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[中医药在新型冠状病毒肺炎分期防治中的特性与疗效分析]

[Analysis of property and efficacy of traditional Chinese medicine in staging revention and treatment of coronavirus disease 2019].

作者信息

Gu Min, Liu Jiao, Shi Nan-Nan, Li Xiao-Dong, Huang Zheng-de, Wu Jian-Kun, Wang Yu-Guang, Wang Yan-Ping, Zhai Hua-Qiang, Wang Yong-Yan

机构信息

School of Chinese Materia Medica, Beijing University of Chinese Medicine Beijing 102488, China.

Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2020 Mar;45(6):1253-1258. doi: 10.19540/j.cnki.cjcmm.20200225.501.

DOI:10.19540/j.cnki.cjcmm.20200225.501
PMID:32281333
Abstract

Coronavirus disease 2019(COVID-19) triggered a severe and complicated epidemic situation, and it is of great significance to discuss the rules and characteristics of the prescription of COVID-19 in traditional Chinese medicine. This study collected prevention and treatment approaches of traditional Chinese medicine for COVID-19 released from the National Health Committee of China, 7 provinces and municipal health committees, the Chinese Medicine Administration and Handbook of Traditional Chinese Medicine Diagnosis and Treatment of COVID-19 between January 1 and February 18, 2020, and prescriptions prepared by 3 masters of Chinese medicine and 4 well-known Chinese medicine experts. These information were selected according to the inclusion and exclusion criteria, and EpiData 3.0 software was used to establish the "Traditional Chinese Medicine Prescription Library for the Prevention and Treatment of COVID-19" and the "Common Database of Traditional Chinese Medicine for the Prevention and Treatment of COVID-19". A total of 93 effective Chinese medicine prescriptions and a total of 157 kinds of constituent medicines were collected. Data analysis was performed by SPSS 18.0 software. The results showed that: ①most of the medicines are with cold and warm properties, 69 with cold medicines, accounting for 43.95%, 57 with warm medicines, accounting for 36.31%, and less with hot medicines, taking up 1.27%; ②there are many pungent, bitter and sweet medicines, and the distribution of medicinal flavors is different at different disease stage. The pungent medicines are mostly found in the early stage, the bitter drugs are the main flavor in the middle and severe stage, and the sweet medicines are mostly used in the recovery stage; ③the meridian of the drug is more concentrated at the lung, stomach, and heart, and most of drugs are into the lung meridian, accounting for 24.55%; these medicines are mostly into the lungs and stomach in the initial and middle stages, and into the heart and kidney in severe stages; ④oral drugs are mostly non-toxic, among which only 6 kinds are toxic, namely Armeniacae Semen Amarum, Dryopteridis Crassirhizomatis Rhizoma, Paridis Rhizoma, Pinelliae Rhizoma, Aconiti Lateralis Radix Praeparaia; ⑤most of the drugs have five types of functions: treating exterior syndromes, resolving dampness, clearing heat, replenishing deficiency, resolving phlegm, cough, and asthma. In the early stage, both drugs for treating exterior syndromes and heat clearing drugs were equally used, accounting for 18.81% each. In the middle stage, drugs resolving phlegm, cough, and asthma drugs are more often used, accounting for 29.61%. In the severe stage, heat clearing drugs are mostly used, accounting for 33.33%. During the recovery period, tonic deficiency drugs are used the most, accounting for 36.47%. The medical characteristics and efficacy of Chinese medicine in preventing and treating COVID-19 are closely related to the understanding of the etiology of Chinese medicine and the location and pathogenesis of the disease. Staged medication and local conditions need attention during the identification and treatment of COVID-19 clinical syndromes.

摘要

新型冠状病毒肺炎(COVID-19)引发了严峻复杂的疫情形势,探讨中医治疗COVID-19的用药规律和特点具有重要意义。本研究收集了2020年1月1日至2月18日期间国家卫生健康委员会、7个省及直辖市卫生健康委员会、国家中医药管理局发布的中医防治COVID-19方案及《新型冠状病毒肺炎诊疗方案(试行第六版)》,以及3位国医大师和4位知名中医专家开出的处方。依据纳入与排除标准筛选这些信息,运用EpiData 3.0软件建立“COVID-19中医防治方剂库”和“COVID-19中医防治共用数据库”。共收集到93首有效中药方剂,总计157味组成药物。采用SPSS 18.0软件进行数据分析。结果显示:①药物药性以寒、温性居多,寒性药69味,占43.95%,温性药57味,占36.31%,热性药较少,占1.27%;②药味以辛、苦、甘味居多,且在不同病期药味分布有差异,辛味药多在初期出现,苦味药是中、重症期的主要药味,甘味药多在恢复期使用;③药物归经多集中于肺、胃、心,入肺经药物最多,占24.55%;这些药物在初期和中期多入肺、胃经,重症期多入心、肾经;④口服药大多无毒,其中有毒药物仅6味,即苦杏仁、粗茎鳞毛蕨、重楼、半夏、制附子;⑤药物功效以解表、化湿、清热、补虚、化痰止咳平喘五类为主。初期解表药与清热药使用相当,各占18.81%。中期化痰止咳平喘药使用较多,占29.61%。重症期清热药使用最多,占33.33%。恢复期补虚药使用最多,占36.47%。中医防治COVID-19的用药特点及疗效与中医对病因、病位及病机的认识密切相关。COVID-19临床证候辨治过程中需注重分期用药和因地制宜。

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