Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan; Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.
Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan.
Neuropeptides. 2021 Dec;90:102201. doi: 10.1016/j.npep.2021.102201. Epub 2021 Oct 1.
Coronavirus Disease-2019 (COVID-19), an infectious disease associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global emergency with high mortality. There are few effective treatments, and many severe patients are treated in an intensive care unit (ICU). The purpose of this study was to evaluate whether the Japanese Kampo medicine ninjin'yoeito (NYT) is effective in treating ICU patients with COVID-19. Nine patients with confirmed SARS-CoV-2 infection admitted to the ICU were enrolled in this study. All patients underwent respiratory management with invasive mechanical ventilation (IMV) and enteral nutrition. Four patients received NYT (7.5 g daily) from an elemental diet tube. We retrospectively examined the prognostic nutritional index (PNI), length of IMV, length of ICU stay, length of hospital stay, rate of tracheostomy, and mortality rate. The median age of the enrolled participants was 60.0 years (4 men and 5 women). The median body mass index was 27.6. The most common comorbidity was diabetes (4 patients, 44%), followed by hypertension (3 patients, 33%) and chronic kidney disease (2 patients, 22%). The median length of IMV, ICU stay, and hospital stay were all shorter in the NYT group than in the non-NYT group (IMV; 4.0 days vs 14.3 days, ICU; 5.3 days vs 14.5 days, hospital stay; 19.9 days vs 28.2 days). In the NYT and non-NYT groups, the median PNI at admission was 29.0 and 31.2, respectively. One week after admission, the PNI was 30.7 in the NYT group and 24.4 in non-NYT group. PNI was significantly (p = 0.032) increased in the NYT group (+13.6%) than in the non-NYT group (-22.0%). The Japanese Kampo medicine NYT might be useful for treating patients with severe COVID-19 in ICU. This study was conducted in a small number of cases, and further large clinical trials are necessary.
新型冠状病毒病（COVID-19）是一种与严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）相关的传染病，是一种具有高死亡率的全球紧急情况。目前有效的治疗方法很少，许多重症患者在重症监护病房（ICU）接受治疗。本研究旨在评估日本汉方药人参汤（NYT）是否对治疗 COVID-19 的 ICU 患者有效。本研究纳入了 9 名确诊为 SARS-CoV-2 感染并收入 ICU 的患者。所有患者均接受有创机械通气（IMV）和肠内营养进行呼吸管理。4 名患者通过要素饮食管接受 NYT（每天 7.5g）治疗。我们回顾性检查了预后营养指数（PNI）、IMV 时间、ICU 住院时间、住院时间、气管切开率和死亡率。入组患者的中位年龄为 60.0 岁（4 名男性和 5 名女性）。中位体重指数为 27.6。最常见的合并症是糖尿病（4 例，44%），其次是高血压（3 例，33%）和慢性肾脏病（2 例，22%）。NYT 组的 IMV 时间、ICU 住院时间和住院时间均短于非 NYT 组（IMV：4.0 天 vs 14.3 天；ICU：5.3 天 vs 14.5 天；住院时间：19.9 天 vs 28.2 天）。在 NYT 和非 NYT 组中，入院时的中位 PNI 分别为 29.0 和 31.2。入院 1 周后，NYT 组的 PNI 为 30.7，非 NYT 组为 24.4。NYT 组的 PNI 显著增加（p=0.032）（+13.6%），而非 NYT 组则显著下降（-22.0%）。日本汉方药 NYT 可能对治疗 ICU 中严重 COVID-19 患者有用。本研究纳入的病例数较少，需要进一步开展大规模临床试验。
