祛湿排毒扶正方治疗寒湿郁肺证和疫毒闭肺证新型冠状病毒肺炎的临床疗效及机制探讨  

Clinical efficacy and mechanism of Qushi Paidu Fuzheng Recipe in treatment of corona virus disease 2019 with syndrome of cold dampness lung stagnation and epidemic toxin closing lung

作　　者：兰俊 樊恭春 孟龙 Lan Jun;Fan Gongchun;Meng Long(Department of Neurology,Shiyan Hospital of Integrated Traditional and Western Medicine,Shiyan 442000,Hubei,China;Shiyan COVID-19 Second Treatment Hospital,Shiyan 442000,Hubei,China;Department of Respiratory Medicine,Shiyan Renmin Hospital,Shiyan 442000,Hubei,China;Department of Obstetrics,Shiyan Maternal and Child Health-Care Hospital,Shiyan 442000,Hubei,China)

机构地区：[1]十堰市中西医结合医院神经内科,湖北十堰442000 [2]十堰市新冠肺炎第二救治医院,湖北十堰442000 [3]十堰市人民医院呼吸内科,湖北十堰442000 [4]十堰市妇幼保健院产科,湖北十堰442000

出　　处：《中国中西医结合急救杂志》2020年第3期262-266,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：湖北省十堰市新冠肺炎防控技术引导性应急科研项目(20Y35)。

摘　　要：目的 探讨祛湿排毒扶正方治疗寒湿郁肺证和疫毒闭肺证新型冠状病毒肺炎(简称新冠肺炎)的临床疗效及作用机制.方法 选择2020年2月1日至20日湖北省十堰市新冠肺炎第二救治医院收治的新冠肺炎患者85例作为研究对象,将患者按入院顺序分为西医治疗组(42例)和祛湿排毒扶正方组(43例).西医治疗组参照《新型冠状病毒肺炎诊治方案(试行第五版)》给予西医常规治疗;祛湿排毒扶正方组在西医常规治疗基础上加用中药祛湿排毒扶正方加减.收集两组患者治疗20 d后的临床症状与证候、实验室指标等资料并进行对比分析.结果 治疗后祛湿排毒扶正方组发热、咳嗽、气促例数以及CT异常、舌苔异常、新型冠状病毒(2019-nCoV)核酸阳性例数均明显少于同期西医治疗组(发热:1例比7例,咳嗽:4例比11例,气促:3例比10例,CT异常:6例比25例,舌苔异常:5例比31例,核酸阳性:20例比36例),差异均有统计学意义(均P<0.05).两组治疗后白细胞计数(WBC)、淋巴细胞计数(LYM)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)均较治疗前有所改善,其中祛湿排毒扶正方组hs-CRP、IL-6改善程度较西医治疗组更为显著〔hs-CRP(mg/L):1.85±2.43比5.98±3.04,IL-6(ng/L):7.98±8.42比15.67±25.21,均P<0.05〕.治疗后D-二聚体在祛湿排毒扶正方组较治疗前明显降低〔mg/L:110.0(61.0,305.0)比189.5(136.5,469.0),P<0.05〕,而在西医治疗组较治疗前有所升高〔mg/L:171.5(118.0,497.8)比161.0(64.0,392.5)〕.祛湿排毒扶正方组的痊愈率明显高于西医治疗组〔53.49%(23/43)比14.29%(6/42),P<0.05〕;祛湿排毒扶正方组和西医治疗组不良反应发生情况比较差异无统计学意义〔46.51%(20/43)比47.62%(20/42),P>0.05〕.结论 联合祛湿排毒扶正方治疗寒湿郁肺证和疫毒闭肺证新冠肺炎的疗效优于单纯西医治疗,其机制可能与抗病毒、抑制炎症因子的�Objective To investigate the clinical efficacy and mechanism of Qushi Paidu Fuzheng Recipe(QPFR)in treatment of corona virus disease 2019(COVID-19)with syndrome of cold dampness lung stagnation and epidemic toxin closing lung.Methods The 85 COVID-19 patients admitted in Shiyan COVID-19 Second Treatment Hospital during February 1 to 20,2020 were selected as research objects,and according to entry order divided into Western medicine group(42 cases)and QPFR group(43 cases).Western medicine group was treated with Western medicine according to Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia(Trial Fifth Edition),and QPFR group was additionally treated with QPFR based on routine treatment.After 20 days of treatment,the clinical symptoms and syndromes,laboratory indexes of both groups were collected for analysis and comparison.Results After treatment,the cases of fever,cough,shortness of breath,number of CT abnormalities,abnormal tongue coating,and novel coronavirus(2019-nCoV)positive cases in QPFR group were significantly less than those of Western medicine group(fever:1 case vs.7 cases,cough:4 cases vs.11 cases,shortness of breath:3 cases vs.10 cases,CT abnormalities:6 cases vs.25 cases,abnormal tongue coating:5 cases vs.31 cases,nucleic acid positive:20 cases vs.36 cases),with significant difference(all P<0.05).After treatment,the white blood cell count(WBC),lymphocytes(LYM),hypersensitive C-reactive protein(hs-CRP),interleukin(IL-6),(ALT),and(AST)in both group were improved than those before treatment,among which the hs-CRP and IL-6 in QPFR group were more obviously improved than those in Western medicine group[hs-CRP(mg/L):1.85±2.43 vs.5.98±3.04,IL-6(ng/L):7.98±8.42 vs.15.67±25.21,all P<0.05].After treatment,the D-dimer in QPFR group significantly decreased than before treatmnet[mg/L:110.0(61.0,305.0)vs.189.5(136.5,469.0),P<0.05]while that in Western medicine group increased[mg/L:171.5(118.0,497.8)vs.161.0(64.0,392.5)].The cure rate of QPFR group was significantly higher than that of Western medicin

关 键 词：祛湿排毒扶正方 新型冠状病毒肺炎 D-二聚体 超敏C-反应蛋白 白细胞介素-6 

分 类 号：R25[医药卫生—中医内科学]