Curative effect of integrated Chinese and Western medicine on 80 severe and critical COVID-19 patients

Yuan WANG; Donghui HUANG; Huixian WANG; Cuiling FENG; Zishao ZHONG; Junxiang CAI; Dongping XIE; Lin SONG; Minyong WEN; Tonghan WANG; Zhongde ZHANG

doi:10.3969/j.issn.1006-2157.2022.06.004

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Curative effect of integrated Chinese and Western medicine on 80 severe and critical COVID-19 patients

COVID-19 Theme | 更新时间：2022-07-11

- Curative effect of integrated Chinese and Western medicine on 80 severe and critical COVID-19 patients
- Journal of Beijing University of Traditional Chinese Medicine Vol. 45, Issue 6, Pages: 555-562(2022)
- 作者机构：
  
  1.广州中医药大学　广州　510006
  2.广东省中医院珠海医院
  3.北京大学人民医院
  4.广东省中医院
  5.湖北省中西医结合医院
  6.广州中医药大学第一附属医院
  7.广东省第二中医院
- 作者简介：
  
  Prof. HUANG Donghui, Master, Chief Physician, Doctoral Supervisor. Guangdong Provincial Hospital of Chinese Medicine Zhuhai Branch. No. 53 Jingle Road, Xiangzhou District, Zhuhai 519015. E-mail: 13600001163@139.com
- 基金信息：
  
  Novel Coronavirus Pneumonia Prevention and Control Special Programs in Institutions of Higher Learning Funded by the Department of Education of Guangdong Province(2020KZDZX1053)
- DOI：10.3969/j.issn.1006-2157.2022.06.004
  CLC： R254.3
- Received：11 November 2021，
  
  Published：30 June 2022
- 稿件说明：
移动端阅览
Yuan WANG, Donghui HUANG, Huixian WANG, et al. Curative effect of integrated Chinese and Western medicine on 80 severe and critical COVID-19 patients[J]. Journal of Beijing University of Traditional Chinese Medicine, 2022, 45(6): 555-562.
DOI：

Yuan WANG, Donghui HUANG, Huixian WANG, et al. Curative effect of integrated Chinese and Western medicine on 80 severe and critical COVID-19 patients[J]. Journal of Beijing University of Traditional Chinese Medicine, 2022, 45(6): 555-562. DOI： 10.3969/j.issn.1006-2157.2022.06.004.

摘要

目的

观察中医药辨证治疗结合西医基础治疗对新型冠状病毒肺炎(COVID-19)重型及危重型患者病情转归及各项指标的影响，综合评估其临床疗效及安全性。

方法

选择2020年2—3月广东省中医医疗队收治于湖北省中西医结合医院的COVID-19重型及危重型患者，按2∶1随机分为试验组及对照组。根据《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》，给予对照组西医基础治疗，试验组在西医基础治疗上全程进行中医辨证施治，针对邪郁少阳证、邪伏膜原证、湿热蕴肺证、疫毒闭肺证、气阴两伤证、气营两燔证及内闭外脱证加用中药汤剂及中成药。观察2组患者结局转归、核酸转阴时间、治疗前后中医证候总积分和实验室指标变化。

结果

试验组总有效率、核酸转阴率高于对照组(

0.05)，但2组28 d病死率、核酸转阴时间差异无统计学意义(

0.05)。治疗后，2组中医证候总积分均下降(

0.05)，且试验组较对照组降低(

0.05)；2组C反应蛋白、血清淀粉样蛋白A、白细胞介素-6均降低，且试验组血清淀粉样蛋白A、白细胞介素-6较对照组降低(

0.05)；试验组白细胞计数、淋巴细胞计数、T淋巴细胞计数、自然杀伤细胞计数及对照组白细胞计数、T淋巴细胞计数均较治疗前升高，且试验组白细胞计数、T淋巴细胞计数均较对照组升高(

0.05)；2组乳酸浓度均较治疗前降低(

0.05)，且试验组较对照组降低(

0.05)；试验组较治疗前氧合指数升高(

0.05)。

结论

中医药辨证治疗结合西医基础治疗能够调节COVID-19重型、危重型患者免疫功能，抑制机体炎症反应，改善组织缺氧及灌注不足，有效缓解患者症状，从而提高临床疗效。

Abstract

Objective

To observe the effects of traditional Chinese medicine (TCM) dialectical treatment combined with Western medicine on the outcome and various indicators of severe and critical COVID-19 patients to comprehensively evaluate the treatment’s clinical efficacy and safety.

Methods

From February to March 2020

patients with severe and critical COVID-19 who were admitted to Hubei Provincial Hospital of Integrated Chinese & Western Medicine and managed by the Guangdong TCM Medical Team were selected as the study subjects. They were divided randomly into the experimental group and the control group in a ratio of 2∶1. The control group was given the basic treatment of Western medicine according to the Western medicine treatment plan issued by the National Health Commission. Along with the basic Western medicine treatment

the experimental group added TCM dialectical treatment that included Chinese herbal decoction and proprietary Chinese medicine for stagnant pathogens trapped in the Shaoyang syndrome

stagnant pathogens trapped in the Moyuan syndrome

dampness-heat obstructing lung syndrome

epidemic toxin-blocking lung

qi-yin deficiency syndrome

the dual blaze of qi and nutrient syndrome

and internal blocking and external detachment syndrome

we observed the outcome

nucleic acid negative time

the total score of the syndrome as well as the change in the laboratory index in the two groups before and after treatment.

Results

The total efficiency and nucleic acid negative conversion rate of the experimental group were higher than those in the control group

and the difference between the two groups was significant (

0.05). However

there was no obvious difference in the 28-d fatality rate and nucleic acid negative time between the two groups (

0.05). The two groups showed a downward trend in TCM scores after treatment

and the decline was more pronounced in the experimental group than in the control group (

0.05). The two groups showed a downward trend after treatment with C-reactive protein

serum amyloid A protein (SAA)

and interleukin-6 (IL-6)

but SAA and IL-6 in the experimental group were more reduced than in the control group (

0.05). White blood cells (WBC)

lymphocytes (LYM)

T lymphocytes

and natural killer cells (NK) of the experimental group

and WBC and T lymphocytes of the control group showed an upward trend after treatment. WBC

LYM

T lymphocytes

and NK of the experimental group also increased more significantly than in the control group (

0.05). Lactic acid (Lac) of both groups decreased after treatment

but Lac of the experimental group decreased more significantly than that of the control group (

0.05). PaO

/FiO

of the experimental group increased after treatment (

0.05).

Conclusion

TCM dialectical treatment combined with Western medical treatment can regulate the immune function of severe and critical COVID-19 patients

inhibit their inflammatory response

improve tissue hypoxia and hypoperfusion

effectively alleviate symptoms

and thus improve the clinical efficacy.

关键词

Keywords

references

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