目的 观察补肺活血胶囊治疗轻中型新型冠状病毒肺炎的临床疗效。方法 选取2022年12月-2023年4月河南省中医院收治的160例轻中型新型冠状病毒肺炎患者,按照随机数字表法将纳入病例随机分为对照组(80例)和治疗组(80例)。对照组患者给予常规药物治疗。治疗组患者在对照组治疗基础上口服补肺活血胶囊,4粒/次,3次/d。两组患者连续治疗2周。观察两组的临床疗效、胸部CT影像学改善情况、核酸转阴时间、症状持续时间、住院天数,比较两组治疗前后炎症指标、凝血功能指标、肺炎严重程度(PSI)评分、CURB-65评分、临床肺部感染(CPIS)评分的变化情况。结果 治疗后,治疗组的总有效率为83.75%,显著高于对照组的43.75%(P<0.05)。治疗组胸部CT改善情况与对照组比较差异无统计学意义。与对照组比较,治疗组患者核酸转阴时间、症状持续时间、住院天数均显著降低(P<0.05)。治疗后,两组患者C反应蛋白(CRP)水平均降低,而白细胞(WBC)、中性粒细胞比例(NEUT%)、淋巴细胞百分比(LYMPH%)水平均升高(P<0.05);治疗后,治疗组CRP水平低于对照组,WBC、NEUT%、LYMPH%水平高于对照组(P<0.05)。治疗后,两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体均下降,而凝血酶时间(TT)水平则增加(P<0.05);治疗后,治疗组关于凝血功能指标的调控效果更显著(P<0.05)。治疗后,两组PSI评分、CURB-65评分及CPIS评分较治疗前均显著下降(P<0.05);治疗后,治疗组PSI评分、CURB-65评分及CPIS评分低于对照组(P<0.05)。结论 补肺活血胶囊治疗新型冠状病毒肺炎临床疗效良好,可以抑制炎症反应,纠正血液高凝状态,从而缩短核酸转阴时间和住院天数,缓解患者临床症状,且安全性较高。

Objective To observe the efficacy of Bufei Huoxue Capsules in treatment of mild and moderate novel coronavirus pneumonia. Methods A total of 160 patients with mild and moderate novel coronavirus pneumonia admitted to Henan Provincial Hospital of Traditional Chinese Medicine from December 2022 to April 2023 were selected and randomly divided into control group (80 cases) and treatment group (80 cases) according to random number table method. Patients in the control group were given conventional drug treatment. Patients in the treatment group were po administered with Bufei Huoxue Capsules on the basis of control group, 4 capsules/time, 3 times daily. Both groups were treated continuously for 2 weeks. The clinical efficacy, chest CT imaging improvement, nucleic acid negative time, symptom duration and hospital stay of two groups were observed, and the changes of inflammation index, coagulation function index, pneumonia severity (PSI) score, CURB-65 score and clinical pulmonary infection (CPIS) score before and after treatment were compared between the two groups. Results After treatment, the total effective rate of treatment group was 83.75%, which was significantly higher than that of control group (43.75%, P < 0.05). There was no significant difference in the improvement of chest CT between treatment group and control group. Compared with the control group, the time of nucleic acid turning negative, symptom duration and hospitalization days in treatment group were significantly reduced (P < 0.05). After treatment, C-reactive protein (CRP) levels were decreased in both groups, but leukocyte (WBC), neutrophil percentage (NEUT%) and lymphocyte percentage (LYMPH%) levels were increased in both groups (P < 0.05). After treatment, CRP levels in treatment group were lower than those in control group, WBC, NEUT% and LYMPH% levels were higher than those in control group (P < 0.05). After treatment, the prothrombin time (PT), activated partial thromboplastin time (APTT) and D-dimer were all decreased, but the thrombin time (TT) level was increased in both groups (P < 0.05). After treatment, the regulation effect of coagulation function index in treatment group was increased significantly (P < 0.05). After treatment, PSI score, CURB-65 score and CPIS score in both groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the PSI score, CURB-65 score and CPIS score of treatment group were lower than those of control group (P < 0.05). Conclusion Bufei Huoxue Capsules has good clinical efficacy in treatment of novel coronavirus pneumonia, and can inhibit inflammation, correct blood hypercoagulability, shorten the negative nucleic acid time and hospitalization days, which can relieve clinical symptoms of patients with high safety.

R974

河南省中医药科学研究专项课题（2023ZY3008）