| 赵倩倩,吕秀洁,吕涵筱,等.银翘辟瘟散治疗轻型新型冠状病毒感染的单中心回顾性队列研究[J].浙江中医药大学学报,2024,48(12):1517-1524. |
| 银翘辟瘟散治疗轻型新型冠状病毒感染的单中心回顾性队列研究 |
| A Single-Center Retrospective Cohort Study of Yinqiao Piwen Powder for the Treatment of Patients with Mild Corona Virus Disease 2019 |
| DOI：10.16466/j.issn1005-5509.2024.12.006 |
| 中文关键词: 轻型新型冠状病毒感染 银翘辟瘟散 单中心回顾性队列研究 辨证治疗 中西医结合 中医证候 防治疫病 循证医学 |
| 英文关键词: mild COVID-19 infection Yinqiao Piwen Powder single-center retrospective cohort study treatment based on syndromes differentiation combination of TCM and western medicine TCM syndromes prevent and cure blight evidence-based medicine |
| 基金项目:国家中医药管理局新型冠状病毒感染中医药应急专项(2023ZYLCYJ02-8)；浙江省名老中医专家传承工作室建设项目(GZS2020027) |
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| 中文摘要: |
| [目的] 评价经验方银翘辟瘟散对轻型新型冠状病毒感染患者治疗的有效性。[方法] 采用单中心回顾性队列研究方法，选取2022年12月18日至12月23日的595例轻型新型冠状病毒感染患者，根据患者用药情况的不同分为西医组、中医组和中西医结合组，三组分别为153例、144例、298例。西医组参照《新型冠状病毒感染诊疗方案(试行第十版)》接受西医常规治疗，中医组接受银翘辟瘟散治疗，中西医结合组在西医组的基础上接受银翘辟瘟散治疗。随访14 d，对患者进行疗效评估，收集患者一般资料、临床症状、症状缓解时间等，评价患者中医证候积分，并分析各组患者症状分布、疗效分布情况。[结果] 轻型新型冠状病毒感染患者最常见的症状为发热、咳嗽、咳痰、乏力、身体疼痛、咽痛和鼻塞流涕等。疗效分布上，中西医结合组的显效率显著优于西医组(χ2=14.022， P<0.001)，治疗后三组患者中医证候积分均显著降低(P<0.001)，其中中西医结合组的中位中医证候疗效指数为100.00(93.21，100.00)，高于中医组[100.00(92.15，100.00)]及西医组[100.00(78.95，100.00)]，三组间的差异具有统计学意义(P<0.05)。三组治疗前后中医证候积分差值差异具有统计学意义(P<0.05)，在这三组之中，中西医组的症状改善显著。另外，经年龄和治疗前中医证候积分矫正后，三组治疗后中医证候积分仍存在差异，且差异具有统计学意义(P<0.05)。三组在咽痛、咳嗽、咳痰、乏力症状的缓解时间差异具有统计学意义(P<0.05)。[结论] 对比于单纯西药治疗，中医辨证治疗和中西医结合治疗在提高临床疗效，降低中医证候积分，缩短咽痛、咳嗽、咳痰等症状缓解时间方面存在优势。该研究结果能为中医药防治疫病效益方面提供循证医学证据。 |
| 英文摘要: |
| [Objective] To evaluate the effectiveness of Yinqiao Piwen Powder， an empirical formula， in the treatment of mild cases of corona virus disease 2019(COVID-19) infection. [Methods] A single-center retrospective cohort study was adopted. A total of 595 patients with mild COVID-19 infection who attended Zhejiang Provincial Hospital of Traditional Chinese Medicine from December 18 to 23，2022 were included in this study and then divided into western medicine group (WM)， traditional Chinese medicine group (TCM) and integrated Chinese and western medicine group (TCM-WM) based on their medication， with 153 cases，144 cases and 298 cases in each respectively. The WM group received routine treatment of western medicine according to the Diagnosis and Treatment Protocol for COVID-19 Patients (Tentative 10th Edition)， the TCM group received Yinqiao Piwen powder treatment， and the TCM-WM group received Yinqiao Piwen Powder treatment on the basis of the treatment of the WM group. After 14 days， the therapeutic effect of patients was evaluated. Specifically， the baseline characteristics， clinical symptoms and symptom relief time of the patients were collected， the TCM symptom scores were estimated， and the distribution of symptoms and efficacy distribution after treatment in each group were analyzed. [Results] The most common symptoms in patients with mild COVID-19 infection were fever， cough， sputum， fatigue， body aches， sore throat， nasal congestion and runny nose. On the efficacy distribution， the markedly effective rate of the TCM-WM group was significantly higher than that of the WM group， which were both significantly different(χ2=14.022， P<0.001) After?treatment， the?total?TCM symptom scores?of?all three groups were?significantly?decreased compared?with?pre-treatment，?indicating a great relief in the?clinical?symptoms?in?all?groups，?with a statistically significant difference (P<0.001). Additionally， the median number of the rate of reduction of TCM symptom scores in the TCM-WM group was 100.00(93.21，100.00)， higher than the TCM group [100.00(92.15，100.00)]and the WM group [100.00(78.95，100.00)]， and showed statistical difference (P<0.05). The differences of TCM symptom scores of three groups between the pre-treatment and post-treatment were significant (P<0.05)， and the TCM-WM group changed the most in the scores. Besides， after correction for age and pre-treatment symptom scores， the differences in post-treatment TCM symptom scores among the three groups were still statistically significant ( P<0.05). Moreover， the differences among the three groups in the symptom relief time of sore throat， cough， sputum and fatigue were statistically significant(P<0.05). [Conclusion] Compared with the western medicine treatment alone， the other two treatments achieved better clinical results in improving the efficacy， reducing the TCM symptom scores and shortening the symptom relief time. The results of our study can provide evidence-based medical proof for the benefits of TCM in the prevention and treatment of epidemics. |
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