Objective

2

To analyze the TCM patterns of interstitial lung disease (ILD) with corona virus disease 2019

and explore its etiology and pathogenesis.

Methods

2

A cross-sectional study was conducted

in which 69 ILD patients diagnosed with COVID-19 in our hospital’s outpatient and wards from December 2022 to January 2023 were included. Their four TCM diagnostic information

general conditions and clinical data of western medicine were collected on the first visit or the day of admission.

Results

2

Among the 69 patients

the initial manifestation was predominantly lung-

wei

syndrome

accompanied by spleen syndromes. 23 symptoms were recorded from the 69 patients. Compared with the mild and moderate cases

the proportion of dyspnea

chest tightness

incomplete defecation

fear of cold

aversion of wind

blood in sputum

dry coating on the tongue and thready pulse in severe and critical patients was significantly higher (

P

<

0.05); while the proportion of headaches was significantly low (

P

<

0.05). Among the 69 patients

there were 3 types of tongue body

and 6 types of tongue coating and pulse pattern

respectively. Compared with mild and moderate patients

the proportion of dry coating on the tongue and thready pulse was higher in severe and critical patients (

P

<

0.05). Among the 69 patients

50 (72.5%) had a mixture of deficiency and excess

while 19 (27.5%) had excess patterns. From the perspective of

zang

-

fu

organ syndrome differentiation

there were a total of 12 syndrome types. Compared with the mild and moderate patients

the proportion of kidney-qi deficiency

kidney-yin and yang deficiency

heat entering

ying

-blood and pestilence blocking the lung in severe and critical patients was significantly higher (

P

<

0.05). The proportion of cold-dampness stagnation in the lung was significantly lower (

P

<

0.05). The affected area of the 69 patients is mainly located in the lung and spleen. Compared with the mild and moderate patients

the proportion of affected area in the kidney and

ying

-blood level is higher in severe and critical patients (

P

<

0.05).

Conclusion

2

COVID-19 is caused by the contraction of pestilence qi. COVID-19 in ILD patients can be manifested as the predominance of dampness toxin. The pathogenesis involves two parts: deficiency of healthy qi (in the lung

spleen

kidney) and excess of evil qi (damp heat toxin). The onset of the disease is in the lung

wei

and it common moves to the lung and spleen in the progressive stage. In severe and critical cases

the kidney and

ying

-blood may also be involved.