中西医结合治疗高原地区新型冠状病毒感染患者的疗效评价

Efficacy evaluation of integrated traditional Chinese medicine and western medicine in treating patients with coronavirus disease 2019 in the plateau area

目的评价采用中西医结合治疗高原地区新型冠状病毒感染(新冠感染)患者的临床疗效。方法选择2022年8月至9月作者作为西藏自治区新冠感染专家救治组成员在西藏自治区第三人民医院收治的新冠感染患者作为研究对象。以是否接受中药配方颗粒治疗将患者分为中西医结合治疗组和西医对照组。绘制Kaplan-Meier曲线,比较两组患者新型冠状病毒核酸转阴时间、住院时间、咳嗽持续时间的差异;并建立多因素COX回归模型调整混杂因素,评价各因素对两组结果的影响。结果共纳入患者363例,其中中西医结合治疗组175例,西医对照组188例。中西医结合治疗组新冠病毒核酸中位转阴时间、住院中位时间、咳嗽持续中位时间均较西医对照组明显缩短〔新冠病毒核酸转阴时间(d):5(3,8)比8(4,13),住院时间(d):8(5,11)比10(6,14),咳嗽持续时间(d):2(2,3)比5(3,7)〕;单因素Log-Rank检验显示,两组差异均有统计学意义(均P<0.01)。COX回归分析显示:调整性别、年龄、疾病分型、是否使用抗病毒药物和连花清瘟5个因素后,新冠病毒核酸转阴时间〔风险比(HR)=1.768,95%可信区间(95%CI)为1.391~2.248〕、住院时间(HR=1.633,95%CI为1.293~2.063)、咳嗽缓时间(HR=2.672,95%CI为2.060~3.464),组间差异仍有统计学意义(均P<0.01)。结论中西医协同治疗高原地区新冠感染在加快病毒核酸转阴和缩短住院时间及咳嗽持续时间方面取得了良好疗效。

Objective To evaluate the clinical efficacy of integrated traditional Chinese medicine(TCM)and western medicine in treating patients with coronavirus disease 2019(COVID-19)in the plateau area.Methods The COVID-19 patients treated in the Third People's Hospital of Tibet Autonomous Region from August to September 2022 were selected as the research objects when the author was a member of the expert treatment team in Tibet Autonomous Region.Patients were divided into integrated Chinese medicine and western medicine group and western medicine control group according to whether they received TCM formula particles.Kaplan-Meier curves were drawn to compare the difference of negative nucleic acid conversion time,hospital length of stay,and cough duration between the two groups.Multivariate COX regression model was established to adjust confounding factors and evaluate the influence of each factor on the results of the two groups.Results A total of 363 patients were enrolled,including 175 cases in the integrated Chinese medicine and western medicine group and 188 cases in the western medicine control group.The median time of 2019 novel coronavirus nucleic acid turning negative,the median hospital length of stay,and the median duration of cough in the integrated Chinese medicine and western medicine group were significantly shorter than those in the western medicine control group[time of 2019 novel coronavirus nucleic acid turning negative(days):5(3,8)vs.8(4,13),time of hospital length of stay(days):8(5,11)vs.10(6,14),the time to duration of cough(days):2(2,3)vs.5(3,7)],and the results of univariate Log-Rank test showed that the differences between the two groups were statistically significant(all P<0.01).Multivariate COX regression showed that after adjusting for sex,age,disease type,use of antiviral drugs and Lianhua Qingwen,there were still significant differences in the time of 2019 novel coronavirus nucleic acid turning negative[hazard ratio(HR)=1.768,95%confidence interval(95%CI)was 1.391-2.248],stay of hospital length(HR=1.633,95%CI was 1.293-2.063),and the duration of cough(HR=2.672,95%CI was 2.060-3.464)between the two groups(all P<0.01).Conclusion The combined treatment of TCM and western medicine in the treatment of COVID-19 in the plateau area has achieved good results in accelerating the time of nucleic acid turning negative and reducing the length of hospital stay and duration of cough.