenesis evolution of post-acute COVID-19 interstitial lung disease
- Beijing Journal of Traditional Chinese Medicine Vol. 44, Issue 8, Pages: 961-966(2025)
- 作者机构：
  
  首都医科大学附属北京中医医院呼吸科，北京 100010
- 作者简介：
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.08.003
  CLC：
- Received：04 April 2025，
  
  Published：25 August 2025
- 稿件说明：
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李雪，周继朴，刘建，等.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.

LI Xue,ZHOU Jipu,LIU Jian,et al.TCM syndrome distribution and pathogenesis evolution of post-acute COVID-19 interstitial lung disease[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(08):961-966.
李雪，周继朴，刘建，等.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. DOI： 10.16025/j.1674-1307.2025.08.003.

LI Xue,ZHOU Jipu,LIU Jian,et al.TCM syndrome distribution and pathogenesis evolution of post-acute COVID-19 interstitial lung disease[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(08):961-966. DOI： 10.16025/j.1674-1307.2025.08.003.

摘要

目的

分析新型冠状病毒感染后间质性肺疾病（PC-ILD）患者的中医症状、证候分布特点，并探究其病机演变规律。

方法

选取2023年2月-2024年6月在首都医科大学附属北京中医医院门诊和病房诊断为PC-ILD的患者103例，对其中医四诊信息及辨证资料进行回顾性分析。

结果

103例患者共涉及20种症状，以肺系症状多见。与急性新型冠状病毒（简称“新冠病毒”）感染后病程≥3个月比较，病程

3个月的患者中口苦、咽喉不利和口黏的比例高（

0.05，

0.01），畏寒和腰膝酸软的比例低（

0.05，

0.01）；与新冠病毒感染轻/中型患者比较，重型/危重型患者中少气、喘憋、乏力的比例高（

0.05，

0.01）；与基础不存在ILD的患者比较，基础存在ILD的患者中少气、喘憋、乏力、腰膝酸软和畏寒的比例高（

0.05，

0.01）。103例患者中有4种舌质，5种舌苔，6种脉象。与急性新冠病毒感染后病程≥3个月比较，病程

3个月患者中黄腻苔、脉滑、脉细和脉濡的比例高（

0.05）；与新冠感染时轻/中型患者比较，重型/危重型患者中脉细比例高（

0.05）；与基础不存在ILD患者比较，基础存在ILD患者中脉沉和脉细的比例高（

0.05，

0.01）。103例患者中有虚实夹杂证79例（76.7%）、实证14例（13.6%）、虚证10例（9.7%）。具体中医证候类型共计13种。与急性新冠病毒感染后病程≥3个月比较，病程

3个月患者中肺阴虚、肾阴虚、湿热内蕴和少阳郁闭证的比例高（

0.01），肾阳虚比例低（

0.05）；与新冠感染时轻/中型患者比较，重型/危重型患者中肺气虚、肺阴虚和肾阴虚证的比例高（

0.05，

0.01）；与基础不存在ILD的患者比较，基础存在ILD的患者中肾气虚和肾阳虚的比例高（

0.05，

0.01）。103例患者总体病位主要在肺。

结论

PC-ILD的中医临床症状以肺系症状为主，病机涉及正虚（肺气亏虚）和邪实（痰浊、湿瘀）两部分；病位位于太阴肺之里，重型/危重型新冠感染者及基础存在ILD患者更易累及少阴肾。

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 （

0.05）， and a lower proportion of aversion to cold and waist/knee soreness （

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 （

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 （

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 （

0.05）. Compared to mild and moderate COVID-19 patients， severe and critical patients had a higher proportion of thready pulse （

0.05）. Compared to patients without ILD， those with underlying ILD had a higher proportion of deep pulse and thready pulse （

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 （

0.05）， and a lower proportion of kidney

yang

deficiency （

0.05）. Compared to mild and moderate COVID-19 patients， severe and critical patients had a higher proportion of lung

deficiency， lung

yin

deficiency， and kidney

yin

deficiency （

0.05）. Compared to patients without ILD， those with ILD had a higher proportion of kidney

deficiency and kidney

yang

deficiency （

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

（lung

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

Keywords

references

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