中药配合艾灸治疗41例新冠肺炎愈后“复阳”患者的临床观察

Clinical Observation of 41 COVID-19 Recurrence Patients Treated with Chinese Medicine Combined with Moxibustion

目的观察41例新型冠状病毒肺炎(COVID-19)愈后"复阳"患者中药配合艾灸的治疗效果。方法根据症状体征,结合《新型冠状病毒肺炎恢复期中医康复指导建议(试行)》的恢复期诊疗方案[1],将所有愈后"复阳"患者分为肺脾气虚及气阴两虚两个基本证型给予遣方用药,并酌情加减,同时结合艾灸治疗,疗程2周。判断整体疗效(自拟标准)、比较治疗前后单项症状痊愈率、症状VAS评分变化、舌象变化及转阴率。结果通过2周治疗,患者痊愈率为34.15%,总有效率达87.80%;常见单项症状痊愈率:咽部不适、失眠、腹胀分别为58.62%、60.0%、69.23%,前后对比均有显著意义(p<0.05);部分患者症状未完全消失,但咽部不适,失眠,胸闷VAS评分较前也有明显减低(p<0.05)。治疗后齿痕舌、白腻苔明显减少,薄白苔明显增多(p<0.05);转阴效果上,1周转阴者33例,占80.48%,2周转阴者6例,占14.63%,疗程内总转阴率95.11%。结论中药结合艾灸不仅能明显改善愈后"复阳"患者临床症状,还可使舌像由异常趋于正常,同时对促进核酸再次转阴具有积极作用,值得临床借鉴。

Objective:To observe the therapeutic effect of Chinese medicine combined with Moxibustion on 41 recurrence cases of COVID-19. Methods:According to the symptoms and signs, combined with the recovery treatment plan of "COVID-19 recovery period guidance advice(Trial)", all patients were divided into two basic syndromes: "lung spleen Qi deficiency" and "Qi Yin Deficiency". They were given prescriptions, and were treated with moxibustion for 2 weeks. The overall curative effect(self-made standard) was evaluated, and the recovery rate of single symptom, the change of VAS score, the change of tongue picture and the negative conversion rate were compared before and after treatment. Results:After 2 weeks of treatment, the cure rate of patients was 34.15%, and the total effective rate was 87.80%;the cure rates of common single symptoms: pharyngeal discomfort, insomnia, abdominal distension were 58.62%, 60.0%, 69.23%, respectively, with significant difference(p < 0.05);some patients symptoms did not disappear completely, but the VAS scores of pharyngeal discomfort, insomnia, chest tightness were also significantly lower than before(p < 0.05). After treatment, the number of teeth trace tongue and white greasy fur decreased significantly, and the number of thin white fur increased significantly(p < 0.05);As for the effect of turning negative in recurrence rate, 33 cases(80.48%) turned negative in 1 week, 6 cases(14.63%) turned negative in 2 weeks, and the total turning negative rate was 95.11%. Conclusion: Traditional Chinese medicine combined with moxibustion can not only significantly improve the clinical symptoms of recurrence patients, but also make the tongue image from abnormal to normal. At the same time, it has a positive effect on promoting nucleic acid to turn negative again, which is worthy of clinical reference.