中西医结合治疗新型冠状病毒肺炎危重症患者40例的临床研究

Integrated Traditional Chinese and Western Medicine in the Treatment of 40 Cases of Critical Patients with COVID-19

目的 回顾性分析40例新型冠状病毒肺炎危重症患者的临床资料,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30日至2020年2月24日在华中科技大学同济医学院附属协和医院西院中西医结合科住院治疗的40例新型冠状病毒肺炎患者资料,对其基本信息、中医候证、实验室检查、临床症状、治疗方案等进行统计分析,并对中西医结合治疗组(26例)和西医治疗组(14例)的临床症状恢复率、体温复常率、C T影像好转率、核酸转阴率等进行比较.结果 40例患者平均年龄(60.01±13.00)岁,主要症状为发热(45.00%)、出汗(70.00%)、胸闷气促(85.00%)、咳嗽(55.00%)、咽干咽痛(45.00%);入院时病情严重程度,重型占75.00%,危重型占25.00%;中医证型以湿热壅肺为主,其中热重于湿者占87.5%、湿重于热者占12.5%.治疗后中西医结合治疗组和西医治疗组的临床症状恢复率分别为92.31%、57.14%,体温复常率分别为96.15%、64.29%,伴随症状消失率分别为88.46%、50.00%,C T影像好转率分别为84.62%、50.00%,核酸转阴率分别为88.46%、50.00%,中西医结合治疗组上述指标均优于西医治疗组(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危重症患者的临床症状,缩短病程,降低死亡率,值得在临床推广应用.

Objective To retrospectively analyze the clinical data of 40 critically ill patients with COVID-19 and to explore the clinical efficacy of integrated Chinese and western medicine in the treatment of COVID-19.Methods Data of 40 patients with COVID-19 who were treated from January 30,2020 to February 24,2020 in Western Hospital of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology were collected.After the treatment,body temperature recovery rate,CT image improvement rate,nucleic acid negative rate were compared.Results The age of the 40 patients was(60.01±13.00)years,the main symptoms were fever(45.00%),sweating(70.00%),chest tightness and shortness of breath(85.00%),cough(55.00%),dry pharynx(45.00%).The severe disease type accounted for 75.00%and critical disease type 25.00%.The main TCM syndrome type was damp-heat obstruction of lung,including dampness-heat syndrome with predominant heat accounting for 87.5%,and dampness-heat syndrome with predominant dampness accounting for 12.5%.After the treatment,the recovery rate of clinical symptoms was 92.31%and 57.14%in integrated Chinese and western medicine group and western medicine group,respectively.The recovery rate of body temperature was 96.15%and 64.29%,respectively.Disappearance rate of accompanied symptom was 88.46%and 50.00%,CT image improvement rate was 84.62%and 50.00%,and nucleic acid conversion rate was 88.46%and 50.00%,respectively.Recovery rate of clinical symptoms,body temperature recovery rate,CT image improvement rate and nucleic acid conversion rate were significantly higher in the Chinese and western medicine treatment group than in the western medicine treatment group(P<0.05,P<0.01).Conclusion The combination of traditional Chinese and western medicine in the treatment of COVID-19 can significantly alleviate the clinical symptoms of critically ill patients,shorten the course of disease and reduce mortality,and it is worthy of clinical application.