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COVID-19 임상표현에 대한 한의학적 접근 -국내외 논문을 중심으로-

Clinical features of COVID-19 as presented in journal articles : A Korean Medical Approach

김상현|안진희|김종현
대한한의학원전학회|2022.02|대한한의학원전학회지 (The Journal Of Korean Medical Classics)|제35권 제1호|pp. 1-32

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키워드

COVID-19코로나-19임상증상임상표현육경변증위기영혈변증clinical representationclinical symptomsix channels pattern identificationdefense-qi-nutrient-blood pattern identification
주제분류한의학

초록

Objectives : 효율적인 한의학 임상 데이터 수집 양식 마련을 위해 COVID-19 환자에게 나타나는 주요 증상 표현들을 확인하고자 한다. Methods : 전 세계에서 보고된 COVID-19 관련 논문들을 검토하여 주요 증상 표현을 정리하였고, 각각에 대응하는 한의학적 표현이 무엇인지 검토했다. 또한 한의학적 관점에서 COVID-19의 증후적 특징을 분석함으로써 보다 체계적인 임상 데이터의 수집을 위해 고려되어야 할 사항들은 무엇인지 고찰하였다. Results : 256건의 논문을 검토한 결과, 대부분의 논문에서 기침과 발열을 기록하였고 호흡곤란, 설사, 근육통, 두통, 구토, 피로감, 흉통, 객담, 콧물 등도 대다수의 논문에 기록되어 있었다. 임상 표현들은 크게 전신 증상, 인후 증상, 흉부 증상, 두면부 증상, 소화기 증상, 근골피부 증상, 정신 증상 및 감각 이상으로 분류할 수 있었다. Conclusions : 각각의 임상 표현들이 한의학의 증상 표현과 유사하긴 하지만 증상의 종류가 적고 한의학의 변증에 활용하기에는 세밀하지 못한 경우가 많다. 향후 효과적인 한의학적 임상 데이터 수집과 분석을 위해서는 시간에 따른 증상 변화, 지역·기후·인종에 따른 비교, 表證 진단 시 裏證의 유무 확인, 血證의 虛實에 대한 평가, 의식 상태 평가 등의 사항이 고려되어야 하고 적절한 증상 평가 기준이 구성되어야 할 것이다.

Abstract

Objectives : This paper examines major symptoms representation in COVID-19 patients as groundwork for development of an effective clinical data collection format in Korean Medicine. Methods : Major symptoms representation in COVID-19 related papers published worldwide were collected. Corresponding symptoms in Korean Medicine were then examined, followed by discussion of symptomatic features that require further consideration in regards to a more systematic clinical data collection. Results : Of 256 papers, most papers listed fever and cough while symptoms such as difficulty breathing, diarrhea, muscle pain, headache, nausea, fatigue, chest pain, phlegm, nasal discharge were also mostly listed. Clinical representations could be categorized into general symptoms, throat symptoms, chest symptoms, head and facial symptoms, gastrointestinal symptoms, musculo-skeletal and cutaneous symptoms, psychiatric symptoms and sensory problems. Conclusions : Although each clinical representation could be likened to certain clinical representations of Korean Medicine, the variety of symptoms were too limiting and lacking in detail to be applied in the pattern identification[辨證] of Korean Medicine. For effective clinical data collection and analysis in the future, symptom change according to time, comparison between location, climate and ethnicity, existence of interior symptoms when diagnosing exterior symptoms, deficiency-excessiveness of blood patterns, consciousness levels, etc., need to be considered in establishing criteria for symptom evaluation.

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