中医药综合康复方案干预重型、危重型新冠肺炎康复期患者的临床随访研究  

Clinical Follow-up Study on the Intervention of TCM Comprehensive Rehabilitation Program for Patients with Severe and Critical COVID-19 in the Convalescent Stage

作　　者：任毅[1] 刘华宝[1] 王瑜婧 牟方政 严晓峰 何德英[1] 陈勇 Ren Yi;Liu Huabao;Wang Yujing;Mou Fangzheng;Yan Xiaofeng;He Deying;Chen Yong(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院,重庆400021 [2]重庆医科大学,重庆400050 [3]重庆市三峡中心医院,重庆404000 [4]重庆市公共卫生医疗中心,重庆400010

出　　处：《中国中医急症》2022年第3期387-390,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市科技局新冠肺炎疫情应急科技攻关项目(cstc2020jscx-fyzxX0036)。

摘　　要：目的评价中医药综合康复方案在重型、危重型新冠肺炎患者康复中的临床疗效和安全性。方法纳入重庆地区重型、危重型新冠肺炎患者共72例,根据患者的中医证型制定综合康复方案,具体包含中药口服、八段锦、艾灸、穴位贴敷、足浴等。出院时及1年后完善中医证候疗效积分量表、MMRC呼吸困难评分、圣乔治呼吸问卷、SF-36生活质量量表、6 min步行试验等问卷,以及胸部CT、血清学等相关辅助检查,并进行统计分析,评估其疗效及其安全性。结果出院时及1年后中医证候疗效积分、MMRC呼吸困难评分、圣乔治呼吸问卷评分、SF-36生活质量量表、6 min步行试验前后对比差异具有统计学意义(P<0.05),中性粒细胞比值、淋巴细胞、淋巴细胞比值、血小板、红细胞、血红蛋白前后对比差异具有统计学意义(P<0.05),白细胞、中性粒细胞前后对比无统计学意义(P>0.05),胸部CT有效率为82.26%。Logistic回归显示,服用中药可提高胸部CT的有效率;6 min步行试验得分越高的患者,其胸部CT病灶吸收越好。结论中医药综合康复方案结合现代肺康复理念,采用中药内服、中医外治、运动康复等方法,可提高重型、危重型新冠肺炎患者的生活质量,改善临床症状,提高运动耐力,改善呼吸功能,对肺部病灶的吸收有积极影响。Objective:To evaluate the clinical efficacy and safety of TCM comprehensive rehabilitation program for severe and critical COVID-19 patients.Methods:A total of 72 patients with severe and critical COVID-19 in Chongqing were enrolled,and comprehensive rehabilitation programs were formulated according to their TCM syndrome types,including oral Chinese medicine,eight-duan Jin,moxibustion,acupoint application,foot bath,etc.The TCM syndrome efficacy score scale,MMRC dyspnea score,St.George′s Respiratory Questionnaire,SF-36 Quality of Life Scale,six-minute walking test and other questionnaires were completed at discharge and 1 year later,as well as chest CT,serological and other related auxiliary examinations.Statistical analysis was performed to evaluate the efficacy and safety.Results:The scores of TCM syndrome efficacy,MMRC dyspnea score,St.George’s Respiratory Questionnaire score,SF-36 quality of life scale and 6-minute walking test before and after discharge and1 year later were statistically significant(P<0.05).There was statistical significance in the ratio of neutrophil,lymphocyte,lymphocyteratio,platelet,red blood cell and hemoglobin before and after treatment(P<0.05),but there were no statistical significances in the ratio of white blood cell and neutrophil before and after treatment(P>0.05).The chest CT effective rate was 82.26%.Logistic regression showed that taking Traditional Chinese medicine can improve the efficiency of chest CT,and the higher the score of the 6-minute walking test,the better the absorption of chest CT lesions.Conclusion:The comprehensive rehabilitation program of Traditional Chinese medicine combined with modern pulmonary rehabilitation concept,using traditional Chinese medicine internal administration,external treatment of traditional Chinese medicine,exercise rehabilitation and other methods,can improve the quality of life of patients with severe and critical COVID-19,clinical symptoms,exercise endurance and respi-ratory function,and have a positive impact on the absorption of lu

关 键 词：新冠肺炎 重型 危重型 中医药 康复 

分 类 号：R563.1[医药卫生—呼吸系统]