Luo Erdan, Zhang Daiyan, Luo Hua, Liu Bowen, Zhao Keming, Zhao Yonghua, Bian Ying, Wang Yitao
1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
2The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China.
Chin Med. 2020 Apr 15;15:34. doi: 10.1186/s13020-020-00317-x. eCollection 2020.
A novel coronavirus was identified in December, 2019 in Wuhan, China, and traditional Chinese medicine (TCM) played an active role in combating the novel coronavirus pneumonia (NCP) caused by this fast-spreading virus COVID-19. Thus, we aimed to explore TCM characteristics of clinical efficacy to NCP, as well as to optimize Qingfei Paidu decoction (QFPDD) and the recommended formulas to NCP by National Health Commission (NHC).
Chinese medical sciences theory and clinical application of TCM were analyzed. A total of 54 NCP patients were observed in a hospital from Wuhan, whose clinical characteristics and utilization of Chinese Medicines (CMs) were described. Paired t test was used to measure the change of patients' hemogram during hospitalization period, indicating the effect of CMs. Multiple linear regression analysis was applied to explore the factors affecting the length of hospital stay. Network pharmacology analysis was applied to figure out the performance of NHC-recommended formulas of five disease stages at levels of compounds, targets and pathways.
The average length of hospital stay was 8.96 days. Patients over 45 stayed 9.79 days in hospital in average, longer than 7.64 days of patients under 45. Comparing the hemograms between admission and discharge of hospital, the number of leukocytes, neutrophil, lymphocyte and platelet increased, while the numbers of erythrocytes, hemoglobin concentration and hematocrit decreased. According to the standard coefficients of regression, the factor affecting the length of stay for the most was CMs in category of invigorating spleen and removing dampness (ISRD), followed by administrating CMs, male, and cough. Thirty-two CMs were screened after deleting duplication from QFPDD and NHC-recommended formulas. Compound quercetin, luteolin, kaempferol, acacetin etc., were all involved in the treatment of various disease stages on the compound level both in generality and individuality.
TCM has a systemic theoretical understanding on the pathological evolution and a positive clinical efficacy on NCP. The CMs of ISRD improved patients' recovery, suggesting the importance of regulating intestinal function and keeping microenvironmental balance in TCM treatment of NCP. The active compounds from QFPDD and NHC-recommended formulas contribute to recovery of varied disease progresses during TCM treating NCP.
2019年12月在中国武汉发现了一种新型冠状病毒，中医药在抗击由这种快速传播的病毒COVID-19引起的新型冠状病毒肺炎（NCP）中发挥了积极作用。因此，我们旨在探讨中医药对NCP的临床疗效特点，以及优化清肺排毒汤（QFPDD）和国家卫生健康委员会（NHC）推荐的NCP方剂。
分析中医药理论及中医临床应用。对武汉某医院共54例NCP患者进行观察，描述其临床特征及中药使用情况。采用配对t检验测量患者住院期间血常规的变化，以表明中药的疗效。应用多元线性回归分析探讨影响住院时间的因素。应用网络药理学分析从化合物、靶点和通路水平阐明NHC推荐的五个疾病阶段方剂的作用机制。
平均住院时间为8.96天。45岁以上患者平均住院9.79天，长于45岁以下患者的7.64天。比较入院和出院时的血常规，白细胞、中性粒细胞、淋巴细胞和血小板数量增加，而红细胞、血红蛋白浓度和血细胞比容数量减少。根据回归标准系数，影响住院时间最长的因素是健脾祛湿类中药，其次是服用中药、男性和咳嗽。从QFPDD和NHC推荐方剂中删除重复项后筛选出32味中药。化合物槲皮素、木犀草素、山奈酚、刺槐素等在化合物水平上对各个疾病阶段的治疗均有普遍和个体化的参与。
中医药对NCP的病理演变有系统的理论认识，对NCP有积极的临床疗效。健脾祛湿类中药促进了患者的康复，提示在中医药治疗NCP中调节肠道功能和维持微环境平衡的重要性。QFPDD和NHC推荐方剂中的活性化合物有助于中医药治疗NCP不同疾病进程的恢复。
