清肺排毒汤联合西医常规治疗新型冠状病毒肺炎合并慢性乙型肝炎的多中心回顾性研究  

Qingfei Paidu Decoction(清肺排毒汤)Combined with Western Medicine Routine Treatment for Coro⁃navirus Disease 2019(COVID-19)Concomitant with Chronic Hepatitis B:A Multi-center Retrospective Study

作　　者：陈仁波[1] 史楠楠[1] 李慧珍 焦丽雯 马艳 刘斌 熊一白 栾相佳[2] 吴桂辉 李继科 张新阳 朱俊腾[5] 肖芙蓉 王晶亚 李群堂[7] 雷枭[8] 黄进[9] 黄秋华 王玉栋[10] 王晓燕 肖艳华 刘洪德[13] 刘晋萍[14] 侯燕玲[14] 张林松 谢海军 白卫国[1] 张华敏[17] 王燕平[1] 王永炎[1] CHEN Renbo;SHI Nannan;LI Huizhen;JIAO Liwen;MA Yan;LIU Bin;XIONG Yibai;LUAN Xiangjia;WU Guihui;LI Jike;ZHANG Xinyang;ZHU Junteng;XIAO Furong;WANG Jingya;LI Quntang;LEI Xiao;HUANG Jin;HUANG Qiuhua;WANG Yudong;WANG Xiaoyan;XIAO Yanhua;LIU Hongde;LIU Jinping;HOU Yanling;ZHANG Linsong;XIE Haijun;BAI Weiguo;ZHANG Huamin;WANG Yanping;WANG Yongyan(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing,100700;Guang'anmen Hospital,China Academy of Chinese Medical Sciences;The Public Health Clinical Center of Chengdu,Sichuan Province;The First Hospital of Suihua City,Heilongjiang Province;The Affiliated Hospital of Putian College,Fujian Province;Qiqihar Hospital of Infectious Diseases,Heilongjiang Province;Chongqing Traditional Chinese Medicine Hospital,Hebei Province;Affiliated Hospital of North Sichuan Medical College;Yongwu Hospital,The People's Hospital of Guangxi Zhuang Autonomous Region;Hengshui Hospital of Chinese Medicine,Hebei Province;Jinzhong Infectious Disease Hospital,Shanxi Province;Kang'an Hospital of Mudanjiang City,Heilongjiang Province;Shijiazhuang Fifth Hospital,Hebei Province;TheFourthPeople'sHospitalofTaiyuan,Shanxi Province;Hospital(T.C.M)Affiliated to Southwest Medical University;Xinzhou People's Hospital,Shanxi Province;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences)

机构地区：[1]中国中医科学院中医临床基础医学研究所,100700 [2]中国中医科学院广安门医院 [3]四川省成都市公共卫生临床医疗中心 [4]黑龙江省绥化市第一医院 [5]福建省莆田学院附属医院 [6]黑龙江省哈尔滨市传染病医院 [7]重庆市中医院 [8]四川省川北医学院附属医院 [9]广西壮族自治区人民医院邕武医院 [10]河北省衡水市中医院 [11]山西省晋中市传染病医院 [12]黑龙江省牡丹江市康安医院 [13]河北省石家庄市第五医院 [14]山西省太原市第四人民医院 [15]西南医科大学附属中医医院 [16]山西省忻州市人民医院 [17]中国中医科学院中药研究所

出　　处：《中医杂志》2021年第19期1694-1701,共8页Journal of Traditional Chinese Medicine

基　　金：中国中医科学院基本科研业务费专项资金(Z-0696);中国中医科学院科技创新工程项目(CI2021A00704)。

摘　　要：目的探讨清肺排毒汤联合西医治疗新型冠状病毒肺炎(简称“新冠肺炎”)合并慢性乙型肝炎(简称“乙肝”)的有效性和安全性。方法回顾性收集2020年1月23日至2020年4月8日期间7个省、市、自治区14家医院收治的新冠肺炎合并乙肝患者的病历资料,根据是否服用清肺排毒汤分为清肺排毒汤组及常规治疗组。两组患者均给予西医常规治疗,包括抗病毒、抗菌药物治疗及吸氧等支持治疗。清肺排毒汤组在常规治疗的基础上口服清肺排毒汤至少2个疗程(6天),每日1剂,早晚两次温服。收集患者一般资料,治疗前后实验室指标[主要包括中性粒细胞计数(NEUT)、淋巴细胞计数(LYMPH)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、尿素(Ur)、肌酐(Cr)、红细胞沉降率(ESR)及C反应蛋白(CRP)、碱性磷酸酶],同时记录治疗1~6天两组患者主要临床症状(发热、咳嗽、干咳、乏力、厌食、咽痛)的变化趋势,完全退热时间及咳嗽、干咳、乏力、厌食、咽痛消失时间,合并用药情况,治疗转归及平均住院时间、新型冠状病毒核酸转阴时间,以及不良反应发生情况。结果共纳入新冠肺炎合并乙肝确诊病例45例,清肺排毒汤组23例,常规治疗组22例。与常规治疗组比较,清肺排毒汤组服药6天内发热、咳嗽、干咳、乏力、咽痛及厌食例数减少趋势更明显。清肺排毒汤组治疗后NEUT、LYMPH、ALT、AST、ESR、CRP指标异常的患者数较治疗前减少(P<0.05);常规治疗组治疗后仅NEUT、CRP指标异常的患者数较治疗前减少(P<0.05)。清肺排毒汤组完全退热时间、咳嗽消失时间及干咳消失时间较常规治疗组显著缩短(P<0.05)。清肺排毒汤组患者平均住院时间为15.0(11.0,18.0)天,常规治疗组为15.5(11.0,22.5)天,两组比较差异无统计学意义(P=0.062);清肺排毒汤组新型冠状病毒核酸转阴平均时间为7.0(5.5,8.0)天,常规治�Objective To explore the effectiveness and safety of Qingfei Paidu Decoction(清肺排毒汤,QPD)combined with conventional treatment(CT)for patients with coronavirus disease 2019(COVID-19)with chronic hepatitis B(CHB).Methods Data were retrospectively collected from patients confirmed with COVID-19 with CHB and were admitted to 14 hospitals in seven provinces(cities)from January 23 to April 8,2020.The included patients were divided into QPD group and CT group according to whether they took QPD in addition to CT.Patients in both groups received antiviral,antibacterial drug treatment,oxygen inhalation and other supportive treatments.Additionally,at least two courses(6 days)of QPD,one dose daily,were orally taken in the morning and evening for patients in QPD group.Data on general information and laboratory indicators mainly including neutrophil count(NEUT),lym‐phocyte count(LYMPH),alanine aminotransferase(ALT),aspartate aminotransferase(AST),Lactate dehydrogenase(LDH),urea(Ur),creatinine(Cr),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and alkaline phosphatase before and after treatment were collected;the changes of clinical symptoms mainly including fever,cough,dry cough,fatigue,anorexia,sore throat)at day 1 to day 6 during treatment were recorded;the resolution time to fever,cough,dry cough,fatigue,anorexia and sore throat,the combined medication,medium duration of hospital stay,time to negative conversion of nucleic acid test result,and adverse reactions were assessed.Results A total of 45 patients with COVID-19 accompanied by CHB were included,with 23 cases in QPD group and 22 in CT group.There were more number of cases with fever,cough,dry cough,fatigue,sore throat and anorexia decreased more in QPD group than in CT group during 6 days of treatment.The number of patients with abnormal NEUT,LYMPH,ALT,AST,ESR and CRP in QPD group significantly decreased after treatment than before treatment(P<0.05),while in CT group,significant decreases were only seen in abnormal NEUT and CRP(P<0.05).The resolu

关 键 词：新型冠状病毒肺炎 慢性乙型肝炎 清肺排毒汤 完全退热时间 

分 类 号：R512.62[医药卫生—内科学] R563.1[医药卫生—临床医学]