中西医结合康复方案治疗新型冠状病毒感染后综合征患者的临床研究  

Clinical study on the treatment of patients with post-COVID-19 syndrome by integration of traditional and western medicine rehabilitation program

作　　者：王博寒 王晓骁[1] 金辉[2] 居文政[1] 汤玲玲 孙宪泓 喻柯瑶 王扶凝 孙庆兰 巫善珩 史锁芳[1] 史潇璐[1] WANG Bohan;WANG Xiaoxiao;JIN Hui;JU Wenzheng;TANG Lingling;SUN Xianhong;YU Keyao;WANG Funing;SUN Qinglan;WU Shanheng;SHI Suofang;SHI Xiaolu(Jiangsu Provincial Hospital of Chinese Medicine/Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China;School of Public Health,Southeast University,Nanjing 210096,China)

机构地区：[1]江苏省中医院/南京中医药大学附属医院,南京210029 [2]东南大学公共卫生学院

出　　处：《北京中医药大学学报》2023年第9期1242-1249,共8页Journal of Beijing University of Traditional Chinese Medicine

基　　金：江苏省自然科学基金项目(No.BK20211391);国家中医药管理局科技项目(No.2021ZYLCYJ05-3)。

摘　　要：目的 评价中西医结合康复方案治疗新型冠状病毒感染后综合征患者的临床疗效。方法 将南京市溧水区中医院和扬州市第二人民医院收治的115例新型冠状病毒感染恢复期患者任意分为治疗组(57例)和对照组(58例)。治疗组采用中西医结合康复方案,给予中药口服(肺脾气虚证给予健脾养肺方、气阴两虚证给予益气养阴方)、中医传统康复疗法(呼吸疗愈法、经络锻炼法、八段锦)和现代呼吸康复治疗(呼吸训练、有氧训练、抗阻肌力训练),对照组给予安慰剂茶饮联合现代呼吸康复治疗,疗程均为14 d。对比治疗前后2组患者6 min步行试验、呼吸肌力、改良英国医学研究会呼吸困难分级(mMRC)评级、四肢躯干肌力等指标,以评估患者心肺功能及身体机能的恢复情况。治疗前后观察患者不良反应的发生情况。结果 (1)在心肺功能方面,与治疗前比较,治疗组患者血氧饱和度、6 min步行距离、距离占预计值增加(P<0.05,P<0.01),6 min距离等级、Borg评分改善(P<0.01)。治疗后,治疗组患者血氧饱和度升高(P<0.05),6 min距离等级分布较对照组改善(P<0.05),心率、血压、6 min步行距离、距离占预计值、Borg评分组间差异无统计学意义。与治疗前比较,治疗组患者呼气峰流速值增加(P<0.01),mMRC评级改善(P<0.01)。与对照组比较,治疗组患者治疗后膈肌活动度增加(P<0.05),膈肌厚度、呼气峰流速值、mMRC评级差异无统计学意义。(2)在身体机能方面,与对照组比较,治疗后治疗组患者上肢前夹肌、躯干屈肌、左髋内收肌肌力变化率增加(P<0.05,P<0.01)。2组患者未见明显不良反应。结论 中西医结合康复方案对新型冠状病毒感染后综合征患者的心肺功能、身体机能康复有益。Objective To evaluate the clinical efficacy of an integration of traditional and western medicine rehabilitation program in the treatment of patients with post-COVID-19 syndrome.Methods A total of 115 patients recovering from COVID-19 admitted to Nanjing Lishui District Hospital of Traditional Chinese Medicine and Yangzhou Second People’s Hospital were randomly divided into the treatment group(57 patients)and the control group(58 patients).The treatment group was treated with an integration of traditional and western medicine rehabilitation program,including Chinese medicine(Jiangpi Yangfei Formula for syndrome of qi deficiency of lung and spleen,and Yiqi Yangyin Formula for syndrome of deficiency of both qi and yin),traditional Chinese medicine rehabilitation therapies(breathing therapy,meridian exercise method,baduanjin),and modern respiratory rehabilitation(breathing exercises,aerobic exercise,and resistance training),while the control group was treated with tea placebo combined with modern respiratory rehabilitation.The course of treatment was 14 days.Before and after treatment,patients in both groups completed a 6-min walking test,respiratory muscle strength,mMRC grade and muscle strength of extremities and trunk to assess the recovery of cardiopulmonary function and physical function.The incidence of adverse effects was observed before and after treatment.Results(1)In terms of cardiopulmonary function,when compared with those before treatment in the treatment group,the blood oxygen saturation,6-min walking distance,and distance as a percentage of predicted value were increased(P<0.05,P<0.01);the 6-min distance class and Borg score were improved(P<0.01).After treatment,compared with the control group,the blood oxygen saturation in the treatment group was increased(P<0.05),and the 6-min distance class was improved(P<0.05).There were no significant differences in heart rate,blood pressure,6-min walk distance,distance as a percentage of predicted value,and Borg score between the two groups.Compared with the c

关 键 词：新型冠状病毒感染 新型冠状病毒感染后综合征 中西医结合 康复 临床研究 

分 类 号：R254.3[医药卫生—中医内科学]