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1.武汉市第三医院(武汉大学附属同仁医院),武汉 430060
2.中日友好医院,北京 100029
陈灵,硕士,主管中药师,从事临床中药学研究,E-mail:57776228@qq.com
陈永刚,博士,副主任中药师,从事中药学研究,E-mail:275502915@qq.com;
程志强,博士,主任中医师,从事中西医结合肿瘤内科研究,E-mail:zhiqiangcheng@163.com
收稿日期:2020-04-02,
网络出版日期:2020-07-23,
纸质出版日期:2020-10-05
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陈灵,陈永刚,程志强等.回顾性分析甘露消毒汤联合西医治疗普通型新型冠状病毒肺炎患者的临床疗效[J].中国实验方剂学杂志,2020,26(19):60-67.
CHEN Ling,CHEN Yong-gang,CHENG Zhi-qiang,et al.Retrospective Analysis on Clinical Efficacy of Ganlu Xiaodu Decoction Combined with Western Medicine in Treatment of Common COVID-19 Patients[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(19):60-67.
陈灵,陈永刚,程志强等.回顾性分析甘露消毒汤联合西医治疗普通型新型冠状病毒肺炎患者的临床疗效[J].中国实验方剂学杂志,2020,26(19):60-67. DOI: 10.13422/j.cnki.syfjx.20202011.
CHEN Ling,CHEN Yong-gang,CHENG Zhi-qiang,et al.Retrospective Analysis on Clinical Efficacy of Ganlu Xiaodu Decoction Combined with Western Medicine in Treatment of Common COVID-19 Patients[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(19):60-67. DOI: 10.13422/j.cnki.syfjx.20202011.
目的
2
分析联合应用甘露消毒汤治疗普通型新型冠状病毒肺炎(coronavirus disease-2019,COVID-19)患者的临床疗效。
方法
2
采取倾向性评分匹配研究法,选择2020年1月25日至2020年3月18日在武汉市第三医院就诊的符合普通型COVID-19患者的临床资料,符合纳入和排除标准的甘露消毒汤联合常规治疗患者115例为治疗组,倾向性配对1∶1,常规治疗患者115例为对照组。比较两组主要症状(发热、咳嗽、咯痰、胸闷、乏力、喘气)的消失率、消失天数、有效率,其他症状消失率,治疗7 d前后的实验室指标差异,肺部计算机断层扫描(CT)有效率,转重率及总住院时间等。
结果
2
两组基线资料比较,差异无统计学意义,具有可比性。治疗7 d,治疗组发热、咳嗽、咯痰、胸闷、乏力、喘气的症状消失率显著高于对照组(
P
<
0.01);治疗组主要症状平均消失天数显著少于对照组(
P
<
0.01);治疗组主要症状治疗有效率93.9%(108/115)显著高于对照组75.7%(87/115,
P
<
0.01);治疗组转重率为0,显著低于对照组16.5%(19/115,
P
<
0.01);治疗7 d,与本组治疗前比较,治疗组白细胞计数,红细胞计数,C反应蛋白,降钙素原,
D
-二聚体均明显下调(
P
<
0.05),淋巴细胞计数明显上调(
P
<
0.01);对照组淋巴细胞计数明显上调(
P
<
0.01),C反应蛋白、降钙素原和
D
-二聚体均明显下调(
P
<
0.05);与对照组比较,治疗组C反应蛋白和降钙素原水平下调明显(
P
<
0.01),淋巴细胞计数上调明显(
P
<
0.05);治疗组肺部CT改善率93.9%(108/115),显著高于对照组75.7%(87/115,
P
<
0.01);两组患者治疗后均痊愈出院,治疗组平均住院时间(14.70±2.76) d,明显少于对照组平均住院时间(15.80±4.37) d(
P
<
0.05);治疗组无不良事件,对照组出现了6例不良事件。
结论
2
联合应用甘露消毒汤能明显改善普通型COVID-19患者发热、咳嗽、咯痰、胸闷、乏力、喘气等症状,提高主要症状有效率,降低普通型转重型比例,调控相关外周血炎症指标的表达,促进肺部炎症吸收,缩短住院时间,提高治愈率,提示甘露消毒汤可以有效地应用于普通型COVID-19患者治疗中。
Objective
2
To analyze the clinical efficacy of Ganlu Xiaodu decoction combined with western medicine in the treatment of common coronavirus disease-2019(COVID-19).
Method
2
With the propensity score matching method,the clinical data of patients with common COVID-19 admitted to Wuhan Third Hospital from January 25,2020 to March 18,2020,were screened out. 115 patients with Ganlu Xiaodu decoction combined with conventional therapy were enrolled in the treatment group according to the inclusion and exclusion criteria,and 115 patients treated with conventional therapy were enrolled in the control group. The disappearance rate of main symptoms(fever,cough,expectoration,chest tightness,fatigue and panting),days of syndrome disappearance,effective rate and disappearance rate of other symptoms,laboratory indexes before treatment and after 7 days' treatment,effective rate in computed tomography(CT) of the lungs,rate of conversion to severe illness and total hospitalization time were compared between the two groups.
Result
2
The baseline data between the two groups showed no statistically significant difference,but were comparable. After 7 days of treatment,the symptom disappearance rate of fever,cough,expectoration,chest tightness,fatigue and panting in the treatment group was significantly higher than that in the control group(
P
<
0.01).The average number of days to disappearance of main symptoms in treatment group was significantly less than that in the control group(
P
<
0.01). The effective rate of main symptoms was 93.9%(108/115)in treatment group
significantly higher than 75.7%(87/115,
P
<
0.01)in control group. In the treatment group,the rate of conversion to severe illness was 0
significantly lower than 16.5% (19/115) in the control group (
P
<
0.01). After treatment for 7 days,the white blood cell count,red blood cell count,c-reactive protein,calcitonin,and
D
-dimer in treatment group were significantly reduced(
P
<
0.05),while lymphocyte count was significantly increased as compared with those before treatment(
P
<
0.01)
the lymphocyte count in control group was also increased significantly in control group(
P
<
0.01),while C-reactive protein,calcitonin and
D
-dimer were significantly reduced(
P
<
0.05). As compared with the control group,C-reactive protein and calcitonin levels in the treatment group were significantly down-regulated(
P
<
0.01),and lymphocyte count rose significantly(
P
<
0.05).The improvement rate of pulmonary CT in the treatment group was 93.9%(108/115),which was significantly higher than 75.7%(87/115)in the control group(
P
<
0.001). After treatment,the patients in both groups were cured and discharged,and the average length of stay in the treatment group was(14.70±2.76) d,significantly less than(15.80±4.37) d in the control group (
P
<
0.05). No adverse events occurred in the treatment group but 6 cases occurred in the control group.
Conclusion
2
Ganlu Xiaodu decoction combined with western medicine can significantly improve the clinical symptoms of common COVID-19 patients such as fever,cough,expectoration,chest tightness,fatigue
panting and shortness of breath,alleviate the main symptoms effectively,reduce the rate of conversion from common to serious COVID-19,regulate the expressions of relevant peripheral inflammation factors,promote absorption of lung inflammation,shorten hospitalization time,and improve the cure rate,indicating that Ganlu Xiaodu decoction can be effective in the treatment of patients with common COVID-19.
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