Objective: To explore on the association between nucleic acid turning-negative-time and traditional Chinese medicine (TCM) symptoms in coronavirus disease 2019 (COVID-19) patients with the Omicron variant.Method: For this retrospective cross-sectional study, we enrolled 189 patients with COVID-19 (age 20-90 years) were included. multiple linear regression models were used to investigate the TCM symptoms affecting the nucleic acid turning-negative-time of COVID-19 patients, during the process of data analysis, taking with nucleic acid turning-negative-time as the dependent variable, and TCM symptoms as independent variables, and at the same time, sex, age, hypertension, diabetes, and coronary heart disease were as confounding variables.Results: The study found that the most common TCM symptoms of COVID-19 patients with Omicron were cough, dry throat, expectoration, fever, sore throat, pharyngeal itching, running nose, and nasal congestion. Regression analysis showed that the fit regressive equation showed a significant difference (F = 4.286, P < 0.001), R = 0.400, the adjusted R 2 = 0.123, and three variables in the regression equation showed significant difference (P < 0. 05). The results showed that nucleic acid turning-negative-time was mostly related to constipation, fever, and expectoration. If the patients had the symptoms of constipation, fever, and expectoration; that is, if patients showed these symptoms, the turning-negative-time of nucleic acid in patients with Omicron will be prolonged.Conclusions: Treatment based on symptoms for patients with constipation, fever, and expectoration may have important clinical significance for the COVID-19 patients with Omicron.

在天津市本土奥密克戎新型冠状病毒肺炎疫情中,通过组建中医会诊专家团队、采取一线与远程有机结合的会诊模式,充分发挥中西协同的治疗优势,在加快患者病情缓解,减少住院时间等方面起到关键作用.文章对该救治模式进行梳理,为应对今后的疫情防治提供借鉴与参考.

[目的]探讨天津地区中西医结合治疗新型冠状病毒奥密克戎变种感染患者核酸转阴时间的影响因素.[方法]筛选新型冠状病毒奥密克戎变种感染患者的电子病历,提取住院号、性别、年龄、疫苗接种信息、既往慢性病情况、临床分型、合并前期症状、发病日期、入院日期、中医首次会诊日期、中医首诊辨证用药信息、核酸转阴日期等资料,采用回顾性分析方法,以患者核酸检测转阴时间作为结局观察指标,并以其平均值分组,比较组间临床特征指标差异,采用多元性线性回归分析评价结局的影响因素.[结果]筛选病历398例,剔除219例,纳入研究179例,分组后组间在合并慢性疾病、合并前期症状、入院时间差、中西医结合干预时间、中医证型分类等5项指标比较上差异具有统计学意义(P<0.05);多元线性回归分析显示合并慢性疾病、中西医结合干预时间、中医证型分类等3项与患者核酸转阴时间呈正相关(P<0.05).[结论]合并慢性疾病、较晚中西医结合干预及中医辨证分类为兼杂证会延长新型冠状病毒奥密克戎变种感染患者核酸转阴时间.

[目的]分析天津市新型冠状病毒肺炎(奥密克戎)成人普通型患者一般情况及中医临床特征.[方法]选取2022年1月27日—2月5日于天津海河医院中医病区收治的本土新型冠状病毒肺炎(奥密克戎)成人普通型患者32例,入院后采集流行病学资料及血常规、C反应蛋白、白细胞介素-6(IL-6)、降钙素原、首发症状、舌象等信息并进行辨证.[结果]研究共纳入32例新型冠状病毒肺炎(奥密克戎)成人普通型患者,包括男13例,女19例,年龄21～71岁,平均年龄(49.34±15.00)岁,其中9例(28.13％)存在基础疾病.流行病学调查发现发热门诊筛查病例1例(3.12％),新型冠状病毒肺炎患者密切接触史12例(37.5％),家庭聚集性发病19例(59.38％).7例患者(21.87％)白细胞计数、淋巴细胞计数、C反应蛋白和IL-6正常;17例患者(53.12％)出现淋巴细胞计数下降,6例患者(18.75％)淋巴细胞合并白细胞计数减少.首发症状:1例患者(3.13％)无症状,31例患者(96.87％)首发症状为咽干,23例患者(71.88％)有咳嗽症状,9例患者出现发热,1例患者(3.13％)伴味觉、嗅觉减退.舌象:淡红舌25例(78.12％)、红舌7例(28.88％),2例患者(6.25％)舌体胖大有齿痕;黄苔21例(65.63％),其中薄黄苔9例(28.13％)、黄腻苔12例(37.5％);白苔10例(31.25％),其中薄白苔6例(18.75％)、白腻苔4例(12.5％);中医证型:湿邪困表证3例(9.37％),瘟热犯卫证24例(75％),热毒袭肺证3例(9.37％),湿蕴脾胃证2例(6.25％).[结论]经过研究分析32例新型冠状病毒肺炎(奥密克戎)成人普通型患者中医临床特点,认为温热蕴结,肺气不宣为主要病机,治疗宜以宣肺化湿、清热透邪为主.

[目的]分析截止2020年3月15日国内发表的中西医结合治疗新型冠状病毒肺炎(COVID-19)的病例报告质量,为提高国际突发公共卫生事件的病案报告质量提供依据,并为今后的临床实践和研究提供方法学参考.[方法]通过检索知网、万方数据库自2020年1月1日—3月15日所发表的相关文献,筛选出相关病例报告,根据中医药病案报告规范(CARC)工作组制定的《中医药病案报告发表规范专家共识》对纳入文献进行质量评价,计算含每条项目的论文报告比例.[结果]共纳入16篇病例报告,涉及病案30则,纳入病例报告的摘要及关键词、研究背景、患者一般情况、四诊收集、诊断及治疗等内容汇报较为完整,但中医病例报告仍存在缺陷,部分报告项目缺乏,大约56.3％的病例报告标题含有"病案"字样及报告病案的例数,研究背景中仅有18.8％的病例报告涉及知情同意方面的内容,而病例报告的诊断大都缺乏明确的诊断依据,在中药汤剂治疗中,62.5％的处方没有准确记录汤剂的用法用量,对中药饮片的产地及质量控制的相关记录更是凤毛麟角,涉及中成药治疗的4则病案也缺乏药品质量控制的标准,讨论部分约43.8％的文章对选方依据进行了阐述,仅有37.5％的文章阐明方解.[结论]COVID-19中西医结合治疗的相关病例报告整体质量有待进一步提高,以有利于COVID-19的中西医结合治疗从经验向循证实践发展,并为COVID-19诊治的相关高级别临床研究提供更佳参考和依据.

目的:临床评价复方芩兰口服液治疗急性上呼吸道感染外感风热证的有效性和安全性.方法:采用随机、双盲、阳性药对照、多中心临床研究的方法.共入组464例受试者,随机入选试验组348例,对照组116例,分别口服复方芩兰口服液和双黄连口服液,疗程3d.结果:试验组和对照组疾病综合疗效愈显率分别为83.14％和73.04％(FAS分析),中医证候疗效愈显率分别为84.59％和70.43％(FAS分析),试验组均显著高于对照组(P＜0.05);试验期间,试验组和对照组均无不良事件发生.结论:复方芩兰口服液治疗感冒(急性上呼吸道感染)外感风热证的整体疗效较好,优于双黄连口服液,且具有较好的安全性.

Traditional Chinese medicine is a unique traditional medicine in China. The development of emergency treatment of traditional Chinese medicine has a long history and in the treatment of emergency and severe cases predecessors has a wealth of theory and clinical experience, and has the unique in some acute treatment and good clinical effect, in contemporary society. The importance is given to the emergency and development of traditional Chinese medicine, and also is facing opportunities and challenges. But also has its own problems and shortcomings, and its development prospect is objective is still has development potential.

目的探讨参附注射液治疗心源性休克疗效。方法 36例心源性休克患者随机分为两组:参附注射液治疗组18例和常规药物对照组18例。对照组采用内科常规治疗;治疗组在对照组内科常规治疗的基础上加用参附注射液治疗。分别观察两组治疗前及治疗后1h、2h、6h后心率、血压变化情况;观察两组治疗前及治疗后一周心率、血压、左心室射血分数变化情况以及两组患者临床症状缓解情况。结果参附注射液治疗组与常规药物对照组比较,在升血压、提高左心室射血分数及缓解临床症状方面具有显著性意义(P<0.05);治疗组与对照组在减慢心率方面差异不明显(P>0.05)。结论参附注射液治疗心源性休克升压作用缓和、持久;能够加速病人休克症状的缓解并提高病人近期心功能;临床应用安全、有效。