中醫(yī)藥(Traditional Chinese medicines)在這次控制和治療新冠肺炎疫情中發(fā)揮了很好的作用。經(jīng)過篩選研究,金花清感顆粒、蓮花清瘟膠囊/顆粒、血必凈注射液、清肺排毒湯、化濕敗毒方、宣肺敗毒方,這“三藥三方”證實(shí)有效。
圖源:新華社
這些方劑具體有什么功效?適合什么人群?下面我們來為大家一一介紹一下。
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(fā)的一個(gè)中成藥,由金銀花、薄荷、甘草等12味藥組成,主要功效是疏風(fēng)宣肺、清熱解毒,在治療輕癥、普通型患者中具有確切療效,可縮短退熱時(shí)間,淋巴細(xì)胞、白細(xì)胞復(fù)常率提高,轉(zhuǎn)重癥率明顯下降。
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(yī)院中醫(yī)部 中國日報(bào)記者王敬 攝
中央指導(dǎo)組專家組成員、中國工程院院士、天津中醫(yī)藥大學(xué)校長張伯禮介紹,已經(jīng)開展的兩項(xiàng)目研究均發(fā)現(xiàn)金花清感效果不錯。二月初,經(jīng)過對武漢102例輕型和普通型新冠肺炎患者的治療發(fā)現(xiàn),病人的轉(zhuǎn)重率明顯下降,僅為11.8%。病人的退熱時(shí)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(yī)院第四醫(yī)學(xué)中心李學(xué)秀教授在北京佑安醫(yī)院開展的一項(xiàng)80例對照研究也發(fā)現(xiàn),給予金花清感的患者,核酸轉(zhuǎn)陰的時(shí)間較對照組提前了兩天半,同時(shí)肺部炎癥好轉(zhuǎn)的時(shí)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(fā)熱、咳嗽、乏力消失時(shí)間快,能夠減少輕型、普通型轉(zhuǎn)重癥的發(fā)生,促進(jìn)核酸轉(zhuǎn)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.
血必凈注射液
Xuebijing Injection
血必凈注射液,是2003年非典期間研發(fā)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,用于治療膿毒癥。
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,適用于因感染誘發(fā)的全身炎癥反應(yīng)綜合征,也可配合治療多器官,臟器功能受損。臨床研究初步顯示,與西醫(yī)藥聯(lián)合使用可提高治愈出院率,減少重癥轉(zhuǎn)危重癥?;A(chǔ)研究初步發(fā)現(xiàn),具有一定的體外抗病毒作用,并能顯著抑制新型冠狀病毒感染誘導(dǎo)的炎癥因子。
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.
除了治療炎癥反應(yīng),防止細(xì)胞因子風(fēng)暴,血必凈還有抗血栓功能,因?yàn)檫@次新冠肺炎還會導(dǎo)致凝血功能過強(qiáng),在體內(nèi)到處形成血栓,從而引起器官的栓塞,損害組織,而血必凈能夠很好地保護(hù)內(nèi)皮細(xì)胞,防止體內(nèi)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,由復(fù)旦大學(xué)中山醫(yī)院白春學(xué)教授牽頭,聯(lián)合33家醫(yī)院進(jìn)行了血必凈的隨機(jī)對照試驗(yàn)。通過710例數(shù)據(jù)分析顯示,血必凈聯(lián)合常規(guī)治療可以將重癥肺炎患者的28天病死率降低8.8%,縮短了4天ICU住院時(shí)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(dǎo)組專家組成員、東南大學(xué)附屬中大醫(yī)院副院長邱海波和鐘南山院士、中山醫(yī)院宋元玲主任等牽頭進(jìn)行的血必凈項(xiàng)目,從1月底時(shí)開始對新冠肺炎重癥、危重癥患者進(jìn)行臨床應(yīng)用。目前已經(jīng)有32家醫(yī)院的156例病人使用血必凈。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(jù)邱海波介紹,血必凈上市后的臨床安全性研究顯示,不良反應(yīng)率在0.3%左右,是一個(gè)十分安全的數(shù)字,并且與其他的抗生素等治療物不會產(chǎn)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(yī)臨床治療藥物的首選,從2月6日起,國家衛(wèi)健委、國家中醫(yī)藥管理局就聯(lián)合發(fā)文向全國推薦使用清肺排毒湯。
清肺排毒湯來源于張仲景《傷寒雜病論》中的幾個(gè)經(jīng)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(fā)熱,咳嗽,乏力等癥狀方面見效比較快而且明顯,能有效促進(jìn)重癥患者肺部影像學(xué)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(guān)基礎(chǔ)研究表明,該方可調(diào)控多條細(xì)胞因子信號通路(cell signal pathway)——細(xì)胞之間發(fā)送傳遞信息,來達(dá)到抑制病毒復(fù)制的目的,從而避免或緩解炎癥風(fēng)暴(cytokine storm) ——細(xì)胞因子受病毒感染等誘因過度反應(yīng),不分?jǐn)澄?,造成對自身的傷害。重點(diǎn)作用于肺,同時(shí)對多個(gè)器官提供保護(hù),可作為治療輕型、普通型、重型、危重型患者的一個(gè)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(dǎo)組專家、國家中醫(yī)藥管理局專家組組長、中國中醫(yī)科學(xué)院首席研究員、中國科學(xué)院院士仝小林介紹,到目前為止,10個(gè)省份1261例新冠肺炎患者服用“清肺排毒湯”后,1102例得以治愈、29例癥狀消失、71例癥狀改善。其中,在40例重癥患者服用后,已有28例出院;12例在院治療,10例癥狀好轉(zhuǎn),“由重轉(zhuǎn)輕”,無一例由輕癥轉(zhuǎn)為重癥或者危重癥。
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(yī)醫(yī)療隊(duì)(中國中醫(yī)科學(xué)院)在早期國家診療方案推薦使用方劑基礎(chǔ)上,結(jié)合在金銀潭醫(yī)院臨床實(shí)踐,總結(jié)凝練出的一個(gè)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(bào)記者王敬 攝
主要功效是解毒化濕、清熱平喘,適用于輕型、普通型和重型患者治療。該方對新冠肺炎可發(fā)揮多環(huán)節(jié)綜合治療作用,可明顯縮短核酸轉(zhuǎn)陰時(shí)間、平均住院天數(shù),明顯改善臨床癥狀、促進(jìn)理化檢查及肺CT好轉(zhuǎn)。通過新型冠狀病毒小鼠模型評價(jià),發(fā)現(xiàn)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,也是來源于幾個(gè)經(jīng)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,適用于輕型、普通型患者治療。有關(guān)研究顯示該方可縮短新冠肺炎患者臨床癥狀消失時(shí)間、體溫復(fù)常時(shí)間、平均住院天數(shù)等,一定程度上能阻斷輕型、普通型轉(zhuǎn)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(bào)記者王敬 攝
國家中醫(yī)藥管理局?jǐn)?shù)據(jù)顯示,截至3月15日0時(shí),湖北省中醫(yī)藥參與治療比例為91.64%,武漢市中醫(yī)藥參與治療比例為89.10%,全國中醫(yī)藥參與治療比例為92.41%。而國家的診療方案中,中醫(yī)藥的參與也一直是非常重要的一部分,并且從疫情一開始就引起了高度的重視。先后不僅派出了三個(gè)中醫(yī)院士專家組前往武漢開展工作,還派出了5批國家中醫(yī)醫(yī)療隊(duì)馳援武漢。
大量的臨床數(shù)據(jù)和觀察顯示,中藥在早期預(yù)防,防止輕癥到重癥危重癥轉(zhuǎn)變和治愈后恢復(fù)期都有很明顯的效果,而且中藥和西藥相結(jié)合的治療方式已經(jīng)大大降低了重癥率和致死率。專家也屢次強(qiáng)調(diào),在治療新冠肺炎沒有有效疫苗和特效藥的時(shí)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(yī)院主任醫(yī)師楊毅此前接受中國日報(bào)采訪時(shí)說,西藥往往追求的是靶向藥,有炎癥了去消炎,有病毒了就要去殺病毒或者產(chǎn)生抗病毒的抗體,而中醫(yī)藥運(yùn)用的是一套不同的系統(tǒng),它更追求的是身體內(nèi)部的陰陽平衡,通過調(diào)節(jié)整體的免疫力來對抗外來的感染。
中央指導(dǎo)組專家、國家中醫(yī)醫(yī)療救治專家組副組長、北京中醫(yī)醫(yī)院院長劉清泉曾說:“這就像是吃飯。不管是饅頭,還是面包,讓人吃飽吃好,就是好的。饅頭和面包本身沒有高低之分?!保ㄓ浾撸簭堁蠓?吳勇)