重庆市长寿区中医药防治新型冠状病毒感染康复患者复阳的效果评价

Effect evaluation of traditional Chinese medicine in preventing and treating secondary infection of patients with COVID-19 infection in Changshou district of Chongqing

目的通过分析中药预防汤剂、治疗汤剂和康复汤剂对新型冠状病毒感染康复患者复阳的治疗效果,总结长寿区中医药防治新型冠状病毒感染的经验,为建立中医药防治新型冠状病毒感染长效机制提供实践依据。方法通过问卷调查的形式分析对长寿区2023年6月采用中医药汤剂防治新型冠状病毒感染康复后复阳患者的效果进行问卷调查,共发放调查问卷25000份。本研究统计长寿区复阳率,并比较不同性别、年龄、职业患者复阳率,比较不同新型冠状病毒疫苗接种情况患者复阳率,比较复阳患者中药预防汤剂、治疗汤剂、康复汤剂服用情况和症状改善情况。结果收回有效问卷23489份。调查结果显示,长寿区新型冠状病毒感染康复后复阳患者为17381例,复阳率为74.00%。女性复阳率(78.10%)大于男性(69.41%),差异有统计学意义(P<0.05);不同年龄段患者复阳率比较,差异有统计学意义(P<0.05),且20~35岁患者复阳率最高(80.35%),其次为>35~50岁患者(75.73%),而<20岁患者复阳率最低(51.21%)。不同职业患者复阳率比较,差异有统计学意义(P<0.05),且医务人员复阳率最高(87.41%),其次为公安人员(86.19%)。参与问卷调查的患者中,22073例完成了新型冠状病毒疫苗全程接种,其中11564例完成了一剂次加强免疫,2826例完成了二次加强免疫;全程接种、部分接种及未接种疫苗患者的复阳率比较,差异有统计学意义(P<0.05)。复阳患者症状持续时间均值为10.97 d;大多数复阳患者的症状为发热(73.94%),其次为咳嗽、咳痰(67.41%)和乏力(65.66%)。复阳患者中,服用中药预防汤剂≥3 d、治疗汤剂≥3 d和康复汤剂≥3 d分别占63.06%、46.46%和45.39%。服用治疗汤剂≥3 d患者的体力差、疲惫感持续时间均值(11.70 d)均短于未服用治疗汤剂患者(13.07 d),差异有统计学意义(P=0.01)。服用康复汤剂≥3 d患者中,4234例自觉体力差、疲惫感症状有所缓解,占53.66%。结论针对新型冠状病毒感染康复后复阳患者需要加强对复阳的监测和评估,及时调整和改进预防措施;同时要加大中医药防治复阳的宣传力度,鼓励公众积极参与中医药防治工作。

Objective To analyze the therapeutic effects of traditional Chinese medicine(TCM)preventive decoction,therapeutic decoction and rehabilitation decoction on secondary infection of patients with COVID-19 infection,to summarize the experience of preventing and treating COVID-19 infection by traditional Chinese medicine in Changshou District,and to provide a practical basis for the establishment of a long-lasting mechanism for preventing and treating COVID-19 infection by traditional Chinese medicine.Methods The effect of TCM decoction in preventing and treating secondary infection of patients COVID-19 infection in June 2023 in Changshou District was analyzed by questionnaire survey,and 25000 questionnaires were distributed.The secondary infection rate of COVID-19 in Changshou District was calculated,and the secondary infection rate of patients with different clinical characteristics,COVID-19 vaccination,and the consumption and symptom improvement after taking TCM preventive decoction,therapeutic decoction and rehabilitation decoction were compared.Results To tally 23489 valid guestionnaires were retrieved.The results of this study showed that the number of patients with secondary infection after COVID-19 infection in Changshou District was 17381,with a secondary infection rate of 74.00%.The secondary infection rate of the female(78.10%)was greater than that of the male(69.41%)with statistically significant difference(P<0.05);the secondary infection rate after COVID-19 infection among patients with different age had statistically significant difference(P<0.05),and the secondary infection rate of patients aged 20-35 years old was the highest(80.35%),followed by people aged>35-50 years old(75.73%),and the secondary infection rate of patients aged<20 years old was the lowest(51.21%).There was a statistically significant difference in the secondary infection rate after COVID-19 infection among patients with different occupations(P<0.05),and the highest secondary infection rate was found in medical personnel(87.41%),followed by public security personnel(86.19%).Among the secondary infection patients in this study,22073 cases completed the full vaccination of COVID-19,including 11564 cases completed a dose of booster immunization and 2826 cases completed a second booster immunization;the difference in secondary infection rate after COVID-19 among patients who were fully,partially and unvaccinated was statistically significant(P<0.05);the average duration of secondary infection symptoms was 10.97 d;the majority of the patients had symptoms such as fever(73.94%),followed by cough and sputum(67.41%)and malaise(65.66%).Among the secondary infection patients,the patients proportions took TCM preventive decoction≥3 d,therapeutic decoction≥3 d and rehabilitation decoction≥3 d were 63.06%,46.46% and 45.39% respectively.The mean duration of poor physical strength and fatigue in patients taking therapeutic decoction≥3 d(11.70 d)was shorter than that in patients without taking therapeutic decoction(13.07 d),and the difference was statistically significant(P=0.01).Among the patients who took the rehabilitation decoction≥3 d,4234 cases realized that the symptoms of poor physical strength and fatigue had been relieved,accounting for 53.66%.Conclusion For patients with secondary infection after COVID-19 infection,it is necessary to strengthen the monitoring and assessment of secondary infection,adjust and improve the preventive measures in time;at the same time,it is necessary to increase the propagandizing for prevention of secondary infection by TCM,and encourage the public to actively participate in the preventive work of TCM.