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中医药研究论丛
 262.1 新冠肺炎住院患者的中医治疗先驱性研究
TJ TCM.26(2) : 1-14, 2023
DOI : 10.6516/TJTCM.202306_26(2).0001
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新冠肺炎住院患者的中医治疗先驱性研究
Traditional Chinese Medicine Treatment to
Hospitalized Patients with COVID-19:
A Pilot Study
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王明仁1 林家琳1 林舜谷1,2,3* 陈朝宗1,2,4*、廖韦程5、翁诗涵6
1 台北市立联合医院仁爱院区中医科
2 台北市立大学通识教育中心
3 国立阳明交通大学公共卫生研究所
4 国立阳明交通大学传统医药研究所
5 台北市立联合医院仁爱院区药剂科
6 台北市立联合医院教学研究部
* 林舜谷与陈朝宗为共同通讯作者
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【摘要】
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前言：随着新冠肺炎在世界范围快速传播，造成全球医疗体系的极大冲击。在2021 年5 月，台湾疫情由於多起境外移入案例与国内群聚案例突然急遽爆发，政府宣布全国进入三级警戒状态。中医也加入对抗新冠肺炎疫情的行列，积极开发相关的治疗方案。本研究的目的是探讨中医治疗对於中重症新冠肺炎住院患者的临床治疗成效。
方法：本研究为单臂式介入研究法，我们招募於台北市立联合医院住院之新冠肺炎病患，患者除西医常规治疗以外，合并宣肺平喘、清热解毒、化浊利湿为主要治疗方向的中医药物，我们评估患者的临床症状、生命徵象、生化检验数值之以及病毒检测转阴天数作为分析指标。
结果：本研究共纳入10 位中度及重度新冠肺炎住院患者。依照不同严重程度分级，重度病患在中医治疗後有71.4%（5/7）的患者C反应蛋白（C-reactiveprotein, CRP）上升，相反地，三位中度病患的CRP 值均下降。若以患者开始接受中医治疗时的呼吸速率分组，小於每分钟20 次的患者在中医治疗後有83%(5/6) 的患者CRP 下降，其中位数与四分位距由29.2±50.6 mg/L 下降到3.0±28.0 mg/L，且Wilcoxon test 检定有达到统计显着差异；相反地，对於呼吸速度大於等於每分钟20 次的患者CRP 数值均上升，中位数由4.3±24.2 mg/L 上升到62.4±60.1 mg/L。对於与凝血功能和血栓形成相关的血小板数量，呼吸频率较大的患者在中医治疗後由296.0±543.3×1000/μL下降到186.5±712.3×1000/μL；相反地，呼吸频率较低的患者则由176.5±111.3×1000/μL 上升到189.0±144.0×1000/μL。呼吸频率较高的患者部份凝血活酶时间（activated partial thromboplastin time, aPTT）在中医治疗後由24.5±15.9 秒上升到34.5±7.1 秒，而呼吸频率较低的患者在治疗前後分别为27.6±14.6 秒与27.9±8.6 秒，几乎没有改变。
结论：本研究呈现新冠肺炎中度与重度住院患者的中医治疗结果，我们发现新冠肺炎严重程度与治疗前的呼吸速度可能是影响中医治疗成效的因素。
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【关键词】新冠肺炎、中医、住院治疗、重症照护
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Ming-Jen Wang1Chia-Lin Lin2Shun-Ku Lin3Chao-Tsung Chen4
Wei-cheng Liao5Shih-Han Weng6
1Department of Traditional Chinese Medicine, Taipei City Hospital Ren-Ai Branch, Taipei,
Taiwan
2General Education Center, University of Taipei, Taipei, Taiwan
3Institute of Public Health, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
4Institute of Traditional Medicine Nationa l, Yang-Ming Chiao-Tung University, Taipei,
Taiwan
5Department of Pharmacy, Taipei City Hospital Ren-Ai Branch, Taipei, Taiwan
6Department of Education and Research, Taipei City Hospital
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【Summary】
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Background: With the pandemic of coronavirus disease rapidly spreading worldwide, it has caused a great impact on the global medical system. In May 2021, Taiwanese government announced that Taiwan had entered third-level alert state due to sudden outbreak of numerous cases of coronavirus disease 2019 (COVID-19) cases. Recent evidence implied Traditional Chinese medicine(TCM) as a potential treatment of COVID-19. Here, we conducted a pilot study to investigate the efficacy of TCM combined standard care in high-risk hospitalized patients with COVID-19.
Methods: This single arm trial, recruiting patients with COVID-19 hospitalized in Taipei City Hospital Ren Ai Branch. In addition to standard therapy, all patients were given TCM formulas according to four diagnostic methods of Chinese Medicine. The primary outcome were clinical presentations, conversion time for COVID-19 viral assay and biochemical data.
Results: Ten hospitalized patients with moderate or severe COVID-19 are enrolled in this study. According to the different severity levels of COVID-19, 71.4%(5/7) of severe patients had an increase in C-reactive protein (CRP) after TCM treatment, whereas all moderate patients had a decrease in CRP. 83% (5/6) of patients with a respiratory rate less than 20 breaths per minute had a reduction inCRP after TCM treatment, and the median and interquartile range decreased from 29.2±50.6 mg/L to 3.0±28.0 mg/L. The Wilcoxon test has reached statistical significance. Conversely, the CRP values increased for patients with respiratory rates greater than 20 breaths per minute, with a median increase from 4.3±24.2 mg/L to 62.4±60.1 mg/L. The platelet (PLT) of the patients with higher
respiratory rate decreased from 296.0±543.3×1000/μL to 186.5±712.3×1000/μL after TCM treatment; In contrast, the patients with lower respiratory rate increased from 176.5±111.3×1000/μL to 189.0±144.0×1000/μL. The activated partial thromboplastin time (aPTT) of patients with higher respiratory rate increased from 24.5±15.9 sec to 34.5±7.1 sec after TCM treatment, while the patients with lower respiratory rate were 27.6±14.6 sec and 27.9±8.6 sec before and after treatment respectively.
Conclusion: We present the results of TCM treatment of moderately and severely hospitalized patients with COVID-19. The severity of new coronary pneumonia and the respiratory rate before treatment may influence the efficacy of TCM treatment.
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【Keywords】COVID-19; traditional Chinese medicine; hospitalization; intensive
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