苦参碱氯化钠注射液治疗40例新型冠状病毒肺炎的临床疗效分析

Clinical efficacy of Matrine and Sodium Chloride Injection in treatment of 40 cases of COVID-19

该文通过回顾性分析40例新型冠状病毒肺炎患者病案,探讨苦参碱氯化钠注射液治疗新型冠状病毒肺炎的临床疗效。基于前期动物实验模型研究结果表明,苦参碱氯化钠注射液对人冠状病毒肺炎寒湿疫毒袭肺病证结合小鼠模型具有显著的治疗作用,对模型组小鼠肺指数抑制率高达86.86%,该研究定位于观察苦参碱氯化钠注射液治疗新型冠状病毒肺炎的临床疗效验证和总结。收集了2020年1月30日至2020年3月21日荆州市传染病(胸科)医院收治的40例新型冠状病毒肺炎确诊病例,使用苦参碱氯化钠注射液联合诊疗方案中推荐的其他中西药的综合治疗方案进行治疗。并对治疗前后的临床表现、实验室数据、核酸转阴时间、影像资料进行对比分析。在使用了苦参碱氯化钠注射液治疗后,40例患者临床症状明显好转、血分析及生化指标基本恢复正常、肺部CT病灶吸收超过50%、患者病毒核酸检测转阴平均时间16.6 d,平均住院时间25.9 d。使用苦参碱氯化钠注射液后患者发热、咳嗽、乏力等典型呼吸道症状及食欲较前明显改善,原有消化道症状的患者改善尤为明显;实验室指标特别是淋巴细胞绝对值及比值、CRP明显改善;短期内复查胸部CT提示肺部病灶吸收情况较前加快,特别是对于网格状、纤维化的病灶改善更明显;与阿比多尔及克立芝等抗病毒药物相比,能显著缩短核酸转阴时间,临床40例小样本量有效率100.0%。结果表明苦参碱氯化钠注射液治疗新型冠状病毒肺炎具有较好的临床疗效,建议加大推广应用和进一步开展大样本临床验证。

In this paper, we analyzed medical records of 40 patients with coronavirus disease 2019(COVID-19), in order to explore the clinical efficacy of Matrine and Sodium Chloride Injection in the treatment of COVID-19. The investigation was based on the results of a previous animal test, which was aimed to investigate and confirme the clinical efficacy of Matrine and Sodium Chloride Injection in the treatment of COVID-19. The animal test demonstrated that Matrine and Sodium Chloride Injection has a significant therapeutic effect on the human coronavirus pneumonia for the model mice. The lung inhibition index reached up to 86.86%. The evaluation was conducted on 40 confirmed cases of COVID-19 treated at Jingzhou Hospital of Infectious Disease(Chest Hospital) of Hubei Pro-vince from January 30th to March 21th, 2020. In these cases, patients were treated with other integrated Chinese and Western medicines regimens in the recommended Matrine and Sodium Chloride Injection diagnosis and treatment regimen. The clinical manifestations, laboratory data, nucleic acid clearance time, and imaging data were compared and analyzed before and after treatment. After administration with Matrine and Sodium Chloride Injection, the clinical symptoms of 40 cases were alleviated markedly, and their blood analysis and biochemical indexes returned to normal. The lung CT showed more than 50% of lesion absorption rate, and the viral nucleic acid test showed the average clearance time of patients was 16.6 days, and the average length of hospital stay was 25.9 days. After administration with Matrine and Sodium Chloride Injection, the symptoms of cough and fatigue were alleviated significantly, and the appetite was significantly improved compared with before, especially for patients with gastrointestinal symptoms. Additionally, laboratory indicators, especially absolute value and ratio of lymphocytes and CRP were significantly alleviated. According to the chest CT for short-term review, the absorption of lung lesions was faster than before, especially for grid-like and fibrotic lesions. Compared with antiviral drugs, such as Abidol and Kriging, the nucleic acid clearance time was significantly shorter than the cases treated with Matrine and Sodium Chloride Injection. The clinical effective rate of 40 cases was 100.0%. We believed that Matrine and Sodium Chloride Injection have a good clinical effect in the treatment of COVID-19, and suggested increasing the clinical application and further conducting large-sample-size cli-nical verification.