中医药(Traditional Chinese medicines)在这次控制和治疗新冠肺炎疫情中发挥了很好的作用。经过筛选研究,金花清感颗粒、莲花清瘟胶囊/颗粒、血必净注射液、清肺排毒汤、化湿败毒方、宣肺败毒方,这“三药三方”证实有效。
图源:新华社
这些方剂具体有什么功效?适合什么人群?下面我们来为大家一一介绍一下。
金花清感颗粒
Jinhua Qinggan Granule
金花清感颗粒,是2009年甲型H1N1流感大流行期间研发的一个中成药,由金银花、薄荷、甘草等12味药组成,主要功效是疏风宣肺、清热解毒,在治疗轻症、普通型患者中具有确切疗效,可缩短退热时间,淋巴细胞、白细胞复常率提高,转重症率明显下降。
Jinhua Qinggan Granule was developed during the 2009 H1N1 influenza pandemic. It consists of 12 herbal components including honeysuckle, mint and licorice and can clear heat and detoxify lungs.
It has a curative effect in treating mild and moderate patients and can also improve the recovery rate of lymphocyte and white blood cells as well as reduce the rate of patients turning more severe.
武汉市第六医院中医部 中国日报记者王敬 摄
中央指导组专家组成员、中国工程院院士、天津中医药大学校长张伯礼介绍,已经开展的两项目研究均发现金花清感效果不错。二月初,经过对武汉102例轻型和普通型新冠肺炎患者的治疗发现,病人的转重率明显下降,仅为11.8%。病人的退热时间仅为1.5天。
In early February, 102 mild patients in Wuhan took Jinhua Qinggan Granule in their treatment. Only 11.8 percent worsened and it took only one and a half days for patients to reduce fever.
解放军总医院第四医学中心李学秀教授在北京佑安医院开展的一项80例对照研究也发现,给予金花清感的患者,核酸转阴的时间较对照组提前了两天半,同时肺部炎症好转的时间平均为8天,而对照组是10.3天。
A comparative experiment showed that patients who took Jinhua Qinggan Granule tested negative for coronavirus two and a half days earlier than a group that did not take the granule. The group treated with the granule also took eight days to show improvement, while the other group took 10.3 days.
莲花清瘟胶囊/颗粒
Lianhua Qingwen Capsule/Granule
连花清瘟胶囊/颗粒由13味药物组成,是治疗感冒、流感的常用中成药,主要功效是清瘟解毒、宣肺泄热,治疗轻型、普通型患者显示有疗效,尤其是发热、咳嗽、乏力消失时间快,能够减少轻型、普通型转重症的发生,促进核酸转阴。
Lianhua Qingwen medicine is a very common traditional Chinese medicine used for the treatment of cold and flu. Composed of 13 herbal components, it has shown curative effects on mild and common patients, especially in relieving fever, cough and fatigue. It can reduce the occurrence of deterioration and help patients test negative.
血必净注射液
Xuebijing Injection
血必净注射液,是2003年非典期间研发上市的中成药,由5味中药提取物组成,主要功效是化瘀解毒,用于治疗脓毒症。
This injection was developed and marketed during the severe acute respiratory syndrome (SARS) epidemic in 2003. It consists of five herbal extracts and its main function is to detoxify and remove blood stasis. It is usually used to treat sepsis.
在治疗重型、危重型患者中,适用于因感染诱发的全身炎症反应综合征,也可配合治疗多器官,脏器功能受损。临床研究初步显示,与西医药联合使用可提高治愈出院率,减少重症转危重症。基础研究初步发现,具有一定的体外抗病毒作用,并能显著抑制新型冠状病毒感染诱导的炎症因子。
It is effective in suppressing systemic inflammatory response syndrome induced by infection in the treatment of severe and critically ill patients as well as repairing impaired organ function.
Initial clinical studies have shown that the injection, combined with Western medicine, can increase the rate of hospital discharge and reduce the rate of deterioration. Basic research has also found that it has a certain antiviral effect in vitro that can significantly inhibit inflammatory factors induced by novel coronavirus infection.
除了治疗炎症反应,防止细胞因子风暴,血必净还有抗血栓功能,因为这次新冠肺炎还会导致凝血功能过强,在体内到处形成血栓,从而引起器官的栓塞,损害组织,而血必净能够很好地保护内皮细胞,防止体内的过度凝血,防止微血栓的形成。
The novel coronavirus also tends to cause excessive clotting in the body that leads to organ embolism and damages tissues, and Xuebijing can help prevent excessive coagulation and the formation of thrombus.
此前,由复旦大学中山医院白春学教授牵头,联合33家医院进行了血必净的随机对照试验。通过710例数据分析显示,血必净联合常规治疗可以将重症肺炎患者的28天病死率降低8.8%,缩短了4天ICU住院时间。
A comparative experiment of 710 cases jointly conducted by over 30 hospitals showed that the injection combined with regular treatment can reduce the mortality rate of severe patients by 8.8 percent and shorten intensive care unit hospitalization by 4 days.
由中央指导组专家组成员、东南大学附属中大医院副院长邱海波和钟南山院士、中山医院宋元玲主任等牵头进行的血必净项目,从1月底时开始对新冠肺炎重症、危重症患者进行临床应用。目前已经有32家医院的156例病人使用血必净。取得了良好的使用效果。
Another project saw Xuebijing Injection applied clinically to severe and critical patients from the end of January, with 156 patients in 32 hospitals treated. They all achieved very good improvements.
据邱海波介绍,血必净上市后的临床安全性研究显示,不良反应率在0.3%左右,是一个十分安全的数字,并且与其他的抗生素等治疗物不会产生排斥。
Research on the clinical safety of Xuebijing also showed that the adverse reaction rate was about 0.3 percent, which is a very safe figure, and it will not react adversely with other antibiotics or treatment.
清肺排毒汤
Lung Cleansing and Detoxifying Decoction
清肺排毒汤是3月初公布的《新型冠状病毒肺炎诊疗方案(试行第七版)》中,中医临床治疗药物的首选,从2月6日起,国家卫健委、国家中医药管理局就联合发文向全国推荐使用清肺排毒汤。
清肺排毒汤来源于张仲景《伤寒杂病论》中的几个经典名方(recipes),全方共21味中药成分(herbal components),其主要功效是宣肺透邪,清热化湿,健脾化饮。主要在改善发热,咳嗽,乏力等症状方面见效比较快而且明显,能有效促进重症患者肺部影像学改善。
Lung Cleansing and Detoxifying Decoction is derived from several classic recipes in a traditional Chinese medicine work known in English as Treatise on Cold Damage Diseases, which was written by Zhang Zhongjing sometime before 220 AD. It has 21 herbal components and is mainly effective in improving symptoms of fever, cough and fatigue as well as lung condition, as shown by CT scans, in severe patients.
cleanse:清洗,清洁
detoxify:排毒,去除毒素
decoction:煮剂
有关基础研究表明,该方可调控多条细胞因子信号通路(cell signal pathway)——细胞之间发送传递信息,来达到抑制病毒复制的目的,从而避免或缓解炎症风暴(cytokine storm) ——细胞因子受病毒感染等诱因过度反应,不分敌我,造成对自身的伤害。重点作用于肺,同时对多个器官提供保护,可作为治疗轻型、普通型、重型、危重型患者的一个通用方。
Studies have proved the decoction can regulate multiple cell signaling pathways – cells communicating with each other by receiving and processing chemical signals in response to environmental changes – to inhibit virus replication and avoid or mitigate cytokine storms, which are an overreaction of cells that damages the immune system.
The decoction targets lungs and can also protect other organs. It can be used as a general recipe for treating mild, moderate, severe and critical patients.
中央指导组专家、国家中医药管理局专家组组长、中国中医科学院首席研究员、中国科学院院士仝小林介绍,到目前为止,10个省份1261例新冠肺炎患者服用“清肺排毒汤”后,1102例得以治愈、29例症状消失、71例症状改善。其中,在40例重症患者服用后,已有28例出院;12例在院治疗,10例症状好转,“由重转轻”,无一例由轻症转为重症或者危重症。
Tong Xiaolin, chief researcher of the Chinese Academy of Chinese Medical Sciences and also an academician of the Chinese Academy of Sciences, said 1,261 novel coronavirus patients in 10 provinces took the decoction, with 1,102 recovering, symptoms no longer appearing in 29, a further 71 showing improvement and no cases deteriorating.
There were also 40 severe patients. After taking the medicine, 28 were discharged from hospital, and the condition of 10 improved, with their symptoms changing from severe to mild.
化湿败毒方
Huashibaidu Formula
化湿败毒方,是由国家中医医疗队(中国中医科学院)在早期国家诊疗方案推荐使用方剂基础上,结合在金银潭医院临床实践,总结凝练出的一个核心方,全方共14味中药。
Huashibaidu Formula is a core recipe developed by the national traditional Chinese medicine team from the China Academy of Chinese Medical Sciences. Composed of 14 herbal components, the formula is based on the recommendations of the early national diagnosis and treatment plan as well as the experiences from clinical practice at Wuhan Jinyintan Hospital.
中国日报记者王敬 摄
主要功效是解毒化湿、清热平喘,适用于轻型、普通型和重型患者治疗。该方对新冠肺炎可发挥多环节综合治疗作用,可明显缩短核酸转阴时间、平均住院天数,明显改善临床症状、促进理化检查及肺CT好转。通过新型冠状病毒小鼠模型评价,发现该方可以降低肺组织病毒载量30%。
Its main efficacy is to detoxify, remove dampness and heat from the body and relieve cough to achieve an inner body balance. It can be used to treat light, moderate and severe patients.
This prescription has a comprehensive treatment effect in different stages of novel coronavirus pneumonia and can significantly shorten the length of hospital stay and improve clinical symptoms and lung condition as shown by CT scans and other examinations. Studies on guinea pigs found the formula can reduce lung viral load by 30 percent.
宣肺败毒颗粒
Xuanfeibaidu Granule
宣肺败毒方,也是来源于几个经典名方,全方共13味中药。
Xuanfeibaidu Granule, with 13 herbal components, originates from several classic traditional recipes.
主要功效是宣肺化湿、清热透邪、泻肺解毒,适用于轻型、普通型患者治疗。有关研究显示该方可缩短新冠肺炎患者临床症状消失时间、体温复常时间、平均住院天数等,一定程度上能阻断轻型、普通型转重型。
It can detoxify the lungs and clear dampness and heat and is used for treating light and moderate patients. Research has shown the prescription can shorten the time it takes for clinical symptoms to vanish and temperature return to normal and can effectively prevent light and moderate patients from deteriorating.
中国日报记者王敬 摄
国家中医药管理局数据显示,截至3月15日0时,湖北省中医药参与治疗比例为91.64%,武汉市中医药参与治疗比例为89.10%,全国中医药参与治疗比例为92.41%。而国家的诊疗方案中,中医药的参与也一直是非常重要的一部分,并且从疫情一开始就引起了高度的重视。先后不仅派出了三个中医院士专家组前往武汉开展工作,还派出了5批国家中医医疗队驰援武汉。
大量的临床数据和观察显示,中药在早期预防,防止轻症到重症危重症转变和治愈后恢复期都有很明显的效果,而且中药和西药相结合的治疗方式已经大大降低了重症率和致死率。专家也屡次强调,在治疗新冠肺炎没有有效疫苗和特效药的时候,中药不失为一种很好的方式,为抗击疫情提供了另一种思路。
湖北省中医院主任医师杨毅此前接受中国日报采访时说,西药往往追求的是靶向药,有炎症了去消炎,有病毒了就要去杀病毒或者产生抗病毒的抗体,而中医药运用的是一套不同的系统,它更追求的是身体内部的阴阳平衡,通过调节整体的免疫力来对抗外来的感染。
中央指导组专家、国家中医医疗救治专家组副组长、北京中医医院院长刘清泉曾说:“这就像是吃饭。不管是馒头,还是面包,让人吃饱吃好,就是好的。馒头和面包本身没有高低之分。”(记者:张洋菲 吴勇)