回顾性分析河北省新型冠状病毒肺炎75例的临床特征及清肺排毒汤的临床疗效  

Clinical characteristics of 75 patients with COVID-19 in Hebei Province and the effect of Qingfei Paidu Decoction:A Retrospective analysis

作　　者：耿立梅 郭登洲 闫红倩 梅建强 马蕴雷 胡小梅 孙惠敏 刘洪德[4] 于向艳 GENG Limei;GUO Dengzhou;YAN Hongqian;MEI Jianqiang;MA Yunlei;HU Xiaomei;SUN Huimin;LIU Hongde;YU Xiangyan(Department of Respiratory Medicine,The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050011;Department of Internal Medicine,Langfang Hospital of Traditional Chinese Medicine,Hebei Province,Langfang,Hebei 065099;Department of Pulmonary Disease,Tangshan Hospital of Traditional Chinese Medicine,Tangshan,Hebei 063011;Department of Integrated Traditional Chinese and Western Medicine,The fifth hospital of Shijiazhuang,Shijiazhuang,Hebei 050024)

机构地区：[1]河北中医学院第一附属医院呼吸科,河北石家庄050011 [2]河北省廊坊市中医医院内科,河北廊坊065099 [3]河北省唐山市中医医院肺病科,河北唐山063011 [4]河北省石家庄市第五医院中西医结合科,河北石家庄050024

出　　处：《河北中医》2022年第6期918-922,948,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局新型冠状病毒感染肺炎中医药应急专项课题(编号:2020ZYLCYJ01-1);河北省科学技术厅重点研发计划项目(编号:20277743D)。

摘　　要：目的回顾性分析75例河北省新型冠状病毒肺炎患者的临床特征及清肺排毒汤的临床疗效。方法收集河北地区75例新型冠状病毒肺炎患者的流行病史、疾病分型、临床症状特征及其转归,构建数据库,联合组47例,西药组28例,回顾性分析其疗效指标,并进行统计分析。结果75例患者以普通型患者为多,为45例(60.0%),重型21例(28.0%),危重型9例(12.0%),其中临床分型在不同年龄、有无基础病、有无寒战、有无乏力、有无腹泻方面差异有统计学意义(P<0.05),不同分型患者的证候分布不同,以寒湿郁肺证、湿热蕴肺证、疫毒闭肺证为常见证候,普通型患者以寒湿郁肺证(55.6%)为主,重型患者以湿热蕴肺证为主(66.7%),危重型患者以疫毒闭肺证为主(44.4%)。75例患者均不同程度应用了α-干扰素和抗病毒药物,普通型患者均未使用免疫调节剂,危重型患者抗菌药物的使用率为100%,激素的应用以重型和危重型患者中多见。α-干扰素、抗病毒药物、免疫调节剂在不同分型中的差异有统计学意义(P<0.05)。联合组患者α-干扰素、抗病毒药物、免疫调节剂药物、抗菌药物、激素等应用持续时间缩短,与西药组比较有统计学意义(P<0.05)。联合组患者退热时间、咳嗽消失时间、乏力消失时间、平均住院时间、第1次核酸转阴时间、影像学75%吸收时间均较西药组提前(P<0.05),转重率低于西药组(P<0.05)。结论河北地区新型冠状病毒肺炎患者符合新型冠状病毒肺炎流行病学史及临床基本特征,患者证候类型以寒湿郁肺证、湿热蕴肺证及疫毒闭肺证为多见,联合应用清肺排毒汤能明显缩短西药的应用时间,有利于避免抗生素及激素等药物的不良反应,改善患者临床症状,促进肺部影像学吸收,缩短住院时间及核酸转阴时间,降低转重率,提高治愈率。Objective Retrospectively analyzed to the clinical characteristics of 75 patients with coronavirus disease 2019(COVID-19)in Hebei and the effect of Qingfei Paidu Decoction.Methods Totally 75 patients with COVID-19 in Hebei were enrolled and divided into the combined group(Western medicine+Qingfei Paidu Decoction,n=47)and the control group(Western medicine,n=28).Epidemiological history,disease classification,clinical symptoms and prognosis of 75 patients were assesses.The curative effect indexes were retrospectively analyzed and statistically analyzed.Results Among 75 patients,there are 45 cases(60.0%)of the common type,21 cases(28.0%)of the severe type,and 9 cases of the critical type(12.0%).In clinical classification,the differences were statistically significant in age,underlying diseases,chills,fatigue and diarrhea(P<0.05).The syndrome distribution in different types of patients was different,and the common syndromes were cold dampness stagnation lung syndrome,dampness-heat cough syndrome,pestilence-toxicity blocking the lung.The main syndrome type in common,severe and critical patients were cold dampness stagnation lung syndrome(55.5%),dampness-heat cough syndrome(76.2%)and pestilence-toxicity blocking the lung(66.7%),respectively.Totally 75 patients were managed by a-interferon and antiviral drugs in varying degree,no immunomodulators were used in common patients,antibiotic usage rate in critical patients reached 100%,the use of hormones was commonly found in severe and critical patients.The difference was statistically significant in the a-interferon,antiviral drugs and immunomodulators among different types.The duration of use of a-interferon,antiviral drugs,immunomodulators,antibiotics,hormones in the combined group was shorter,the difference was statistically significant between the combined group and the control group(P<0.05).Compared with the control group,the antipyretic time,cough disappearance time,the disappearance time of fatigue,mean hospitalization time,the negative time of nucleic acid,75%imagi

关 键 词：肺炎:冠状病毒感染 中药疗法 

分 类 号：R289.6[医药卫生—方剂学] R563.1[医药卫生—中药学]