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中药对新型冠状病毒肺炎患者的影响:一项多中心回顾性队列研究

Effect of Chinese Medicine in Patients with COVID-19: A Multi-center Retrospective Cohort Study.

作者信息

Zhao Guo-Zhen, Yan Shi-Yan, Li Bo, Guo Yu-Hong, Song Shuang, Hu Ya-Hui, Guo Shi-Qi, Hu Jing, Du Yuan, Lu Hai-Tian, Ye Hao-Ran, Ren Zhi-Ying, Zhu Ling-Fei, Xu Xiao-Long, Su Rui, Liu Qing-Quan

机构信息

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, 100010, China.

School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.

出版信息

Chin J Integr Med. 2024 Nov;30(11):974-983. doi: 10.1007/s11655-024-4108-7. Epub 2024 May 31.

Abstract

OBJECTIVE

To evaluate the effectiveness and safety of Chinese medicine (CM) in the treatment of coronavirus disease 2019 (COVID-19) in China.

METHODS

A multi-center retrospective cohort study was carried out, with cumulative CM treatment period of ⩾3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting (IPTW), and the Cox proportional hazards regression model was used for statistical analysis.

RESULTS

A total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio (HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval (CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29 (95% CI: 0.19 to 0.44, P<0.001). Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller.

CONCLUSION

This real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19 patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions. (Registration No. ChiCTR2200062917).

摘要

目的

评估中药在中国治疗2019冠状病毒病(COVID-19)中的有效性和安全性。

方法

开展一项多中心回顾性队列研究,将住院期间累计中药治疗时间≥3天作为暴露因素。数据来自2019年12月19日至2020年5月16日在中国武汉4家医疗中心连续收治的住院患者。在进行数据提取、核查和清理后,采用治疗权重逆概率法(IPTW)对混杂因素进行调整,并使用Cox比例风险回归模型进行统计分析。

结果

共纳入2272例COVID-19患者。中药组1684例,对照组588例。与对照组相比,中药组病情恶化率的风险比(HR)为0.52[95%置信区间(CI):0.41至0.64,P<0.001]。在入院时不同严重程度的患者中结果一致,并且通过3项敏感性分析证实了结果的稳健性。此外,中药组全因死亡率的HR为0.29(95%CI:0.19至0.44,P<0.001)。在安全性方面,中药组肝功能或肾功能异常的患者比例较小。

结论

这项真实世界研究表明,在基础常规治疗上全程联合中药治疗,可能安全降低COVID-19患者的病情恶化率和全因死亡率。这一结果可为支持当前COVID-19的治疗提供新的证据。需要进一步开展前瞻性临床试验以评估特定中药干预措施的疗效和安全性。(注册号:ChiCTR2200062917)

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