基于倾向性评分匹配法评价金叶败毒颗粒与连花清瘟胶囊治疗新冠重症患者疗效的回顾性队列研究

Efficacy of Jinyebaidu(金叶败毒) Granule and Lianhuaqingwen(连花清瘟) Capsule in the Treatment of Severe COVID-19 Patients:A Retrospective Cohort Study Adjusted with Propensity Score Matching

目的:回顾性评价金叶败毒颗粒与连花清瘟胶囊治疗新冠重症患者的临床疗效。方法:选取2020年1月18日~2020年4月26日于华中科技大学同济医学院附属同济医院接受过金叶败毒颗粒或连花清瘟胶囊治疗≥5 d的新冠重症患者出院病历资料577例,按照治疗方法不同分为金叶败毒治疗组(159例)和连花清瘟治疗组(418例)。将以上患者按年龄、性别、基础疾病和接受治疗方式相同的标准进行1∶1匹配,采用倾向性评分匹配法平衡混杂因素,获得组间协变量均衡的样本,在此基础上比较两组患者的临床治愈率、住院时长、核酸转阴时间、胸部CT改善时间和用药前后实验室检查结果。结果:经倾向性评分匹配,两组各纳入157例重症患者,基线特征具有可比性。金叶败毒组与连花清瘟组在临床治愈率(93.63%vs 90.45%,P>0.05)、住院时长(27 d vs 32 d,P>0.05)、核酸转阴时间(24 d vs 27 d,P>0.05)和胸部CT改善时间(30 d vs 31 d,P>0.05)等方面无显著性差异。与连花清瘟相比,服用金叶败毒颗粒能显著提高重症患者的淋巴细胞水平(0.31×10^(9)/L vs 0.22×109/L,P<0.05)。结论:与连花清瘟胶囊相比,金叶败毒颗粒可能在提高新冠重症患者淋巴细胞方面具有优势。

Objective:To evaluate the efficacy of Jinyebaidu(金叶败毒) Granule(JYG)and Lianhuaqingwen(连花清瘟) Capsule(LHC)in the treatment of severe COVID-19 patients.Methods:A total of 577 severe COVID-19 patients treated in Tongji Hospital from January 18 to April 26 in 2020 were retrospectively selected,including 159 patients in the JYG group and 418 patients in the LHC group.Through propensity score matching,157 pairs of severe COVID-19 patients were identified,and the main baseline characteristics(age,sex,underlying disease,and therapy)of the patients were comparable in the two groups.A cohort study was carried out to compare the efficacy between JYG and LHC.Results:Although no significant diferences were observed in the clinical cure rate(93.63%vs 90.45%,P>0.05),the days of hospital stay(27 vs 32,P>0.05),the days to negative conversion of SARS-CoV-2 RNA assay(24 vs 27,P>0.05),or the days to improvement on chest CT(30 vs 31,P>0.05)between the two groups,a higher level of lymphocytes was observed in the JYG group than in the LHC group(0.31×10^(9)/L vs 0.22×10^(9)/L,P<0.05)after treatment.Conclusion:JYG might be superior to LHC in increasing lymphocytes in severe COVID-19 patients,which remains to be verified in the future.