清肺排毒汤联合西医常规治疗重型新型冠状病毒肺炎50例临床疗效回顾性分析  

Qingfei Paidu Decoction(清肺排毒汤)Combined with Conventional Therapy for 50 Severe Cases of Coronavirus Disease 2019(COVID-19):A Retrospective Study

作　　者：王芳 郭旸 焦丽雯 张新阳 梁宁 关黎 宗星煜 栾相佳[5] 张磊[6] 王晶亚 陈仁波[2] 李慧珍 范逸品[2] 赵晨 肖芙蓉 黄进[8] 肖艳华 王银珍 张林松 胡运宏 孙盛 王明选[14] 白卫国[2] 马艳 史楠楠[2] 葛又文 张华敏[15] 蔺刚 王燕平[2] 王永炎[2] WANG Fang;GUO Yang;JIAO Liwen;ZHANG Xinyang;LIANG Ning;GUAN Li;ZONG Xingyu;LUAN Xiangjia;ZHANG Lei;WANG Jingya;CHEN Renbo;LI Huizhen;FAN Yipin;ZHAO Chen;XIAO Furong;HUANG Jin;XIAO Yanhua;WANG Yinzhen;ZHANG Linsong;HU Yunhong;SUN Sheng;WANG Mingxuan;BAI Weiguo;MA Yan;SHI Nannan;GE Youwen;ZHANG Huamin;LIN Gang;WANG Yanping;WANG Yongyan(Community Health Service Management Center,Dongcheng District,Beijing,100010,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;The First Hospital of Suihua City,Heilongjiang Province;Infectious Disease Hospital of Heilongjiang Province;Guang’anmen Hospital,China Academy of Chinese Medical Sciences;Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences;Harbin Infectious Hospital,Heilongjiang Province;Yongwu Hospital,People’s Hospital of Guangxi Zhuang Autonomous Region;Mudanjiang Kangan Hospital,Heilongjiang Province;Jincheng People’s Hospital,Shanxi Province;The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University;Xingtai Hospital of Traditional Chinese Medicine,Hebei Province;Chengde Hospital of Traditional Chinese Medicine,Hebei Province;Suining Central Hospital,Sichuan Province;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences)

机构地区：[1]北京市东城区社区卫生服务管理中心,北京市东城区100010 [2]中国中医科学院中医临床基础医学研究所 [3]黑龙江省绥化市第一医院 [4]黑龙江省传染病防治院 [5]中国中医科学院广安门医院 [6]中国中医科学院中医药信息研究所 [7]黑龙江省哈尔滨市传染病医院 [8]广西壮族自治区人民医院邕武医院 [9]黑龙江省牡丹江市康安医院 [10]山西省晋城市人民医院 [11]西南医科大学附属中医医院 [12]河北省邢台市中医院 [13]河北省承德市中医院 [14]四川省遂宁市中心医院 [15]中国中医科学院中药研究所

出　　处：《中医杂志》2021年第20期1801-1805,共5页Journal of Traditional Chinese Medicine

基　　金：中央级公益性科研院所基本科研业务费专项资金资助(Z-0696);中国中医科学院科技创新工程(CI2021A00704)。

摘　　要：目的回顾性分析清肺排毒汤联合西医常规治疗重型新型冠状病毒肺炎(新冠肺炎)患者的临床疗效。方法收集2020年1月28日至2月26日在黑龙江、广西、河北、山西及四川5个省10家医院服用清肺排毒汤合并西医常规治疗且疗程≥6天的重型新冠肺炎患者临床资料。提取患者的一般情况、临床症状、实验室检查与影像学检查结果,统计患者治疗3天、6天后临床症状改善情况,计算其核酸转阴时间、肺部病灶吸收率、住院时间、实验室异常指标变化情况。结果共纳入50例重型新冠肺炎病例,男23例(46.0%),女27例(54.0%);年龄24~85岁,中位数(Q1,Q3)为58.0(45.0,67.0)岁,≥60岁者23例(46.0%)。合并症≥1种的患者40例(80.0%),其中合并高血压病16例(32.0%),糖尿病10例(20.0%)。入院时主要症状为咳嗽(35例,70.0%)、发热(32例,64.0%)、乏力(20例,40.0%)、气喘(18例,36.0%)、干咳(15例,30.0%)、厌食(12例,24.0%)。清肺排毒汤合并西医常规治疗3天后,发热、咳嗽及乏力患者显著减少(P<0.05);6天后,发热、乏力、咳嗽、干咳、厌食及气喘的患者均较治疗前显著减少(P<0.05)。服用清肺排毒汤6天后,46例(92.0%)患者肺部病灶显示不同程度的吸收,且白细胞计数、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、乳酸脱氢酶、血沉、C反应蛋白、降钙素原异常升高及淋巴细胞计数降低的患者数量均较治疗前显著减少(P<0.05)。第一次核酸平均转阴时间中位数(Q1,Q3)为10.0(7.26,10.13)天,平均住院时间中位数(Q1,Q3)为19.36天(15.23,24.32)。50例患者住院期间均未发生严重不良事件,均痊愈出院。结论清肺排毒汤联合西医常规治疗可有效改善重型新冠肺炎患者临床症状,且安全性好。Objective combined with conventional therapy for severe coronavirus disease 2019(COVID-19)in 50 cases.MethodsData of severe COVID-19 cases who were treated by Qingfei PaiDu Decoction and conventional therapy for at least six days was collected from 10 hospitals in five provinces(Heilongjiang,Guangxi,Hebei,Shanxi,Sichuan)during January28 to February 26,2020.The general information,clinical symptoms,laboratory indexes,and imaging results were collected.The improvement of clinical symptoms after 3 days and six days of treatment with Qingfei PaiDu Decoction was analyzed;the time to negative conversion of nucleic acid test result,absorption rate of lung lesions,length of hospital stay,and changes of laboratory abnormal indicators were assessed.ResultsA total of 50 severe cases of COVID-19 were included,involving 23(46.0%)males and 27(54.0%)females;the age ranged from 24 to 85,and the median age was 58.0(45.0,67.0)years old;twenty-three patients(34.7%)were over 60 years old.Forty patients(80.0%)had at least one complication,of which 16 patients(32.0%)were with hypertension and 10 patients(20.0%)were with diabetes.At admission,cough(35 cases,70.0%),fever(32 cases,64.0%),fatigue(20 cases,40.0%),asthma(18 cases,36.0%),dry cough(15 cases,30%)and anorexia(12 cases,24%)were the major symptoms.Compared to the clinical symptoms before treatment,the number of patients with fever,cough and fatigue significantly decreased after 3 days treatment(P<0.05),and that with fever,fatigue,cough,dry cough,anorexia and asthma significantly decreased as well after 6 days treatment(P<0.05).Forty-six patients(96.0%)showed different degrees of absorption of lung lesions after 6 days treatment;and the number of patients with abnormally increased white blood cell count,alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,erythrocyte sedimentation rate,C-reactive protein,procalcitonin,as well as that of abnormally decreased lymphocyte count were significantly reduced(P<0.05).The median time to the first negative conversion of

关 键 词：新型冠状病毒肺炎 清肺排毒汤 重型 住院时间 核酸转阴时间 回顾性研究 

分 类 号：R563.1[医药卫生—呼吸系统]