COVID-19 患者的中医药早期治疗干预：一项回顾性队列研究。
Early therapeutic interventions of traditional Chinese medicine in COVID-19 patients: A retrospective cohort study.
机构信息
Department of Respiratory Disease, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Department of Respiratory Disease, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
出版信息
J Integr Med. 2021 May;19(3):226-231. doi: 10.1016/j.joim.2021.01.002. Epub 2021 Jan 13.
OBJECTIVE
To observe the early interventions of traditional Chinese Medicine (TCM) on the conversion time of nucleic acid in patients with coronavirus disease 2019 (COVID-19), and find possible underlying mechanisms of action.
METHODS
A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM, at a designated hospital in China. The patients were categorized into three groups: TCM1, TCM2 and TCM3, who respectively received TCM interventions within 7, 8-14, and greater than 15 days of hospitalization. Different indicators such as the conversion time of pharyngeal swab nucleic acid, the conversion time of fecal nucleic acid, length of hospital stay, and inflammatory markers (leukocyte count, and lymphocyte count and percentage) were analyzed to observe the impact of early TCM interventions on these groups.
RESULTS
The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5, 7 and 16 d (P < 0.001), with TCM1 and TCM2 being statistically different from TCM3 (P < 0.01). TCM1 (P < 0.05) and TCM3 (P < 0.01) were statistically different from TCM2. The median conversion times of fecal nucleic acid in the three groups were 7, 9 and 17 d (P < 0.001). Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2 (P < 0.01). The median lengths of hospital stay in the three groups were 13, 16 and 21 d (P < 0.001). TCM1 and TCM2 were statistically different from TCM3 (P < 0.01); TCM1 and TCM3 were statistically different from TCM2 (P < 0.01). Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients, with a statistically significant difference observed at each time point in the group (P < 0.001). Statistically significant differences in lymphocyte count and percentage in TCM2 (P < 0.001), and in leucocyte count (P = 0.043) and lymphocyte count (P = 0.038) in TCM3 were observed. The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission (P = 0.044).
CONCLUSION
In this study, it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines, TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid, as well as shorter length of hospital stay, thus helping promote faster recovery of the patient. The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.
目的
观察中医药（TCM）对新型冠状病毒病（COVID-19）患者核酸转阴时间的早期干预作用，并寻找可能的作用机制。
方法
对在中国某定点医院接受 TCM 治疗的 300 例确诊 COVID-19 患者进行回顾性队列研究。患者分为三组：TCM1 组、TCM2 组和 TCM3 组，分别在住院后 7 天、8-14 天和大于 15 天接受 TCM 干预。分析不同指标（咽拭子核酸转阴时间、粪便核酸转阴时间、住院时间和炎症标志物[白细胞计数、淋巴细胞计数和百分比]），观察早期 TCM 干预对各组的影响。
结果
三组患者咽拭子核酸中位转阴时间分别为 5.5、7 和 16 d（P<0.001），TCM1 组和 TCM2 组与 TCM3 组比较差异有统计学意义（P<0.01），TCM1 组与 TCM2 组比较差异也有统计学意义（P<0.05）。三组患者粪便核酸中位转阴时间分别为 7、9 和 17 d（P<0.001），TCM1 组与 TCM3 组和 TCM2 组比较差异均有统计学意义（P<0.01）。三组患者住院时间中位数分别为 13、16 和 21 d（P<0.001），TCM1 组和 TCM2 组与 TCM3 组比较差异均有统计学意义（P<0.01），TCM1 组和 TCM3 组与 TCM2 组比较差异也有统计学意义（P<0.01）。TCM1 组患者白细胞和淋巴细胞计数随住院时间的延长逐渐升高，各时间点组间比较差异均有统计学意义（P<0.001）。TCM2 组淋巴细胞计数和百分比（P<0.001）、TCM3 组白细胞计数（P=0.043）和淋巴细胞计数（P=0.038）比较差异均有统计学意义。三组间比较，入院第 3 天淋巴细胞百分比差异有统计学意义（P=0.044）。
结论
在 COVID-19 患者中西药联合治疗中，住院期间较早进行 TCM 干预与咽拭子和粪便核酸转阴时间更快、住院时间更短相关，从而有助于促进患者更快康复。其作用机制可能与改善 COVID-19 患者的炎症有关。
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