Application regularity of medicinal and dietary substances for patients during COVID-19 rehabilitation

药食两用物质在新型冠状病毒肺炎康复期的应用规律

Objective This study focused on the application regularity of medicinal and dietary sub-stances(MDS)of traditional Chinese medicine(TCM)diet therapy during rehabilitation,in order to help patients with Corona Virus Disease 2019(COVID-19)reduce sequelae and improve their life quality.Methods The official websites of the national and provincial health committees,the website of the National Administration of Traditional Chinese Medicine,the China BioMedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP),and Wanfang Database were used to search the keywords,such as“coronavirus”“novel coronavirus pneumonia”“COVID-19”“protocol”“guideline”“consensus”and“rehabilitation period”.The search time was from the establishment of databases to July 31,2022.The prevention and control protocols of various provinces and cities were manually supplemented and screened out.The information on the frequency,property,flavor,meridian tropism,and efficacy of MDS was collected for association rule analysis through the Apriori algorithm.Hierarchical cluster analysis was performed using the Euclidean distance and longest distance.Results A total of 18 protocols were screened out,including 56 lists of TCM diet therapy,and 47 kinds of MDS with a frequency of 132 times during the rehabilitation of COVID-19.Among them,six lists of diet therapy were collected from national websites,26 from local government websites,and 24 from social and academic institution websites.The intended population can be divided into seven categories including normal recovery,lung-spleen Qi deficiency,deficiency of both Qi and Yin,spleen-stomach weakness,deficiency of Yang Qi,kidney Qi deficiency,and blood deficiency.Shanyao(Dioscoreae Rhizoma)and Lianzi(Nelumbinis Semen),followed by Dazao(Jujubae Fructus)were used most commonly in MDS,with mainly flat property,sweet flavor,and spleen and lung meridians in meridian tropism.Besides,deficiency-tonifying drugs were commonly used in MDS.Through association rule analysis,12 groups of association MDS pairs were obtained.The pair of Yiyiren(Coicis Semen)and Chenpi(Citri Reticulatae Pericarpium)had the highest Lift value,and Yiyiren(Coicis Semen)was used most frequently in the MDS category for eliminating pathogenic factors.The results of complex network analysis showed that the core MDS were Yiyiren(Coicis Semen),Shanyao(Dioscoreae Rhizoma),Huangqi(Astragali Radix),Fuling(Poria),and Dazao(Jujubae Fructus).Three core categories were classified by cluster analysis,including the category of strengthening spleen,nourishing kidney,and grasping Qi,the category of removing phlegm,abating panting,and regulating Qi,and the category of strengthening the middle-energizer and reinforcing Qi.Conclusion Based on the TCM theory,most patients during the rehabilitation of COVID-19 are in a state of lingering pathogens due to deficient vital Qi.TCM diet therapy is based on the principle of“giving both reinforcing and reducing treatment”,and the MDS combinations focus on both reinforcing the health Qi and eliminating pathogenic factors.The diet therapy mainly uses the MDS with flat property and sweet flavor,which belongs to deficiency-tonifying drugs,adding suitable MDS of pathogen-eliminating drugs according to different situations.The ultimate goal is to promote lung inflammation absorption,improve pulmonary fibrosis,increase immunity,reduce the occurrence of sequelae,and improve life quality.

目的探析中医食疗药食两用物质在新型冠状病毒肺炎康复期的应用规律,帮助患者减少后遗症的发生,提高生活质量。方法计算机检索国家及各省市卫生健康委员会官网、中医药管理局官网、中国生物医学文献数据库、中国知网、维普和万方数据库,以“冠状病毒”“新冠肺炎”“COVID-19”“方案”“指南”“共识”“康复期”等关键词为检索词,检索时间自建库至2022年7月31日,手工补充检索各省市防控方案,筛选出包含康复期食疗方的信息。对所有药食两用物质的推荐频次、性味归经、功效进行统计,运用Apriori算法对药食两用物质进行关联规则分析,采用欧氏距离和最长距离法对高频药食两用物质进行系统聚类分析。结果筛选出18个方案,共推荐56条新型冠状病毒肺炎康复期食疗信息,47种药食两用物质,累计推荐频次132次。其中食疗信息包括国家级6条,地方政府级26条,社会学术机构级24条;适用人群分为7类:正常恢复人群、肺脾气虚人群、气阴两虚人群、脾胃虚弱人群、阳虚人群、肾气亏虚人群、血虚失养人群;推荐频次前3的物质分别为山药、莲子、大枣;性味以平、甘为主;归经以脾、肺经为主;功效分类以补虚药为主;物质关联分析显示药物组合共12对,薏苡仁-陈皮为提升度最高的组合,薏苡仁是药对中出现频次最多的祛邪类物质。复杂网络可视化分析显示核心药物为:薏苡仁、山药、黄芪、茯苓、大枣;聚类分析筛选出高频药食两用物质组合3类,依次为健脾益肾纳气类、化痰平喘理气类和补中益气类。结论中医认为新型冠状病毒肺炎康复期患者出院后多处于正虚邪恋状态,中医食疗以“补泻兼施”为基本原则,食疗配伍主张扶正祛邪并用,使用性平味甘为主的补虚类药食两用物质,根据不同情况配伍适宜的祛邪类物质,最终达到促进肺部炎症吸收、改善肺纤维化、提高免疫力、减少后遗症发生及提高生活质量的目的。