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政府三级护理医院中辅助阿育吠陀疗法对重症新冠后毛霉菌病患者的疗效和安全性评估——一项病例对照研究

Evaluation of efficacy and safety of adjuvant Ayurvedic therapy in patients with severe post-covid mucor-mycosis at a Government tertiary care hospital - A Case-Control study.

作者信息

Adluri Uma Shankar Prasad, Perugu Srikanthbabu

机构信息

M.D,D.N.B(Internal Medicine) B.A.M.S,M.Phil( Ayurveda), S.I.V.A.S Health & Research Institute, Sunshine Hospitals, Secunderabad, Telangana, India.

Principal I/C, Professor & HOD-Kayachikitsa, Dr. B.R.K.R Govt. Ayurvedic College, Erragadda, Hyderabad, Telangana, India.

出版信息

J Ayurveda Integr Med. 2022 Jul-Sep;13(3):100585. doi: 10.1016/j.jaim.2022.100585. Epub 2022 Jun 27.

Abstract

BACKGROUND

In the wake of the unprecedented Mucormycosis epidemic following the delta variant run second wave of SARS COV-2, the Government of Telangana decided to utilize Ayurveda for its adjuvant immune-boosting role. Based on clinical assessment of patients, Mucor mycosis was identified as Vataja vidradhi and treatment was planned.

OBJECTIVE

To assess the safety and efficacy of Ayurvedic regime as an adjuvant therapy in post covid mucor mycosis patients at Gandhi Hospital, the largest Government tertiary care center in Telangana.

METHODS

In this prospective case control study, 77 patients with positive or probable post covid mucor mycosis were included. The varunadi kwatha regimen could be given in very few patients precluding its meaningful analysis. 65 patients received Pancha Tikta Ghrita Guggulu [PTGG] regimen. These patients were assigned into 2 groups; Intervention [A] group n = 36, who used PTGG for a mean duration of 34.1 days and Control [B] group [drop outs] n = 29 who used PTGG for a mean duration of 2.1 days. Objective parameters like biochemical changes and parameters like disease progression, recurrence, mortality rate, subjective and objective wellbeing, readmission, repeat surgeries, and persistence of symptoms were assessed before and after treatment. Statistical analysis was done using Mann Whitney, chi square and ANOVA test.

RESULTS

The Intervention group mortality rate was ZERO where as it was 13.8% in control group. The statistical analysis showed significant improvement in all clinical parameters tested.

CONCLUSION

PTGG based regimen as adjuvant seemed to help across the entire spectrum of Mucormycosis. It was safe and tolerated very well with concomitant antifungal usage and in pre and post-operative patients, thus validating the host factor modification approach of Ayurveda and an integrative usage.

摘要

背景

在新冠病毒德尔塔变异株引发的第二波疫情之后,出现了前所未有的毛霉菌病流行,特伦甘纳邦政府决定利用阿育吠陀发挥其辅助增强免疫力的作用。根据对患者的临床评估,毛霉菌病被确定为风邪性脓肿,并制定了相应的治疗方案。

目的

在特伦甘纳邦最大的政府三级护理中心甘地医院,评估阿育吠陀疗法作为辅助治疗对新冠后毛霉菌病患者的安全性和有效性。

方法

在这项前瞻性病例对照研究中,纳入了77例新冠后毛霉菌病确诊或疑似患者。由于只有极少数患者接受了varunadi kwatha疗法,无法进行有意义的分析。65例患者接受了五味蒂卡酥油古古卢(PTGG)疗法。这些患者被分为两组;干预组[A],n = 36,平均使用PTGG 34.1天;对照组[退出组],n = 29,平均使用PTGG 2.1天。在治疗前后评估生化变化等客观参数以及疾病进展、复发、死亡率、主观和客观健康状况、再次入院、重复手术和症状持续等参数。使用曼-惠特尼检验、卡方检验和方差分析进行统计分析。

结果

干预组死亡率为零,而对照组为13.8%。统计分析表明,所有测试的临床参数均有显著改善。

结论

基于PTGG的辅助疗法似乎对整个毛霉菌病谱系都有帮助。在联合使用抗真菌药物时,以及在术前和术后患者中,该疗法安全且耐受性良好,从而验证了阿育吠陀的宿主因素调节方法和综合应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec36/9253353/de0354ded29c/gr1.jpg

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