基于病例分析的中医药治疗新型冠状病毒肺炎疗效评价标准的探索研究  

Pilot Study on the Evaluation Standard of the Curative Effects of Traditional Chinese Medicine on Coronavirus Disease 2019(COVID-19)Based on Cases Analysis

作　　者：詹志来 刘佳[1] 杨伟 王玉光[2] 阮连国 黄苹 郭兰萍[1] 边永君 陈素平 陈扬 陈盈盈 丛晓东 董国菊 郭敬 胡力捷 黄璐琦[1] 蒋建新 李斌[1] 李浩[1] 李静[1] 吕诚[1] 吕文良 苗青[1] 齐文升 史华新[1] 王冰[1] 王刚 王健[1] 王微[1] 谢晓磊 缐永悦 徐春艳 徐明[1] 闫蓓 杨金亮 杨志旭[1] 张丽[1] 周振琪 朱浩宁 ZHAN Zhilai;LIU Jia;YANG Wei;WANG Yuguang;RUAN Lianguo;HUANG Ping;GUO Lanping;BIAN Yongjun;CHEN Suping;CHEN Yang;CHEN Yingying;CONG Xiaodong;DONG Guoju;GUO Jing;HU Lijie;HUANG Luqi;JIANG Jianxin;LI Bin;LI Hao;LI Jing;LYU Cheng;LYU Wenliang;MIAO Qing;QI Wensheng;SHI Huaxin;WANG Bing;WANG Gang;WANG Jian;WANG Wei;XIE Xiaolei;XIAN Yongyue;XU Chunyan;XU Ming;YAN Bei;YANG Jinliang;YANG Zhixu;ZHANG Li;ZHOU Zhenqi;ZHU Haoning(China Academy of Chinese Medical Sciences,Beijing,100700;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University;Wuhan Jinyintan Hospital;General Road Street Health Center,Dongxihu District,Wuhan)

机构地区：[1]中国中医科学院,100700 [2]首都医科大学附属北京中医医院 [3]武汉市金银潭医院 [4]武汉市东西湖区将军路街卫生院

出　　处：《中医杂志》2020年第12期1013-1023,共11页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划“公共安全风险防控与应急技术装备”重点专项“中医药防治2019-nCoV研究”项目(2020YFC0841500)。

摘　　要：目的构建中医药治疗新型冠状病毒肺炎(新冠肺炎)疗效评价标准。方法检索中医药治疗新冠肺炎的相关文献,提取其中临床疗效评价信息;对所承担武汉市金银潭医院、武汉市将军路街卫生院救治任务所获得的临床数据进行分析,获取可用于中医药疗效评价的指标。结合文献报道与临床资料筛选出中医药治疗新冠肺炎的疗效评价指标,并根据其反映机体恢复的能力大小,结合专家意见设置相应的权重等信息,提出中医药治疗新冠肺炎疗效评价指标的遴选原则,并进行疗效评价指标筛选。结果综合文献与临床资料分析,能够较好地反映经过中医药治疗后机体功能恢复的有发热、咳嗽、呼吸急促、乏力、纳差、恶心、胸闷、舌象等主要证候指标,指端血氧饱和度(%)、淋巴细胞计数(LY)、淋巴细胞百分比(LY%)、中性粒细胞计数(NEUT)、中性粒细胞百分比(NEUT%)、C反应蛋白(CRP)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)等实验室检查及胸部影像学检查,认为以上指标可作为中医药治疗新冠肺炎疗效的评价指标。结论设计完成了中医药治疗新冠肺炎疗效评价量表,构建了疗效评价指标体系及结果判定标准。该标准的构建将有利于后续中医药临床数据的收集,可为科学评价中医药在治疗新冠肺炎中的作用与优势提供依据。Objective To construct the evaluation standard of curative effects of traditional Chinese medicine(TCM)on coronavirus disease 2019(COVID-19).Methods Relevant literature on TCM in the treatment of COVID-19 were retrieved to extract the clinical efficacy evaluation information.The actual clinical data from Wuhan Jinyintan Hospital and General Road Street Health Center of Wuhan were analyzed to obtain the indexes that can be used in evaluating TCM curative effects.Combined with literature reports and clinical data,evaluation index of the efficacy of TCM in the treatment of COVID-19 were screened,and based on the efficacy to reflect the body recover,combined with expert suggestion to set the corresponding weight,we put forward the selection principles of evaluation index of TCM in the treatment of COVID-19 and screen the evaluation indexes of curative effects.Results Based on comprehensive literature and clinical data analysis,following indexes can better reflect the recover of body after treatment with TCM,such as fever,cough,shortness of breath,fatigue,anorexia,nausea,chest tightness,tongue image finger tip oxygen saturation(%),lymphocyte count(LY),lymphocyte percentage(LY%),neutrophil count(NEUT),neutrophil percentage(NEUT%),C-reactive protein(CRP),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)and other laboratory tests and chest imaging examination.It is believed that the above indicators can be used as evaluation indicators of the efficacy of TCM in the treatment of COVID-19.Conclusion Curative effects evaluation scale of TCM in the treatment of COVID-19 was designed and completed,and curative effect evaluation index system and result evaluation standard were constructed.This standard will facilitate the subsequent collection of clinical data of TCM and provide a basis for scientific evaluation of the role and advantages of TCM in the treatment of COVID-19.

关 键 词：新型冠状病毒肺炎 指标筛选 评价量表 中医药疗效评价标准 

分 类 号：R259[医药卫生—中西医结合]