化湿解毒方治疗新型冠状病毒肺炎湿热郁肺证的临床研究

宋欠红 柳尧 朱虹江 叶勇 雷春燕 赵淳

摘要：目的觀察化湿解毒方治疗新型冠状病毒肺炎湿热郁肺证患者的临床疗效及对相关炎症指标表达影响和CT影像学改变。方法收集确诊轻型及普通型新型冠状病毒肺炎湿热郁肺证患者63例，分为治疗组44例，对照组19例，对照组口服阿比多尔、洛匹那韦/利托那韦，干扰素雾化，治疗组在对照组基础上口服化湿解毒方。于治疗前、后进行中医证候评分及外周血的白细胞计数（WBC），淋巴细胞比值（LYM%），中性粒细胞比值（NEU%），降钙素原（PCT），C反应蛋白（CRP），D-二聚体（D-Dimer）表达，肺部CT 渗出吸收率等比较。结果治疗10d后，治疗组患者中医证候积分明显减轻，总有效率高于对照组（P<0.05）;2组患者CRP、PCT、D-二聚体水平与治疗前比较均有显著下降（P<0.05）;治疗后治疗组与对照组比较，CRP 和 PCT 表达有显著差异（P<0.05），D-二聚体表达差异无统计学意义（P>0.05）;胸部CT渗出吸收率比较，差异有统计学差异（P<0.05）。结论早期及时使用化湿解毒方可以减轻新型冠状病毒肺炎湿热郁肺证患者的症状，调控相关炎症指标的表达，促进肺部渗出的吸收，有较好的临床疗效。

关键词：化湿解毒方;新型冠状病毒肺炎;湿热郁肺

中图分类号：R563.1文献标志码：B文章编号：1007-2349（2021）02-0023-05

Clinical Study on Huashijiedu Decoction in Treating Patientswith Damp-heat

Stagnation Lung Syndrome  of New Coronavirus Pneumonia

SONG Qian-hong1， LIU Yao1， ZHU Hong-jiang1， YE Yong1， LEI Chun-yan2， ZHAO Chun1

（1. The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine， Kunming 650021， China;

2. Xi'an Qizhi School， Xi'an， 710061， China）

【Abstract】Objective： To observe the clinical effect of Huashijiedu Decoction in the treatment of patients with damp-heat stagnation of lung syndrome of new coronavirus pneumonia and its influence on the expression of related inflammation indicators and CT imaging changes. Methods： 63 patients with diagnosed mild and common new coronavirus pneumonia with damp-heat stagnation syndrome were collected and divided into a treatment group with 44 cases and a control group with 19 cases. The control group was given oral abidol， lopinavir/ritonavir with interferon nebulization and the treatment group was added with oral Huashijiedu Decoction on the basis of the control group. The TCM syndrome score and peripheral blood white blood cell count （WBC）， lymphocyte ratio （LYM%）， neutrophil ratio （NEU%）， procalcitonin （PCT）， C-reactive protein （CRP）， D-Dimer （D-Dimer） expression， lung CT exudation and absorption rate were compared before and after treatment. Results： After 10-day treatment， the TCM syndrome scores of the patients in the treatment group were significantly reduced， and the total effective rate was higher than that in the control group （P<0.05）. The levels of CRP， PCT， and D-dimer in the two groups were significantly decreased when compared with those before treatment （P<0.05）. After treatment， the expression of CRP and PCT was significantly different between the treatment group and the control group （P<0.05）. There was no significant difference in the expression of D-dimer （P>0.05） and the comparison of chest CT exudation and absorption rate showed the difference was statistically significant （P<0.05）. Conclusion： The early and timely use of Huashijiedu Decoction can reduce the symptoms of patients with the damp-heat stagnation syndrome of new coronavirus pneumonia， regulate the expression of related inflammatory indicators， and promote the absorption of pulmonary exudate， which has a good clinical effect.

【Key words】Huashijiedu Decoction;New Coronavirus Pneumonia;Damp-heat stagnation lung

2019年12月以来，湖北省武汉市及周边城市陆续发现冠状病毒[corona virus disease 2019（Covid-2019）]肺炎患者。笔者作为援鄂医疗队队员于1月27日赴湖北省咸宁市参加新冠肺炎的防治工作。截止2020年3月20日，共诊治确诊患者176例（轻型35例、普通型109例、重症21例、危重症11例）。其中，中医辨证为湿热郁肺证新冠肺炎患者63例，使用化湿解毒方疗组44例，对照组19例。取得较好疗效，现报道如下。

1资料与方法

1.1一般资料收集2020年1月27日—2020年3月23日湖北通城县人民医院及咸安区人民医院隔离病区收治的确诊为轻型及普通型新冠肺炎患者，共63例。治疗组44例，对照组19例;男35例，女28 例;年龄19～75 岁，平均（48.26±9.15）岁;轻型患者18 例，普通型患者45例;发病时间（4.15±0.75）d;既往患高血压18 例，冠心病21例，糖尿病13例。……