基于《新型冠状病毒感染诊疗方案(试行第十版)》探讨中药联合隔物灸贴治疗新型冠状病毒感染恢复期患者方案优化的临床疗效

Clinical Efficacy of Chinese Medicine Combined with Indirect Moxibustion Plaster on COVID-19 Patients During Recovery Period Based on COVID-19 Diagnosis and Treatment Protoco(l Tenth Edition)

目的:观察中药联合隔物灸贴治疗新型冠状病毒(以下简称新冠)感染恢复期患者的临床疗效。方法:将90例新冠感染恢复期患者随机分为中药组、隔物灸贴组、中药联合隔物灸贴组(联合组),每组各30例。基于《新型冠状病毒感染诊疗方案(试行第十版)》(《方案》)的恢复期中医药方案进行治疗,中药组予以辨证中药口服治疗,每日1剂,日服2次;隔物灸贴组予以足三里、脾俞、大椎、肺俞、孔最、天突等穴灸贴治疗,每日1次,每次贴敷40 min;联合组予以中药联合隔物灸贴治疗,疗程2周。分别于治疗前后观察各组中医症状评分、肺部计算机断层扫描术(CT)评分、圣乔治呼吸问卷(SGRQ)评分、血常规指标[白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)]、炎症指标[C反应蛋白(CRP)、血清铁蛋白、白细胞介素-6(IL-6)]水平,并评定各组临床疗效。结果:与本组治疗前比较,治疗后各组患者中医症状总分及单项评分、肺部CT评分、SGRQ评分、CRP、IL-6、铁蛋白水平均明显降低(P<0.05),WBC、LYM明显升高(P<0.05),NEUT水平较治疗前差异无统计学意义。与中药组和隔物灸贴组治疗后比较,联合组患者上述指标均优于中药组与隔物灸贴组,差异具有统计学意义(P<0.05)。治疗后联合组患者愈显率为76.7%(23/30),中药组患者愈显率为50.0%(15/30),隔物灸贴组患者愈显率为46.7%(14/30),联合组患者愈显率明显高于中药组(χ^(2)=4.593,P<0.05)和隔物灸贴组(χ^(2)=5.711,P<0.05),差异具有统计学意义。联合组患者总有效率为96.7%(29/30),中药组患者总有效率为93.3%(28/30),隔物灸贴组患者总有效率为86.7%(26/30),联合组患者总有效率高于中药组和隔物灸贴组,但差异无统计学意义。结论:中药联合隔物灸贴治疗可有效改善新冠感染恢复期患者临床症状,促进肺部炎症、血常规、炎症指标改善,提高生活质量,较单纯中药治疗和隔物灸贴治疗更具优势。

Objective:To observe the clinical efficacy of Chinese medicine combined with indirect moxibustion plaster on corona virus disease 2019(COVID-19)patients during recovery period.Method:Ninety patients of COVID-19 during the recovery period were randomly divided into a Chinese medicine group,an indirect moxibustion plaster group,and a combination group,with 30 cases in each group.According to the 10th edition of COVID-19 Diagnosis and Treatment Protocol,patients in the Chinese medicine group received oral Chinese medicine based on syndrome differentiation,one dose per day,twice a day.Patients in the indirect moxibustion plaster group were treated with indirect moxibustion plaster at Zusanli(ST 36),Pishu(BL 20),Dazhui(GV 14),Feishu(BL 13),Kongzui(LU 6),and Tiantu(CV 22),once a day,40 min each time.Patients in the combination group were treated with Chinese medicine combined with indirect moxibustion plaster.Treatment lasted two weeks.Before and after treatment,the traditional Chinese medicine(TCM)symptom score,pulmonary computed tomography(CT)score,St.George's Respiratory Questionnaire(SGRQ)score,blood routine indexes[white blood cell count(WBC),neutrophil count(NEUT),and lymphocyte count(LYM)],and inflammatory indexes[C-reactive protein(CRP),serum ferritin,and interleukin-6(IL-6)]were observed in the three groups.The clinical efficacy was evaluated.Result:After treatment,the scores of TCM symptoms,pulmonary CT,and SGRQ,CRP,IL-6,and ferritin in the three groups decreased(P<0.05),while WBC and LYM increased(P<0.05),but there was no significant difference in NEUT.The above indexes in the combination group were better than those in the other two groups(P<0.05).After treatment,the cured and markedly effective rate was 76.7%(23/30)in the combination group,50.0%(15/30)in the Chinese medicine group,and 46.7%(14/30)in the indirect moxibustion plaster group.The cured and markedly effective rate of the combination group was significantly higher than that of the Chinese medicine group(χ^(2)=4.593,P<0.05)and the indirect moxibustion plaster group(χ^(2)=5.711,P<0.05).The total effective rate was 96.7%(29/30)in the combination group,93.3%(28/30)in the Chinese medicine group,and 86.7%(26/30)in the indirect moxibustion plaster group.The total effective rate of the combination group was higher than that of the Chinese medicine group and the indirect moxibustion plaster group,but the differences were not statistically significant.Conclusion:Chinese medicine combined with indirect moxibustion plaster can effectively improve the clinical symptoms,promote pulmonary inflammation,blood routine indexes,and inflammatory indexes,and improve the quality of life of COVID-19 patients during the recovery period,which is more advantageous than Chinese medicine alone or indirect moxibustion plaster.