清肺排毒汤治疗新型冠状病毒肺炎的文献研究

Literature Review of Qingfei Paidu Decoction(清肺排毒汤)for Coronavirus Disease 2019

目的基于文献探讨清肺排毒汤治疗新型冠状病毒肺炎(简称新冠肺炎)的现状与价值。方法检索中国生物医学文献数据库(SinoMed)、中国期刊全文数据库(CNKI)、万方数据知识服务平台(万方数据库)、PubMed数据库、EmBase数据库和Cochrane数据库自2020年1月27日至2021年1月22日收录的清肺排毒汤治疗新冠肺炎的文献,从理论、基础、临床研究三个方面进行整合,探析新冠肺炎的中医病名,清肺排毒汤的组成来源、功效主治及其治疗新冠肺炎的潜在作用机制,分析清肺排毒汤临床有效性与安全性。结果共纳入文献81篇,其中理论研究28篇,基础研究22篇,临床研究31篇。在基础研究中,包括生物信息学研究15篇、其他研究4篇、成分研究3篇;在临床研究中,包括个案报道11篇、队列研究10篇、病例系列研究8篇以及随机对照与非随机对照研究各1篇。"寒湿疫"作为新冠肺炎的中医病名是学者们较为普遍的认识。清肺排毒汤主要来源于射干麻黄汤、小柴胡汤、五苓散、麻杏石甘汤四首古代经典名方,具有散寒祛湿、理肺排毒的功效。其可能通过槲皮素、木犀草素、山柰酚等主要成分,作用于白细胞介素、丝裂原活化蛋白激酶、肿瘤坏死因子等关键分子,通过影响Toll样受体通路、肿瘤坏死因子信号通路、白细胞介素信号通路等途径,进而发挥免疫调节、抗感染、抑制炎症风暴等作用,在临床中显示出良好的治疗效果和较好的安全性。结论清肺排毒汤是治疗新冠肺炎的有效方,具有重要的临床价值。进一步开展清肺排毒汤的深入研究有利于加快其成果转化,在抗击新冠肺炎疫情中发挥越来越重要的作用。

Objective To explore the current status and value of Qingfei Paidu Decoction(清肺排毒汤,QPD)for coronavirus disease 2019(COVID-19)through literature review.Methods Electronic databases including SinoMed,CNKI,Wanfang,PubMed,Embase and Cochrane database were searched for literature on QPD for the treatment of COVID-19 published from January 27th,2020 to January 22nd,2021.The literature were grouped into the theoretical,laboratory and clinical studies,and were analyzed to explore the corresponding traditional Chinese medicine(TCM)terms to COVID-19,the formula sources,actions,indications and possible mechanism of QPD for COVID-19,as well as the clinical effectiveness and safety of QPD.Results A total of 81 papers were included,involving 28 theoretical articles,22 laboratory researches and 31 clinical studies.The laboratory researches were conducted to explore bioinformatics(15 papers),other purposes(4 papers)and formula compositions(3 papers).The clinical studies included 11 case reports,10 cohort studies,eight case series,one non-randomized controlled trial and one RCT."Cold-damp epidemic"is commonly accepted as the TCM term corresponding to COVID-19.QPD is prescribed based on four classical formulas including Shegan Mahuang Decoction(射干麻黄汤),Xiaochaihu Decoction(小柴胡汤),Wuling Powder(五苓散),Maxin Shigan Decoction(麻杏石甘汤),and has the function of dissipating cold and dispelling dampness,rectifying the lung and expelling toxins.The quercetin,luteolin,kaempferol and other major components of QPD may work to regulate immune function,play anti-infection and suppress the inflammatory storms through Toll-like receptor pathway,tumor necrosis factor signaling pathway,interleukin signaling pathway and others by acting on key molecules such as interleukin,mitogen-activated protein kinase and tumor necrosis factor,showing good clinical effectiveness and safety.Conclusion QPD is effective for the treatment of COVID-19 and has great value in clinical practice.Further in-depth researches on QPD will help accelerate its transformation and play an increasingly important role in the fight against the COVID-19 epidemic.