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化湿败毒颗粒治疗新型冠状病毒奥密克戎变异株感染患者的有效性和安全性:一项单中心回顾性队列研究。

Efficacy and Safety of Huashi Baidu Granules in Treating Patients with SARS-CoV-2 Omicron Variant: A Single-Center Retrospective Cohort Study.

机构信息

Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.

Department of Classical Traditional Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, 400021, China.

出版信息

Chin J Integr Med. 2024 Feb;30(2):107-114. doi: 10.1007/s11655-023-3549-8. Epub 2023 May 24.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of Huashi Baidu Granules (HSBD) in treating patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant.

METHODS

A single-center retrospective cohort study was conducted during COVID-19 Omicron epidemic in the Mobile Cabin Hospital of Shanghai New International Expo Center from April 1st to May 23rd, 2022. All COVID-19 patients with asymptomatic or mild infection were assigned to the treatment group (HSBD users) and the control group (non-HSBD users). After propensity score matching in a 1:1 ratio, 496 HSBD users of treatment group were matched by propensity score to 496 non-HSBD users. Patients in the treatment group were administrated HSBD (5 g/bag) orally for 1 bag twice a day for 7 consecutive days. Patients in the control group received standard care and routine treatment. The primary outcomes were the negative conversion time of nucleic acid and negative conversion rate at day 7. Secondary outcomes included the hospitalized days, the time of the first nucleic acid negative conversion, and new-onset symptoms in asymptomatic patients. Adverse events (AEs) that occurred during the study were recorded. Further subgroup analysis was conducted in vaccinated (378 HSBD users and 390 non-HSBD users) and unvaccinated patients (118 HSBD users and 106 non-HSBD users).

RESULTS

The median negative conversion time of nucleic acid in the treatment group was significantly shortened than the control group [3 days (IQR: 2-5 days) vs. 5 days (IQR: 4-6 days); P<0.01]. The negative conversion rate of nucleic acid in the treatment group were significantly higher than those in the control group at day 7 (91.73% vs. 86.90%, P=0.014). Compared with the control group, the hospitalized days in the treatment group were significantly reduced [10 days (IQR: 8-11 days) vs. 11 days (IQR: 10.25-12 days); P<0.01]. The time of the first nucleic acid negative conversion had significant differences between the treatment and control groups [3 days (IQR: 2-4 days) vs. 5 days (IQR: 4-6 days); P<0.01]. The incidence of new-onset symptoms including cough, pharyngalgia, expectoration and fever in the treatment group were lower than the control group (P<0.05 or P<0.01). In the vaccinated patients, the median negative conversion time and hospitalized days were significantly shorter than the control group after HSDB treatment [3 days (IQR: 2-5 days) vs. 5 days (IQR: 4-6 days), P<0.01; 10 days (IQR: 8-11 days) vs. 11 days (IQR: 10-12 days), P<0.01]. In the unvaccinated patients, HSBD treatment efficiently shorten the median negative conversion time and hospitalized days [4 days (IQR: 2-6 days) vs. 5 days (IQR: 4-7 days), P<0.01; 10.5 days (IQR: 8.75-11 days) vs. 11.0 days (IQR: 10.75-13 days); P<0.01]. No serious AEs were reported during the study.

CONCLUSION

HSBD treatment significantly shortened the negative conversion time of nuclear acid, the length of hospitalization, and the time of the first nucleic acid negative conversion in patients infected with SARS-COV-2 Omicron variant (Trial registry No. ChiCTR2200060472).

摘要

目的

评价化湿败毒颗粒治疗新型冠状病毒 2 型奥密克戎变异株(SARS-CoV-2)感染的有效性和安全性。

方法

在 2022 年 4 月 1 日至 5 月 23 日期间,对上海新国际博览中心方舱医院内发生的新型冠状病毒 2 型奥密克戎变异株疫情进行了一项单中心回顾性队列研究。所有无症状或轻症感染的 COVID-19 患者被分为治疗组(化湿败毒颗粒使用者)和对照组(非化湿败毒颗粒使用者)。采用倾向评分匹配法(1:1 比例),将 496 例治疗组的化湿败毒颗粒使用者与 496 例非化湿败毒颗粒使用者进行匹配。治疗组患者口服化湿败毒颗粒(5 g/袋),每日 2 次,连续 7 天。对照组患者接受标准护理和常规治疗。主要结局是核酸转阴时间和第 7 天的核酸转阴率。次要结局包括住院天数、首次核酸转阴时间和无症状患者新发症状。记录研究期间发生的不良事件(AE)。进一步在接种组(378 例化湿败毒颗粒使用者和 390 例非化湿败毒颗粒使用者)和未接种组(118 例化湿败毒颗粒使用者和 106 例非化湿败毒颗粒使用者)中进行了亚组分析。

结果

治疗组核酸转阴时间中位数明显短于对照组[3 天(IQR:2-5 天)比 5 天(IQR:4-6 天);P<0.01]。治疗组第 7 天的核酸转阴率明显高于对照组[91.73%比 86.90%,P=0.014]。与对照组相比,治疗组的住院天数明显减少[10 天(IQR:8-11 天)比 11 天(IQR:10.25-12 天);P<0.01]。治疗组和对照组首次核酸转阴时间差异有统计学意义[3 天(IQR:2-4 天)比 5 天(IQR:4-6 天);P<0.01]。治疗组咳嗽、咽痛、咳痰和发热等新发症状的发生率低于对照组(P<0.05 或 P<0.01)。在接种组中,化湿败毒颗粒治疗后,治疗组的核酸转阴时间和住院天数明显短于对照组[3 天(IQR:2-5 天)比 5 天(IQR:4-6 天),P<0.01;10 天(IQR:8-11 天)比 11 天(IQR:10-12 天),P<0.01]。在未接种组中,化湿败毒颗粒治疗有效缩短了核酸转阴时间和住院天数[4 天(IQR:2-6 天)比 5 天(IQR:4-7 天),P<0.01;10.5 天(IQR:8.75-11 天)比 11.0 天(IQR:10.75-13 天),P<0.01]。研究期间未报告严重的 AE。

结论

化湿败毒颗粒治疗可显著缩短新型冠状病毒 2 型奥密克戎变异株感染患者的核酸转阴时间、住院时间和首次核酸转阴时间(试验注册号:ChiCTR2200060472)。

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