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医药导报  2020, Vol. 39 Issue (5): 640-644    DOI: 10.3870/j.issn.1004-0781.2020.05.012
  新型冠状病毒肺炎专栏 本期目录 | 过刊浏览 | 高级检索 |
清肺透邪扶正方治疗新型冠状病毒肺炎的临床疗效及机制
丁晓娟1(),张勇1(),何东初1,张梦云1,谭映军2,余爱荣3,俞桥1,伍伟1,杨文超1,黄河颂1,刘琳1
1.中国人民解放军中部战区总医院 中西医结合科
2.院长办公室
3.临床药理科,武汉 430070
Clinical Effect and Mechanism of Qingfei Touxie Fuzheng Recipe in the Treatment of COVID-19
Xiaojuan DING1(),Yong ZHANG1(),Dongchu HE1,Mengyun ZHANG1,Yingjun TAN2,Airong YU3,Qiao YU1,Wei WU1,Wenchao YANG1,Hesong HUANG1,Lin LIU1
1.Department of Integrated Traditional Chinese and Western Medicine
2.Dean's Office
3.Department of Clinical Pharmacology,General Hospital of Central Theatre Command of the Chinese People's Liberation Army,Wuhan 430070,China
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摘要 

目的 探讨清肺透邪扶正方治疗新型冠状病毒肺炎的临床疗效及机制。方法 新型冠状病毒肺炎患者100例,随机分为治疗组(51例)和对照组(49例),两组均根据《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》,给予抗病毒、抗感染等治疗,治疗组再给予清肺透邪扶正方加减治疗,治疗10 d后收集患者临床症状、检验指标、CT表现等资料分析对比。结果 治疗10 d后,治疗组在缓解发热、咳嗽咳痰、胸闷气促等临床症状,促进肺部病灶吸收,改善氧合等方面均显著优于对照组;治疗组红细胞沉降率(ESR)、C反应蛋白、白细胞介素(IL)-6等降低,与对照组比较差异有统计学意义(P<0.05),干扰素-γ(IFN-γ)上升,但与对照组差异无统计学意义(P>0.05)。结论 清肺透邪扶正方联合西药治疗新型冠状病毒肺炎对比单纯西药治疗,疗效更为显著,其可能作用机制为上调“抗病毒”和下调“促炎”因子。

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丁晓娟
张勇
何东初
张梦云
谭映军
余爱荣
俞桥
伍伟
杨文超
黄河颂
刘琳
关键词 清肺透邪扶正方新型冠状病毒肺炎干扰素-γ白细胞介素-6    
Abstract

Objective To investigate the clinical efficacy and mechanism of Qingfei Touxie Fuzheng recipe in the treatment of coronavirus disease 2019 (COVID-19). Methods One hundred COVID-19 patients were randomly divided into the treatment group (n=51) and the control group (n=49). According to the Diagnosis and Treatment Plan for COVID-19(Trial Fifth Edition),both groups were treated with western medicine based antiviral and anti-infection treatment.The treatment group were additionally treated with Qingfei Touxie Fuzheng recipe.After 10 days of treatment,the clinical symptoms,physical examination indexes,and CT manifestations of both groups were collected for analysis and comparison. Results After 10 days of treatment,the treatment group was significantly better than the control group in alleviating clinical symptoms fever,coughing and expectoration,chest tightness and shortness of breath,promoting the absorption of pulmonary lesions,improving oxygenation,etc..Compared with the control group,the levels of ESR,CRP,and IL-6 were significantly decreased in the treatment group(P<0.05),and the difference was statistically significant. The level of IFN-γ was increased,but there was no statistical difference between the data analysis and comparison(P>0.05). Conclusion The treatment of COVID-19 with Qingfei Touxie Fuzheng recipe combined with western medicines was more effective than the treatment with western medicine alone,and the possible mechanism lies in the up-regulation of “antiviral” factors and down-regulation of “pro-inflammatory” factors.

Key wordsQingfei Touxie Fuzheng recipe    Coronavirus disease 2019    Interferon-γ    Interleukin-6
收稿日期: 2020-02-21      出版日期: 2020-05-28
引用本文:   
丁晓娟,张勇,何东初,张梦云,谭映军,余爱荣,俞桥,伍伟,杨文超,黄河颂,刘琳. 清肺透邪扶正方治疗新型冠状病毒肺炎的临床疗效及机制[J]. 医药导报, 2020, 39(5): 640-644.
Xiaojuan DING,Yong ZHANG,Dongchu HE,Mengyun ZHANG,Yingjun TAN,Airong YU,Qiao YU,Wei WU,Wenchao YANG,Hesong HUANG,Lin LIU. Clinical Effect and Mechanism of Qingfei Touxie Fuzheng Recipe in the Treatment of COVID-19. Herald of Medicine, 2020, 39(5): 640-644.
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http://www.yydbzz.com/CN/10.3870/j.issn.1004-0781.2020.05.012      或      http://www.yydbzz.com/CN/Y2020/V39/I5/640
组别 例数 年龄/
性别 合并基础疾病 入院前有症状
时间/d
轻型 普通型 重症及危
重症
治疗组 51 54.7±21.3 12 39 20 31 5.3±3.1 10 36 5
对照组 49 50.8±23.5 10 39 19 30 6.0±3.7 11 34 4
表1  两组患者基本临床资料比较
组别与
时间
例数 发热 咳嗽/
咳痰
鼻塞/
流涕
腹痛/
腹泻
胸闷/
气促
氧饱和度/
%
氧合
指数
CT表现
对照组 49
治疗前 49 41 2 9 17 94.5±5.2 207.0±65.7 49
治疗后 6 13 0 2 11 97.0±2.6 226.0±48.0 28
好转率/% 87.8 68.3 100.0 77.8 35.3 75.0 67.3 42.9
治疗组 51
治疗前 51 43 1 7 18 95.7±2.8 203±35.7 51
治疗后 1 5 0 1 4 97.3±2.0 231±61.5 19
好转率/% 98.0 88.4 100.0 85.7 77.8 90.0 84.3 62.7
χ2 4.060 5.026 - 0.163 6.443 4.457 3.944 3.968
P 0.044 0.025 - 0.687 0.011 0.035 0.047 0.046
表2  两组患者治疗前后临床症状及指标比较
组别与时间 例数 ESR/
(mm·h-1)
CPR/
(mg·L-1)
IL-6 TNF-α IFN-γ
(pg·mL-1)
治疗组 51
治疗前 63.8±9.5 40.4±6.8 36.5±32.7 18.4±16.2 11.9±15.1
治疗后 24.7±5.9 8.0±4.0 10.8±27.8 3.0±2.2 40.7±22.0
好转率/% 95.0 95.2 94.1 50.0 86.2
对照组 49
治疗前 73.3±16.0 71.6±13.9 57.6±10.2 19.4±16.1 20.5±26.1
治疗后 66.3±14.7 40.3±15.8 28.4±4.7 9.9±9.0 41.1±33.4
好转率/% 62.5 81.3 79.6 71.4 71.4
χ2 14.79 5.528 4.662 0.241 3.320
P <0.01 0.019 0.031 0.623 0.068
表3  两者患者治疗前后炎症指标比较
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