摘要：目的：系统评价中国地区新型冠状病毒肺炎（Corona Virus Disease 2019，COVID-19）患者中医证候特征，为临床中医药辨证治疗提供循证医学依据。方法：计算机通过CNKI、WANFANG、Pubmed数据检索关于新型冠状病毒中医证候特征的相关研究，检索时限设定为建库至2020年2月27日。2名研究者独立筛选文献、提取数据和评估研究偏移风险，采用Stata12.0软件对纳入的研究合并效应量，进行荟萃分析。结果：最终共纳入11项研究。Meta分析结果显示：发热表现占比最高，分布频率为84%[95%CI（79%，90%）]，而且亚组分析显示该病可能存在地区差异：湖北省发热率高于湖北以外省份，南方高于北方。其次常见的中医症状包括：纳差64% [95%CI（36%，91%）]，咳嗽62%[95%CI（49%，74%）]，乏力53%[95%CI（40%，57%）]。舌诊以红舌69%[95%CI（46%，92%）]和腻苔78%[95%CI（63%，94%）]为主；脉象以滑脉42%[95%CI（17%，68%）]为主。中医证型分析发现湿毒型在COVID-19疾病占比最高72%[95%CI（53%，91%）]。结论：我们分析了COVID-19的常见中医症状和体征（包括脉象、舌象），为临床全面考虑中医证候，准确辨证治疗提供参考。需要强调的是：①我们证实了湿毒处于该病的核心地位；② COVID-19具有明显的地域差异；③纳差是患者仅次于发热的重要表现，而且舌苔厚腻、便溏、腹泻等脾胃功能障碍表现突出，具有明显“邪犯中焦”的特点。因此建议中医药在临床常规辨证论治的同时，也要 “因地制宜”，考虑气候，地域差异；同时加强对患者脾胃的固护，这与国家制定的中医诊疗方案强调“脾胃治疗贯穿始终”不谋而合。以上结论期待为中医药临床辨证论治提供循证支持。
Abstract: objective: to systematically evaluate the TCM syndrome characteristics of patients with Corona Virus Disease 2019(COVID-19) in China, and provide evidence-based medicine basis for clinical TCM syndrome differentiation and treatment.Methods: the computer searched related researches on TCM syndrome characteristics of novel coronavirus through the data of CNKI, WAN FANG and Pubmed, and the retrieval time was set as from the establishment of the database to February 27, 2020. Two researchers independently screened the literature, extracted the data, and evaluated the study migration risk, and used Stata12.0 software to conduct a meta-analysis of the included studies' combined effect size. Results: a total of 11 studies were included. The results of the meta-analysis showed that The fever ratio is highest 84% [95%ci (79%, 90%)], and the subgroup analysis showed that there might be regional differences in the disease: the fever rate in Hubei province was higher than that in provinces outside Hubei province, and that in the south was higher than that in the north.The second most common TCM symptoms include: Poor appetite of 64% [95%ci (36%, 91%)], cough of 62%[95%ci (49%, 74%)], and fatigue of 53%[95%ci (40%, 57%)].Tongue diagnosis was dominated by red tongue 69%[95%ci (46%, 92%)] and greasy tongue coating 78%[95%ci (63%, 94%)].The pulse was dominated by slimy veins (42% CI (17%, 68%)). The analysis of TCM syndromes found that the wet-toxic type accounted for the highest proportion of COVID-19 diseases in 72%[95%CI (53%, 91%)].Conclusion: we analyzed the common TCM symptoms and signs (including pulse and tongue) of COVID-19 to provide a reference for the consideration of TCM syndromes and accurate syndrome differentiation and treatment. It is important to emphasize that: ①we confirmed that the wet poison is at the heart of the disease; ②COVID-19 showed obvious regional differences.③Poor appetite is an important manifestation of the patient after fever, and the tongue coating thick and greasy, loose stool, diarrhoea and other spleen and stomach dysfunction are prominent. Therefore, it is suggested that traditional Chinese medicine should take measures according to local conditions and consider climate and regional differences while treating patients with clinical syndrome differentiation. At the same time, they were strengthening the protection of the patient's spleen and stomach, which is consistent with the national TCM diagnosis and treatment program that emphasizes "Protect the spleen and stomach throughout".The above conclusions are expected to provide evidence-based support for TCM clinical treatment based on syndrome differentiation.