中西医结合治疗新型冠状病毒肺炎34例临床研究

Clinical Observation on 34 Patients with Novel Coronavirus Pneumonia (COVID-19) Treated with Intergrated Traditional Chinese and Western Medicine

目的回顾性分析52例新型冠状病毒肺炎患者的临床资料,探讨中西医结合治疗新型冠状病毒肺炎的临床疗效。方法收集2020年1月15日至2月8日湖北省中西医结合医院52例新型冠状病毒肺炎患者临床资料,对其基本信息、中医证候、实验室检查、治疗方法等进行调查分析。按照干预方法不同分为西药组(18例)和中西药组(34例),西药组给予西药抗病毒、抗感染、辅助支持药物,中西药组在西药组治疗基础上给予中药汤剂、中成药及中药注射液治疗,比较两组患者的临床症状消失时间、体温复常时间、其他症状消失率、平均住院天数、临床治愈率及死亡率等。结果52例患者中男性23例,女性29例,年龄(54.00±12.83)岁,发病到住院时间为(7.44±2.99)天;主要症状为:发热(75%)、乏力(61.5%)、咳嗽(50%),其他症状(34.6%);入院时的病情:普通型占76.9%,重型患者占19.2%,危重型患者占3.8%;中医证型为:湿毒郁肺占30.8%、疫毒闭肺占25%、湿热蕴毒占21.2%、邪热壅肺占19.2%、内闭外脱占3.8%;实验室检查发现:淋巴细胞百分比(18.53±11.01)%,血清淀粉样蛋白A(111.65±76.98)mg/L,C反应蛋白(31.34±21.99)mg/L,血沉(22.60±15.65)mm/h;中西药组临床症状消失时间[(5.15±1.68)天]、体温复常时间[(2.64±1.31)天]、平均住院天数[(7.38±2.06)天]及中医证候量表评分[(12.17±8.72)分]均较西药组明显减少(P<0.05或P<0.01);中西药组出院时其他伴随症状消失率85.3%、临床治愈率91.2%及普通型转重型5.9%发生率均明显优于西药组(分别为38.9%、61.1%、33.3%)(P<0.05或P<0.01)。结论中西医结合治疗新型冠状病毒肺炎能显著减轻患者的临床症状,缩短病程,提高临床治愈率,且优于单纯西药治疗,值得推广应用。

Objective To investigate the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of novel coronavirus pneumonia(COVID-19)by retrospectively analyzing the clinical records of 52 patients.Methods The data of patients with COVID-19 from Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine during January 15 th,2020 to February 8 th,2020 were collected to investigate and analyze the basic information,traditional Chinese medical syndromes,laboratory tests and treatment methods.Patients were divided into two groups according to the intervention,a western medicine group of 18 cases treated with anti-virus,anti-infection and auxiliary supportive drugs,and an integrated treatment group of 34 cases treated with traditional Chinese medicine decoctions,patent Chinese medicines and traditional Chinese medicine injections in addition to the western medicine group.Clinical symptoms disappearance time,body temperature normalization time,accompanying symptom disappearance rate,average hospitalization days,clinical cure rate,and mortality rate were compared between groups.Results The 52 patients include 23 male patients and 29 female patients,the average age was(54.00±12.83)years old,and the time from onset to hospitalization was(7.44±2.99)days.The main symptoms include fever(75%),fatigue(61.5%),cough(50%),and other symptoms(34.6%).According to the conditions at the time of admission,there were 76.9%ordinary type,19.2%severe patients,and 3.8%critical patients.The main syndrome types in Chinese medicine were dampness-toxin stagnated in the lung(30.8%),pestilence-toxicity blocking the lung(25.0%),damp-heat accumulation toxin in the lung(21.2%),pathogenic heat congesting in the lung(19.2%)and internal blockade and external collapse(3.8%).Laboratory testing showed the following results:lymphocytes percentage(18.53±11.01)%,serum amyloid A(111.65±76.98)mg/L,C-reaction protein(31.34±21.99)mg/L and erythrocyte sedimentation rate(22.60±15.65)mm/H.The clinical symptom disappearance time[(5.15±1.68)d],body temperature recovery time[(2.64±1.31)d],average hospitalization days[(7.38±2.06)d],and Chinese medicine syndrome scale score[(13.29±3.79)points]of the integrated treatment group were significantly lower than those in the western medicine group(P<0.05 or P<0.01).When patients were discharged from hospital,the accompanying symptom disappearance rate(87.9%),the clinical cure rate(91.2%),and the incidence of common type patients developed to severe type(5.9%)in the integrated treatment group were significantly superior to those in the western medicine group(the corresponding results 38.9%,61.1%,and 33.3%respectively,P<0.05 or P<0.01).Conclusion The treatment of integrated Chinese and western medicine can significantly alleviate the clinical symptoms,shorten the course of disease and improve the cure rate,showing advantage to single use western medicine,which is worthy of clinical promotion and application.