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连花清瘟胶囊治疗新型冠状病毒肺炎的有效性和安全性:一项倾向评分匹配队列研究。

Effectiveness and Safety of Lianhua Qingwen Capsules for COVID-19: A Propensity-Score Matched Cohort Study.

作者信息

Lu Yun, Zhang Meng, Yang Qing-Qing, Li Wen-Jing, Yang Kun, Hu Wen, Gao Su-Yu, Jiang Qiao-Li, Lin Li-Kai, Cheng Hong, Sun Feng

机构信息

Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.

出版信息

Evid Based Complement Alternat Med. 2023 Feb 17;2023:6028554. doi: 10.1155/2023/6028554. eCollection 2023.

Abstract

As a traditional Chinese medicine, Lianhua Qingwen capsules have been widely used to treat Coronavirus Disease 2019 (COVID-19). This study was aimed to demonstrate the association between treatment with Lianhua Qingwen capsules and the clinical outcomes of hospitalized patients with COVID-19. This retrospective study was conducted at four hospitals in Central China. Data of hospitalized COVID-19 patients were collected between December 19, 2019 and April 26, 2020. Based on whether Lianhua Qingwen capsules were used, patients were classified into Lianhua Qingwen and non-Lianhua Qingwen (control) groups. To control for confounding factors, we used conditional logistic regression in a propensity-score matched (PSM) cohort (1 : 1 balanced), as well as logistic regression without matching as sensitivity analysis. A total of 4918 patients were included, 2760 of whom received Lianhua Qingwen capsules and 2158 of whom did not. In the PSM model, after adjusting for confounders, the in-hospital mortality was similar between the Lianhua Qingwen group and the control group (6.8% vs. 3.3%, adjusted OR, 0.66 [95% CI, 0.38-1.15], = 0.138). The negative conversion rate of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection was higher in the Lianhua Qingwen group (88.3% vs. 96.1%, adjusted OR, 4.02 [95% CI, 2.58-6.25], < 0.001). The incidence of acute liver injury was comparable between the two groups (14.0% vs. 11.5%, adjusted OR: 0.85 [95% CI, 0.71-1.02], = 0.083), and the incidence of acute kidney injury was lower in the Lianhua Qingwen group (5.3% vs. 3.0%, adjusted OR: 0.71 [95% CI, 0.50-1.00], = 0.048). Treatment with Lianhua Qingwen capsules was not significantly associated with in-hospital mortality in COVID-19 patients. In the Lianhua Qingwen group, the negative conversion rate of SARS-CoV-2 infection was higher and the incidence of acute kidney injury was lower than in the control group.

摘要

作为一种传统中药,连花清瘟胶囊已被广泛用于治疗新型冠状病毒肺炎(COVID-19)。本研究旨在证明连花清瘟胶囊治疗与COVID-19住院患者临床结局之间的关联。这项回顾性研究在中国中部的四家医院进行。收集了2019年12月19日至2020年4月26日期间COVID-19住院患者的数据。根据是否使用连花清瘟胶囊,将患者分为连花清瘟组和非连花清瘟(对照)组。为控制混杂因素,我们在倾向评分匹配(PSM)队列(1∶1平衡)中使用条件逻辑回归,并在不匹配的情况下使用逻辑回归作为敏感性分析。共纳入4918例患者,其中2760例接受连花清瘟胶囊治疗,2158例未接受。在PSM模型中,调整混杂因素后,连花清瘟组和对照组的院内死亡率相似(6.8%对3.3%,调整后的OR为0.66[95%CI,0.38 - 1.15],P = 0.138)。连花清瘟组严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的转阴率更高(88.3%对96.1%,调整后的OR为4.02[95%CI,2.58 - 6.25],P < 0.001)。两组急性肝损伤的发生率相当(14.0%对11.5%,调整后的OR:0.85[95%CI,0.71 - 1.02],P = 0.083),连花清瘟组急性肾损伤的发生率较低(5.3%对3.0%,调整后的OR:0.71[95%CI,0.50 - 1.00],P = 0.048)。连花清瘟胶囊治疗与COVID-19患者的院内死亡率无显著关联。在连花清瘟组中,SARS-CoV-2感染的转阴率高于对照组,急性肾损伤的发生率低于对照组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31f6/9957644/0ebd7539d28d/ECAM2023-6028554.001.jpg

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