中醫藥(Traditional Chinese medicines)在這次控製和治療新冠肺炎疫情中發揮了很好的作用。經過篩選研究,金花清感顆粒、蓮花清瘟膠囊/顆粒、血必淨注射液、清肺排毒湯、化濕敗毒方、宣肺敗毒方,這“三藥三方”證實有效。
圖源:新華社
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金花清感顆粒
Jinhua Qinggan Granule
金花清感顆粒,是2009年甲型H1N1流感大流行期間研發的一個中成藥,由金銀花、薄荷、甘草等12味藥組成,主要功效是疏風宣肺、清熱解毒,在治療輕症、普通型患者中具有確切療效,可縮短退熱時間,淋巴細胞、白細胞複常率提高,轉重症率明顯下降。
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.
武漢市第六醫院中醫部 中國日報記者王敬 攝
中央指導組專家組成員、中國工程院院士、天津中醫藥大學校長張伯禮介紹,已經開展的兩項目研究均發現金花清感效果不錯。二月初,經過對武漢102例輕型和普通型新冠肺炎患者的治療發現,病人的轉重率明顯下降,僅為11.8%。病人的退熱時間僅為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.
解放軍總醫院第四醫學中心李學秀教授在北京佑安醫院開展的一項80例對照研究也發現,給予金花清感的患者,核酸轉陰的時間較對照組提前了兩天半,同時肺部炎症好轉的時間平均為8天,而對照組是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.
蓮花清瘟膠囊/顆粒
Lianhua Qingwen Capsule/Granule
連花清瘟膠囊/顆粒由13味藥物組成,是治療感冒、流感的常用中成藥,主要功效是清瘟解毒、宣肺泄熱,治療輕型、普通型患者顯示有療效,尤其是發熱、咳嗽、乏力消失時間快,能夠減少輕型、普通型轉重症的發生,促進核酸轉陰。
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.
血必淨注射液
Xuebijing Injection
血必淨注射液,是2003年非典期間研發上市的中成藥,由5味中藥提取物組成,主要功效是化瘀解毒,用於治療膿毒症。
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.
在治療重型、危重型患者中,適用於因感染誘發的全身炎症反應綜合征,也可配合治療多器官,髒器功能受損。臨床研究初步顯示,與西醫藥聯合使用可提高治愈出院率,減少重症轉危重症。基礎研究初步發現,具有一定的體外抗病毒作用,並能顯著抑製新型冠狀病毒感染誘導的炎症因子。
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.
除了治療炎症反應,防止細胞因子風暴,血必淨還有抗血栓功能,因為這次新冠肺炎還會導致凝血功能過強,在體內到處形成血栓,從而引起器官的栓塞,損害組織,而血必淨能夠很好地保護內皮細胞,防止體內的過度凝血,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,由複旦大學中山醫院白春學教授牽頭,聯合33家醫院進行了血必淨的隨機對照試驗。通過710例數據分析顯示,血必淨聯合常規治療可以將重症肺炎患者的28天病死率降低8.8%,縮短了4天ICU住院時間。
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.
由中央指導組專家組成員、東南大學附屬中大醫院副院長邱海波和鍾南山院士、中山醫院宋元玲主任等牽頭進行的血必淨項目,從1月底時開始對新冠肺炎重症、危重症患者進行臨床應用。目前已經有32家醫院的156例病人使用血必淨。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.
據邱海波介紹,血必淨上市後的臨床安全性研究顯示,不良反應率在0.3%左右,是一個十分安全的數字,並且與其他的抗生素等治療物不會產生排斥。
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.
清肺排毒湯
Lung Cleansing and Detoxifying Decoction
清肺排毒湯是3月初公布的《新型冠狀病毒肺炎診療方案(試行第七版)》中,中醫臨床治療藥物的首選,從2月6日起,國家衛健委、國家中醫藥管理局就聯合發文向全國推薦使用清肺排毒湯。
清肺排毒湯來源於張仲景《傷寒雜病論》中的幾個經典名方(recipes),全方共21味中藥成分(herbal components),其主要功效是宣肺透邪,清熱化濕,健脾化飲。主要在改善發熱,咳嗽,乏力等症狀方麵見效比較快而且明顯,能有效促進重症患者肺部影像學改善。
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,清潔
detoxify:排毒,去除毒素
decoction:煮劑
有關基礎研究表明,該方可調控多條細胞因子信號通路(cell signal pathway)——細胞之間發送傳遞信息,來達到抑製病毒複製的目的,從而避免或緩解炎症風暴(cytokine storm) ——細胞因子受病毒感染等誘因過度反應,不分敵我,造成對自身的傷害。重點作用於肺,同時對多個器官提供保護,可作為治療輕型、普通型、重型、危重型患者的一個通用方。
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.
中央指導組專家、國家中醫藥管理局專家組組長、中國中醫科學院首席研究員、中國科學院院士仝小林介紹,到目前為止,10個省份1261例新冠肺炎患者服用“清肺排毒湯”後,1102例得以治愈、29例症狀消失、71例症狀改善。其中,在40例重症患者服用後,已有28例出院;12例在院治療,10例症狀好轉,“由重轉輕”,無一例由輕症轉為重症或者危重症。
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.
化濕敗毒方
Huashibaidu Formula
化濕敗毒方,是由國家中醫醫療隊(中國中醫科學院)在早期國家診療方案推薦使用方劑基礎上,結合在金銀潭醫院臨床實踐,總結凝練出的一個核心方,全方共14味中藥。
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.
中國日報記者王敬 攝
主要功效是解毒化濕、清熱平喘,適用於輕型、普通型和重型患者治療。該方對新冠肺炎可發揮多環節綜合治療作用,可明顯縮短核酸轉陰時間、平均住院天數,明顯改善臨床症狀、促進理化檢查及肺CT好轉。通過新型冠狀病毒小鼠模型評價,發現該方可以降低肺組織病毒載量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.
宣肺敗毒顆粒
Xuanfeibaidu Granule
宣肺敗毒方,也是來源於幾個經典名方,全方共13味中藥。
Xuanfeibaidu Granule, with 13 herbal components, originates from several classic traditional recipes.
主要功效是宣肺化濕、清熱透邪、瀉肺解毒,適用於輕型、普通型患者治療。有關研究顯示該方可縮短新冠肺炎患者臨床症狀消失時間、體溫複常時間、平均住院天數等,一定程度上能阻斷輕型、普通型轉重型。
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.
中國日報記者王敬 攝
國家中醫藥管理局數據顯示,截至3月15日0時,湖北省中醫藥參與治療比例為91.64%,武漢市中醫藥參與治療比例為89.10%,全國中醫藥參與治療比例為92.41%。而國家的診療方案中,中醫藥的參與也一直是非常重要的一部分,並且從疫情一開始就引起了高度的重視。先後不僅派出了三個中醫院士專家組前往武漢開展工作,還派出了5批國家中醫醫療隊馳援武漢。
大量的臨床數據和觀察顯示,中藥在早期預防,防止輕症到重症危重症轉變和治愈後恢複期都有很明顯的效果,而且中藥和西藥相結合的治療方式已經大大降低了重症率和致死率。專家也屢次強調,在治療新冠肺炎沒有有效疫苗和特效藥的時候,中藥不失為一種很好的方式,為抗擊疫情提供了另一種思路。
湖北省中醫院主任醫師楊毅此前接受中國日報采訪時說,西藥往往追求的是靶向藥,有炎症了去消炎,有病毒了就要去殺病毒或者產生抗病毒的抗體,而中醫藥運用的是一套不同的係統,它更追求的是身體內部的陰陽平衡,通過調節整體的免疫力來對抗外來的感染。
中央指導組專家、國家中醫醫療救治專家組副組長、北京中醫醫院院長劉清泉曾說:“這就像是吃飯。不管是饅頭,還是麵包,讓人吃飽吃好,就是好的。饅頭和麵包本身沒有高低之分。”(記者:張洋菲 吳勇