| Objective:Through retrospective clinical case analysis,to explore the clinical efficacy and safety of Xuanfei Huazhuo Prescription(XFHZP)combined treatment on novel coronavirus pneumonia(wild strain,Delta variant strain and Omicron variant strain subgroup)in Gansu Province,so as to provide real-world data support for clinical application of XFHZP and promote drug development and marketing.To promote Chinese traditional medicine prevention and treatment of disease play a role.Method:In this study,cases were retrieved and collected through the information system of the designated hospital for treatment of the novel coronavirus pneumonia in Gansu Province.Subjects were screened according to the inclusion and exclusion criteria,and data were extracted according to the principle of data standardization:1)Indigenous wild SARS-CoV-2 infected patients confirmed in Gansu Province from January 2020to February 2020;2)Infected persons with SARS-CoV-2 Delta variant in Gansu Province from October 2021 to November 2021;3)Infected persons with SARS-CoV-2 Omicron variant in Gansu Province from March 2022 to April 2022.According to whether XFHZP was used or not,the three subgroups were divided into study group and control group,and the data were statistically analyzed by Excel and SPSS 25.0software.Results:1)wild strain:There were 86 cases of novel coronavirus pneumonia caused by SARS-CoV-2 wild strain,including 45 cases in the study group and 41 cases in the control group.Compared with before treatment,fever,cough,phlegm,fatigue,muscle soreness,pharyngeal discomfort,chest tightness,shortness of breath,dizziness,loss of appetite,nausea and diarrhea were significantly improved after 10 days of treatment in the study group(P<0.05).After 10 days of treatment,the indexes of leukocyte(WBC),lymphocyte(LYM),platelet(PLT),alanine aminotransferase(ALT),total bilirubin(TBIL),direct bilirubin(DBIL)and indirect bilirubin(IBIL)in the study group were higher than those before treatment(P<0.05).Neutrophil(NE)and C-reactive protein(CRP)were significantly decreased after treatment,and the difference was statistically significant(P<0.05).After 10 days of treatment,the levels of WBC,LYM,PLT,TBIL,DBIL and IBIL in control group were higher than before treatment,and the difference was statistically significant(P<0.05).CRP and creatine kinase(CK)levels were decreased(P<0.05).Compared with the control group,the difference values of WBC,LYM,NE and CRP in the study group before and after treatment were statistically significant(P<0.05).After 10 days of treatment,there was a statistically significant difference in lung lesion absorption rate between the study group and the control group{34(79.07%)VS 21(56.76%).χ~2=4.609,P=0.032}.The mean length of stay in the study group and control group was{13.04(10.00,15.00)VS15.71(12.00,19.00)days;Z=2.722,P=0.006},the mean nucleic acid conversion time was{9.89(7.00,12.00)VS 11.98(9.00,16.00)days;Z=2.095,P=0.036}.Compared with the control group,the time of nucleic acid turning negative and the length of hospital stay in the study group were shortened(P<0.05),and the differences were statistically significant.2)Delta Variant:140 patients infected with SARS-CoV-2 Delta variant were included,all of whom were treated with XFHZP,including 65 males(46.43%)and 75 females(53.57%),with an average age of(42.45±21.06)years.After combined treatment with XFHZP for 10days,the clinical symptoms of fever,pharyngeal discomfort,cough,sputum,dizziness,nasal congestion and runny nose,fatigue,muscle soreness,abdominal pain and diarrhea were significantly improved compared with those before treatment(P<0.05).Compared with before treatment,LYM(<0.8×109/L),NE(<2×109/L)and PLT(>300×109/L)were significantly decreased after 10 days of XFHZP treatment(P<0.05).CRP,procalcitonin(PCT),interleukin-6(IL-6),serum amyloid protease A(SAA),ALT,aspartate aminotransferase(AST),lactate dehydrogenase(LDH),CK,creatine kinase isozyme(CK-MB),D-dimer were greater than upper normal limit(UNL)was significantly decreased(P<0.05).Compared with the mean circulating threshold(Ct)of the first SARS-CoV-2 nucleic acid,the mean Ct values of ORFlab gene and N gene of the second nucleic acid with two consecutive negative nucleic acids were significantly increased(P<0.05).The mean values of serum Ig M and Ig G were2.56(0.09,0.83)and 9.29(0.26,6.12)g/L,respectively.After nucleic acid turned negative,Ig M 11.00(1.13,8.87)and Ig G 95.64(89.30,121.82)g/L were obtained.The positive rates of Ig M(50.00%VS 12.14%)and Ig G(10.00%VS 84.29%)in patients admitted to hospital and nucleic acid conversion were statistically significant(P<0.05).After XFHZP treatment,the imaging absorption rate was 83.17%.The duration of negative nucleic acid transformation in patients with Delta variant was 14.72(12.00,17.00)days,and the length of hospital stay was 17.39(14.00,20.00)days.3)Omicron Variant:223 cases of SARS-CoV-2 Omicron variant were collected,including 103 cases in the study group and 120 cases in the control group.The counts of LYM,NE and PLT in the study group were higher after treatment than before treatment(P<0.05).The levels of WBC,CRP,IL-6,PCT,ALT,AST,creatinine(Crea),D-dimer and fibrinogen(FIB)were decreased compared with those before treatment,and the differences were statistically significant(P<0.05).The counts of WBC,LYM,NE and PLT in control group were higher after treatment than before treatment(P<0.05).The levels of CRP,IL-6,PCT,ALT,AST and FIB were decreased compared with those before treatment(P<0.05).Compared with the control group,the difference values of LYM,PLT,WBC,CRP and IL-6 in the study group before and after treatment were statistically significant(P<0.05).There was no significant difference in lung lesion absorption rate between the two groups{36(80.00%)VS 39(68.42%);χ~2=1.732,P=0.188}.The mean nucleic acid Ct values of some patients in the study group were ORFlab(7.13±4.80)and N(25.95±5.05).The positive rate of serum Ig G antibody in the study group after negative nucleic acid conversion was significantly higher than that on admission(38.83%VS 68.93%;χ~2=18.773,P<0.05).The length of hospital stay in the study group was shorter than the control group{12.42(11.00,14.00)VS 14.27(12.00,16.00),Z=3.232,P=0.001}.Conclusion:In the case of novel coronavirus infection in Gansu Province,the combination treatment of Xuanfei Huazhuo Prescription was effective to the wild strain,Delta variant and Omicron variant subgroups without serious adverse reactions.XFHZP can effectively relieve fever,cough,sputum and other clinical symptoms,inhibit inflammatory response,regulate immune function,promote the absorption of lung inflammation,accelerate the negative nucleic acid conversion,shorten the length of hospital stay. |
