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沙参麦冬汤联合西药治疗85岁以上奥密克戎感染患者的疗效及安全性:一项回顾性研究

The Efficacy and Safety of Shashen-Maidong Decoction Combined with Western Medicine in the Treatment of Omicron Infected Individuals Over 85 Years Old: A Retrospective Study.

作者信息

Lin Xiao-Xi, Yin Yu-Qi, Zhang Wen-Zheng, Huang Jia-Huan, Hu Wei-Shang

机构信息

Geriatric Medicine Center, Department No. 2 of Acupuncture & Massage, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310024, People's Republic of China.

The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Nov 28;16:7339-7348. doi: 10.2147/IDR.S433815. eCollection 2023.

Abstract

BACKGROUND

During the Omicron variant outbreak of COVID-19 (2022-2023), Chinese healthcare institutions combined traditional Chinese medicine (TCM) with Western medical practices to treat COVID-19 patients, especially the elderly. The efficacy and safety of this approach, especially for individuals aged over 85, need further investigation.

METHODS

In this retrospective study, a cohort of 62 patients aged over 85 years, diagnosed with COVID-19 infection, was examined. Among them, 34 patients were administered Shashen-Maidong decoction in conjunction with Western medicine (SMD+WM group), while the remaining 28 patients received only Western medicine (WM group). Comparative analysis was conducted between the two groups, encompassing parameters such as the duration for the nucleic acid test to turn negative, length of intensive care unit (ICU) stay, mortality rate, utilization of high-flow nasal cannula oxygen (HFNC), occurrence of endo-tracheal intubation, frequency of recurrent respiratory infections within three months, and various laboratory indicators.

RESULTS

There were no significant differences observed between the two groups in terms of the duration for the nucleic acid test to turn negative, the length of ICU stay, mortality rate, utilization of HFNC, performance of endo-tracheal intubation, or the frequency of recurrent respiratory infections within three months (P > 0.05). However, in comparison to the WM group, the SMD+WM group exhibited notably lower growth rates in white blood cell (WBC) and neutrophil (NEUT) values. Additionally, the SMD+WM group demonstrated superior improvement in cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) values.

CONCLUSION

In contrast to the administration of Western medicine alone, the combined use of Shashen-Maidong decoction with Western medicine significantly suppresses the increase in WBC count, particularly in NEUT levels, in elderly patients diagnosed with COVID-19. Moreover, this combined treatment exhibits a protective effect on cardiac function and demonstrates a relatively safe profile.

摘要

背景

在2022 - 2023年新冠病毒奥密克戎变异株疫情期间,中国医疗机构采用中西医结合的方法治疗新冠患者,尤其是老年患者。这种方法的疗效和安全性,特别是对于85岁以上的个体,需要进一步研究。

方法

在这项回顾性研究中,对62例年龄超过85岁、被诊断为新冠病毒感染的患者进行了检查。其中,34例患者接受沙参麦冬汤联合西药治疗(沙参麦冬汤 + 西药组),其余28例患者仅接受西药治疗(西药组)。对两组进行了比较分析,包括核酸检测转阴时间、重症监护病房(ICU)住院时间、死亡率、高流量鼻导管吸氧(HFNC)的使用情况、气管插管的发生率、三个月内反复呼吸道感染的频率以及各种实验室指标。

结果

两组在核酸检测转阴时间、ICU住院时间、死亡率、HFNC的使用情况、气管插管操作以及三个月内反复呼吸道感染的频率方面均未观察到显著差异(P > 0.05)。然而,与西药组相比,沙参麦冬汤 + 西药组的白细胞(WBC)和中性粒细胞(NEUT)值的增长率明显较低。此外,沙参麦冬汤 + 西药组在心肌肌钙蛋白I(cTnI)和B型利钠肽(BNP)值方面表现出更好的改善。

结论

与单独使用西药相比,沙参麦冬汤联合西药显著抑制了新冠病毒感染老年患者白细胞计数的增加,特别是中性粒细胞水平。此外,这种联合治疗对心脏功能具有保护作用,并且显示出相对安全的特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/642e/10693277/04f6dc51d5e9/IDR-16-7339-g0001.jpg

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