中西医结合治疗上海地区49例非危重型新型冠状病毒肺炎临床疗效观察  

Clinical observation on 49 cases of non-critical COVID-19 in Shanghai treated by integrated traditional Chinese and western medicine

作　　者：时佳 杨宗国[1] 叶晨[1] 陈姼姼 陆云飞[1] 吕莹[1] 徐庆年[1] 汤伯宗[1] 殷科珊[1] 陈晓蓉[1] SHI Jia;YANG Zongguo;YE Chen;CHEN Shishi;LU Yunfei;LYU Ying;XU Qingnian;TANG Bozong;YIN Keshan;CHEN Xiaorong(Department of Traditional Chinese Medicine,Shanghai Public Health Clinical Center,Shanghai 201508,China;Graduate School,Nanjing University of Chinese Medicine,Nanjing 210046,Jiangsu,China)

机构地区：[1]上海市公共卫生临床中心中医科,上海201508 [2]南京中医药大学研究生院,江苏南京210046

出　　处：《上海中医药杂志》2020年第4期30-35,共6页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家科技重大专项基金“突发急性传染病中医药早期临床救治体系及预案研究”项目(2017ZX10305501);上海市卫计委病毒性肺炎中医诊疗方案研究项目(2018LQ014);上海市中医药管理局中医药防治新型冠状病毒肺炎应急专项“中医药治疗新型冠状病毒肺炎真实世界临床观察研究”项目(2020NCP001)

摘　　要：目的回顾性观察中西医结合治疗非危重型新型冠状病毒肺炎(简称"新冠肺炎")患者的临床疗效,并与单纯西医疗法对比。方法将上海市公共卫生临床中心收治的67例新冠肺炎患者,按照接受疗法的不同分为西医组(18例)和中西医结合组(49例)。西医组予氧疗、抗病毒及对症支持治疗,重症患者给予抗炎、调节免疫及丙种球蛋白支持治疗;中西医结合组在西医组治疗基础上,加予中成药或汤药口服治疗。收集并分析两组患者的临床资料,包括一般情况、相关实验室指标、影像学表现、症状信息、中医证候(包括舌象、脉象)信息;观察比较两组患者的临床疗效相关指标,包括退热时间、临床症状积分、CT改善率、危重型转化率、住院时间、总病程。结果①西医组和中西医结合组一般情况、相关实验室指标水平、影像学表现比较,差异无统计学意义(P>0.05)。②全部患者均接受抗病毒治疗,西医组27.78%的患者使用抗生素治疗,中西医结合组34.69%的患者使用抗生素治疗。③患者主要表现为发热(71.64%)、咳嗽/干咳(52.24%)、乏力(47.76%)、纳差(35.82%)、咽痛/痒(31.34%)、咳白痰/黄痰(26.87%)、出汗(25.37%)、腹泻(22.39%)、鼻塞(13.43%)、头痛/晕(13.43%);两组间临床症状比较差异无统计学意义(P>0.05)。④中西医结合组中湿毒郁肺证32例,占65.31%;热毒闭肺证17例,占34.69%;患者以舌色红或淡红、舌苔白腻为多见,滑脉多见。⑤与西医组相比,中西医结合组住院天数更短、入院第6天临床症状积分更低(P<0.05);而两组患者的总病程、退热时间、入院第6天CT改善率比较差异无统计学意义(P>0.05)。⑥观察期间,两组均未出现向危重型转化的病例。结论中西医结合治疗,在改善新冠肺炎患者主要临床症状以及缩短住院时间方面,显示出较大的优势。Objective To observe retrospectively the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of non-critical coronavirus disease 2019(COVID-19)patients,compared with western medicine therapy.Methods Sixty-seven patients with COVID-19 admitted to Shanghai Public Health Clinical Center were divided into the western medicine group(n=18)and the integrative medicine group(n=49)according to different therapies.The western medicine group was given oxygen therapy,antiviral and symptomatic support treatment,while patients with severe condition were given anti-inflammatory,immune regulation and intravenous immunoglobulin(IVIG)support treatment.Besides the adoption of the same treatment in the western medicine group,the integrative medicine group was also administered with Chinese patent medicine or decoction orally.The clinical data of the two groups of patients,including general conditions,relevant laboratory indexes,imaging manifestations,symptom information,and TCM pattern information(including tongue and pulse)were collected and analyzed.The clinical efficacy related indexes of the two groups of patients were observed and compared,including antipyretic time,clinical symptom score,CT improvement rate,critical case conversion rate,hospitalization time and total course of disease.Results(1)There was no significant difference in the general conditions,relevant laboratory indexes and imaging manifestations between the western medicine group and the integrative medicine group(P>0.05).(2)All patients received antiviral treatment,and 27.78%were treated with antibiotics in the western medicine group,while 34.69%in the integrative medicine group.(3)The main manifestations of the patients were fever(71.64%),cough/dry cough(52.24%),fatigue(47.76%),poor appetite(35.82%),sore/itching throat(31.34%),white/yellow sputum(26.87%),sweating(25.37%),diarrhea(22.39%),nasal obstruction(13.43%),and headache/dizziness(13.43%).There was no significant differences between the two groups(P>0.05).(4)In the int

关 键 词：新型冠状病毒肺炎 新型冠状病毒 中西医结合疗法 疗效观察 回顾性分析 

分 类 号：R563.1[医药卫生—呼吸系统]