222例感染新型冠状病毒的恶性肿瘤患者临床特征及中医药应用情况回顾性研究  

Clinical Characteristics and Use of Traditional Chinese Medicine Therapy in 222 Malignant Tumor Cases with COVID-19:A Retrospective Study

作　　者：王应天 孙红[1] 李嫚[2] 宋娜[3] 缑娇 罗文芳[5] 刘军 马荣 王薇[1] 李占东[1] 孟博 姚晓燕[8] WANG Yingtian;SUN Hong;LI Man;SONG Na;GOU Jiao;LUO Wenfang;LIU Jun;MA Rong;WANG Wei;LI Zhandong;MENG Bo;YAO Xiaoyan(Beijing Cancer Hospital/Beijing Institute of Cancer Research,Beijing,100142;Hubei Provincial Cancer Hospital;Chongqing Traditional Chinese Medicine Hospital;Shaanxi Traditional Chinese Medicine Hospital;The First Affiliated Hospital of University of South China;Nanjing Jiangbei Hospital Affiliated to Nantong University;Inner Mongolia Hospital of Traditional Chinese Medicine;Guang'anmen Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所,北京市100142 [2]湖北省肿瘤医院 [3]重庆市中医院 [4]陕西省中医医院 [5]湖南南华大学附属第一医院 [6]南通大学附属南京江北医院 [7]内蒙古自治区中医医院 [8]中国中医科学院广安门医院

出　　处：《中医杂志》2024年第7期716-721,共6页Journal of Traditional Chinese Medicine

摘　　要：目的研究感染新型冠状病毒(新冠病毒)的恶性肿瘤患者临床特征及中医药应用情况,为疫病背景下恶性肿瘤患者中医药防治策略及诊疗重点提供参考。方法回顾性采集2023年1月1—20日全国7家研究中心接诊的225例感染新冠病毒的恶性肿瘤患者病历资料,收集患者感染后主要症状及持续时间、核酸转阴时间、中医药应用情况、恢复抗肿瘤治疗后不良反应变化情况。结果共纳入222例患者病历资料进行分析,其中轻型205例,中型17例。临床报告频次较高的前4个症状依次为发热(165例次)、咳痰/干咳(99例次)、食欲下降(95例次)及乏力(85例次),其中40例次咳痰/干咳、37例次乏力、29例次食欲下降持续超过14天。核酸报告明确转阴时间的105例患者中位转阴时间为14天,其中肺癌较消化系统恶性肿瘤、有骨髓抑制较无骨髓抑制患者核酸转阴时间延长(P<0.01)。在感染期间应用中成药治疗的患者占47.30%(105/222),中药汤剂占21.17%(47/222);预防及康复阶段中医药应用比例分别为1.80%(4/222)、7.21%(16/222)。核酸转阴后恢复原方案抗肿瘤药物治疗的55例患者同步予以中医药防护治疗,观察到的不良反应包括消化道反应、骨髓抑制、神经毒性均为1~2级,随访期间无新增不良事件。结论部分感染新冠病毒的恶性肿瘤患者症状持续时间及核酸转阴时间延长,合理应用中医药治疗手段可促进患者康复,有助于感染后抗肿瘤治疗的顺利进行。Objective To analyze the clinical characteristics and the use of traditional Chinese medicine(TCM)therapy in cancer patients with COVID-19,and to provide reference for making TCM prevention and treatment strategies and determining diagnosis and treatment priorities for patients with malignant tumors in the COVID-19 epi⁃demic.Methods The medical records of 225 malignant tumor cases with COVID-19 who were admitted to 7 national research centers from January 1st to 20th,2023 were retrospectively collected,and the main symptoms and duration after infection,nucleic acid negative conversion time,use of TCM therapy,and changes in adverse reactions after resuming anti-tumor treatment were analyzed.Results A total of 222 malignant tumor patients with COVID-19 were included in the analysis,involving 205 mild cases and 17 moderate cases.The top four most frequently reported clini⁃cal symptoms were fever(165 cases),expectoration or dry cough(99 cases),decreased appetite(95 cases)and fatigue(85 cases),of which 40 expectoration or dry cough cases,37 fatigue cases and 29 decreased appetite cases lasted for more than 14 days.One hundred and five patients with nucleic acid detection report had a median negative conversion time of 14 days.The nucleic acid negative conversion time was significantly longer in patients with lung cancer compared to those with digestive system malignant tumors,and in those with myelosuppression than those without(P<0.01).During the infection period,47.30%(105/222)of the patients used Chinese patent medicine,and 21.17%(47/222)were treated with herbal decoctions.The use of TCM in patients during the prevention and rehabili⁃tation period,was 1.80%(4/222)and 7.21%(16/222),respectively.Fifty-five patients resumed anti-tumor treat⁃ment after nucleic acid negative conversion,and received TCM simultaneously.Observed adverse reactions,includ⁃ing gastrointestinal reactions,bone marrow suppression,and neurotoxicity,were all grade 1 to 2,and no new adverse events occurred during follow-up.Conclusion Cert

关 键 词：恶性肿瘤 新型冠状病毒 中医药疗法 核酸转阴时间 回顾性研究 

分 类 号：R273[医药卫生—中西医结合]