在出院后 84 天的随访中，中药对 COVID-19 恢复期患者症状、证候演变和肺部炎症吸收的影响：一项前瞻性队列和巢式病例对照研究。
Effects of Chinese Medicine on Symptoms, Syndrome Evolution, and Lung Inflammation Absorption in COVID-19 Convalescent Patients during 84-Day Follow-up after Hospital Discharge: A Prospective Cohort and Nested Case-Control Study.
机构信息
Integrated Traditional Chinese and Western Medicine Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
Chronic Disease Management Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
出版信息
Chin J Integr Med. 2021 Apr;27(4):245-251. doi: 10.1007/s11655-021-3328-3. Epub 2021 Feb 3.
OBJECTIVE
To observe the changes of symptoms, Chinese medicine (CM) syndrome, and lung inflammation absorption during convalescence in patients with coronavirus disease 2019 (COVID-19) who had not totally recovered after hospital discharge and whether CM could promote the improvement process.
METHODS
This study was designed as a prospective cohort and nested case-control study. A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day. Patients were divided into the CM (64 cases) and the control groups (32 cases) based on the treatment with or without CM and followed up at 14, 28, 56, and 84 days after discharge. In the CM group, patients received the 28-day CM treatment according to two types of CM syndrome. Improvements in clinical symptoms, CM syndrome, and absorption of lung inflammation were observed.
RESULTS
All the 96 patients completed the 84-day follow-up from January 21 to March 28, 2020. By the 84th day of follow-up, respiratory symptoms were less than 5%. There was no significant difference in the improvement rates of symptoms, including fatigue, sputum, cough, dry throat, thirst, and upset, between the two groups (P>0.05). Totally 82 patients (85.42%) showed complete lung inflammation absorption at the 84-day follow-up. On day 14, the CM group had a significantly higher absorption rate than the control group (P<0.05) and the relative risk of absorption for CM vs. control group was 3.029 (95% confidence interval: 1.026-8.940). The proportions of CM syndrome types changed with time prolonging: the proportion of the pathogen residue syndrome gradually decreased, and the proportion of both qi and yin deficiency syndrome gradually increased.
CONCLUSIONS
Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging. CM could improve lung inflammation for early recovery. The types of CM syndrome can be transformed with time prolonging. (Registration No. ChiCTR2000029430).
目的
观察新冠肺炎出院后未完全康复患者在恢复期的症状、中医证候及肺部炎症吸收变化，探讨中医能否促进其康复过程。
方法
本研究采用前瞻性队列和嵌套病例对照研究设计。共纳入 2020 年 1 月 21 日至 3 月 28 日北京佑安医院和北京回民医院出院患者 96 例，出院当天开始随访。根据是否给予中医治疗将患者分为中医组（64 例）和对照组（32 例），分别于出院后第 14、28、56、84 天随访。中医组患者根据中医证候类型给予 28 天中医治疗。观察患者临床症状、中医证候及肺部炎症吸收的改善情况。
结果
96 例患者均完成 84 天随访。截至 2020 年 3 月 28 日，患者出院后第 84 天，呼吸症状少于 5%。两组患者症状（乏力、咳痰、咳嗽、咽干、口渴、心烦）改善率比较，差异无统计学意义（P>0.05）。84 天随访时，82 例（85.42%）患者肺部炎症完全吸收。第 14 天，中医组吸收比例高于对照组，差异有统计学意义（P<0.05），中医组与对照组比较，吸收的相对危险度为 3.029（95%可信区间：1.026~8.940）。中医证候类型随时间变化而改变：病邪残留证比例逐渐减少，气阴两虚证比例逐渐增加。
结论
新冠肺炎出院后患者仍有症状及肺部炎症，随时间延长逐渐康复。中医能促进肺部炎症的早期吸收，中医证候类型随时间延长而发生转化。（注册号：ChiCTR2000029430）
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