Ono Rie, Takayama Shin, Arita Ryutaro, Ishizawa Kota, Kikuchi Akiko, Abe Michiaki, Ohsawa Minoru, Saito Natsumi, Kanno Takeshi, Onodera Koh, Ishii Tadashi
Department of Kampo Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan.
Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan.
Front Med (Lausanne). 2025 Jul 21;12:1609812. doi: 10.3389/fmed.2025.1609812. eCollection 2025.
Long COVID symptoms, especially brain fog, significantly impair patient quality of life (QOL); however, effective treatments remain elusive. Japanese traditional medicine (JTM, usually called Kampo medicine) is often used adjunctively to treat patients with diverse manifestations of long COVID.
To evaluate the effectiveness of JTM in treating long COVID using a comprehensive QOL assessment.
This single-center, prospective observational study evaluated QOL changes in patients with symptoms persisting beyond 28 days from the onset of COVID-19 (long COVID) who visited our general medicine outpatient department between October 2021 and August 2024. The treatment plan was determined by the attending physician based on the patient's condition. The health-related QOL (HR-QOL) was comprehensively assessed using EuroQol-5 demensions-5levels (EQ-5D-5L) scores (ranging from -0.025 to 1.000, with higher values indicating better HR-QOL) at baseline and 3 months after the first visit. The formulations and factors associated with QOL changes were analyzed using multivariate logistic regression analyses.
We analyzed 112 patients. The most common symptoms were fatigue (83.9%). The median (interquartile range) HR-QOL of the entire cohort significantly increased from 0.711 (0.561-0.711) at baseline to 0.833 (0.671-0.890) at 3 months ( < 0.0001); the proportion of patients exceeding the national standard significantly increased from 7.1% to 20.4% ( = 0.0037). The brain fog patients group (50.0%, = 56), the median (interquartile range) HR-QOL of the entire cohort significantly increased from 0.677 (0.551-0.770) at baseline to 0.750 (0.623-0.846) at 3 months ( < 0.005). However, the proportion of patients achieving the Japanese average HR-QOL did not show improvement significantly. A total of 101 patients (90.2%) were treated with JTM, and a combination of kamikihito and saikokeishito was administered to 20 patients. Multivariate regression analysis revealed that the combination usage was associated with greater improvements in the HR-QOL in all patients (odds ratio 5.4) and brain fog patients' group (odds ratio 6.1).
Long COVID treatment involving JTM improved the patients' QOL at 3 months. The combination of kamikihito with saikokeishito may be a potential treatment option for long COVID. However, a randomized controlled trial is required to confirm its efficacy.
长期新冠症状，尤其是脑雾，严重损害患者生活质量（QOL）；然而，有效的治疗方法仍然难以捉摸。日本传统医学（JTM，通常称为汉方医学）常被辅助用于治疗有多种长期新冠表现的患者。
使用全面的生活质量评估来评估JTM治疗长期新冠的有效性。
这项单中心前瞻性观察性研究评估了2021年10月至2024年8月期间到我们普通内科门诊就诊的新冠病毒病（COVID-19）发病28天后症状仍持续的患者（长期新冠）的生活质量变化。治疗方案由主治医师根据患者病情确定。在基线和首次就诊后3个月，使用欧洲五维度健康量表（EQ-5D-5L）评分（范围从-0.025至1.000，分数越高表明健康相关生活质量越好）对健康相关生活质量（HR-QOL）进行全面评估。使用多因素逻辑回归分析来分析与生活质量变化相关的配方和因素。
我们分析了112例患者。最常见的症状是疲劳（83.9%）。整个队列的HR-QOL中位数（四分位间距）从基线时的0.711（0.561 - 0.711）显著增加到3个月时的0.833（0.671 - 0.890）（P < 0.0001）；超过国家标准的患者比例从7.1%显著增加到20.4%（P = 0.0037）。脑雾患者组（n = 56，占50.0%）中，整个队列的HR-QOL中位数（四分位间距）从基线时的0.677（0.551 - 0.770）显著增加到3个月时的0.750（0.623 - 0.846）（P < 0.005）。然而，达到日本平均HR-QOL的患者比例没有显著改善。共有101例患者（90.2%）接受了JTM治疗，20例患者接受了加味逍遥散和柴胡桂枝汤的联合治疗。多因素回归分析显示，联合使用在所有患者（优势比5.4）和脑雾患者组（优势比6.1）中与HR-QOL的更大改善相关。
涉及JTM的长期新冠治疗在3个月时改善了患者的生活质量。加味逍遥散与柴胡桂枝汤的联合使用可能是长期新冠的一种潜在治疗选择。然而，需要进行随机对照试验来证实其疗效。
