ABSTRACT
Dayuanyin,a representative prescription for the treatment of dampness pathogen lodging in pleurodiaphragmatic interspace syndrome,was first recorded in Treatise on Pestilence(<<>>)by Wu Youke in the Ming Dynasty for dealing with pestilence,and it still plays an important role in the treatment of coronavirus disease 2019(COVID-19)differentiated into dampness stagnating in lung syndrome. The related original ancient records were retrieved from the Chinese Classics of Traditional Chinese Medicine(Version 5.0),Full-text Database of Ancient Chinese Medicine Books,and Ancient Books of Traditional Chinese Medicine Database (http://www. gydc. ac. cn:81/),with 'Dayuanyin' and 'Dayuansan' as the search terms,followed by statistical analysis and textual research. The composition,dosage,processing of original medicinal materials,efficacy, indications, processing and administration methods, modern basic research, and clinical applications of Dayuanyin were summarized,so as to provide literature reference for its modern development and clinical application. The findings demonstrated that the composition in most medical records was identical with that of the original prescription,except that some records concerning Angelicae Dahuricae Radix and Tsaoko Fructus differed. In terms of dosage,it did not change much,with the only difference observed in Tsaoko Fructus. The processing methods of medicinal materials in Dayuanyin were not specified in historical records,so the raw medicinal materials were recommended. The processing and administration methods in the original record were basically followed in the later generations,except that some medical records chose Zingiberis Rhizoma Recens as the guide and changed the decocting amount and administration time. In terms of efficacy and indications, Dayuanyin was originally developed for dispelling pathogenic Qi away from the pleurodiaphragmatic interspace, but later employed for the treatment of such diseases as 'pestilence','epidemic malaria',and 'seasonal epidemic'. It was mainly indicated to 'epidemic diseases' with latent pathogen in pleurodiaphragmatic interspace as the pathogenesis and fever as the manifestation. In modern clinical application,ancients physicians considered 'fever' and 'powder-like tongue coating' as the important signs for this prescription. Modern physicians have utilized Dayuanyin for treating fever,diseases in the digestive,respiratory,urinary,and endocrine systems,skin diseases,pediatric diseases,as well as epidemic diseases like influenza,severe acute respiratory syndrome (SARS),and avian flu due to its good effects.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
ABSTRACT
Dayuanyin,a representative prescription for the treatment of dampness pathogen lodging in pleurodiaphragmatic interspace syndrome,was first recorded in Treatise on Pestilence(<<>>)by Wu Youke in the Ming Dynasty for dealing with pestilence,and it still plays an important role in the treatment of coronavirus disease 2019(COVID-19)differentiated into dampness stagnating in lung syndrome. The related original ancient records were retrieved from the Chinese Classics of Traditional Chinese Medicine(Version 5.0),Full-text Database of Ancient Chinese Medicine Books,and Ancient Books of Traditional Chinese Medicine Database (http://www. gydc. ac. cn:81/),with 'Dayuanyin' and 'Dayuansan' as the search terms,followed by statistical analysis and textual research. The composition,dosage,processing of original medicinal materials,efficacy, indications, processing and administration methods, modern basic research, and clinical applications of Dayuanyin were summarized,so as to provide literature reference for its modern development and clinical application. The findings demonstrated that the composition in most medical records was identical with that of the original prescription,except that some records concerning Angelicae Dahuricae Radix and Tsaoko Fructus differed. In terms of dosage,it did not change much,with the only difference observed in Tsaoko Fructus. The processing methods of medicinal materials in Dayuanyin were not specified in historical records,so the raw medicinal materials were recommended. The processing and administration methods in the original record were basically followed in the later generations,except that some medical records chose Zingiberis Rhizoma Recens as the guide and changed the decocting amount and administration time. In terms of efficacy and indications, Dayuanyin was originally developed for dispelling pathogenic Qi away from the pleurodiaphragmatic interspace, but later employed for the treatment of such diseases as 'pestilence','epidemic malaria',and 'seasonal epidemic'. It was mainly indicated to 'epidemic diseases' with latent pathogen in pleurodiaphragmatic interspace as the pathogenesis and fever as the manifestation. In modern clinical application,ancients physicians considered 'fever' and 'powder-like tongue coating' as the important signs for this prescription. Modern physicians have utilized Dayuanyin for treating fever,diseases in the digestive,respiratory,urinary,and endocrine systems,skin diseases,pediatric diseases,as well as epidemic diseases like influenza,severe acute respiratory syndrome (SARS),and avian flu due to its good effects.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
ABSTRACT
Background:Coronavirus disease 2019 (COVID-19) is a serious and even lethal respiratory illness. The mortality of critically ill patients with COVID-19, especially short term mortality, is considerable. It is crucial and urgent to develop risk models that can predict the mortality risks of patients with COVID-19 at an early stage, which is helpful to guide clinicians in making appropriate decisions and optimizing the allocation of hospital resoureces.Methods:In this retrospective observational study, we enrolled 949 adult patients with laboratory-confirmed COVID-19 admitted to Tongji Hospital in Wuhan between January 28 and February 12, 2020. Demographic, clinical and laboratory data were collected and analyzed. A multivariable Cox proportional hazard regression analysis was performed to calculate hazard ratios and 95% confidence interval for assessing the risk factors for 30-day mortality.Results:The 30-day mortality was 11.8% (112 of 949 patients). Forty-nine point nine percent (474) patients had one or more comorbidities, with hypertension being the most common (359 [37.8%] patients), followed by diabetes (169 [17.8%] patients) and coronary heart disease (89 [9.4%] patients). Age above 50 years, respiratory rate above 30 beats per minute, white blood cell count of more than10 × 109/L, neutrophil count of more than 7 × 109/L, lymphocyte count of less than 0.8 × 109/L, platelet count of less than 100 × 109/L, lactate dehydrogenase of more than 400 U/L and high-sensitivity C-reactive protein of more than 50 mg/L were independent risk factors associated with 30-day mortality in patients with COVID-19. A predictive CAPRL score was proposed integrating independent risk factors. The 30-day mortality were 0% (0 of 156), 1.8% (8 of 434), 12.9% (26 of 201), 43.0% (55 of 128), and 76.7% (23 of 30) for patients with 0, 1, 2, 3, ≥4 points, respectively.Conclusions:We designed an easy-to-use clinically predictive tool for assessing 30-day mortality risk of COVID-19. It can accurately stratify hospitalized patients with COVID-19 into relevant risk categories and could provide guidance to make further clinical decisions. © 2021 The Chinese Medical Association, Published by Wolters Kluwer Health, Inc.