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Objective: To retrospectively analyze the clinical data of 52 patients with coronavirus disease-2019 COVID-19 and explore the clinical efficacy of modified Sanxiaoyin on mild/moderate COVID-19 patients. Method(s): The propensity score matching method was used to collect the clinical data of mild or moderate COVID-19 patients enrolled in the designated hospital of the Second Hospital of Jingzhou from December 2019 to May 2020. A total of 26 eligible patients who were treated with modified Sanxiaoyin were included in the observation group,and the 26 patients treated with conventional method were the regarded as the control. The disappearance of clinical symptoms,disappearance time of main symptoms,efficacy on traditional Chinese medicineTCMsymptoms,hospitalization duration,laboratory test indicators,and CT imaging changes in the two groups were compared. Result(s): The general data in the two groups were insignificantly different and thus they were comparable. After 7 days of treatment,the disappearance rate of fever,cough, fatigue,dry throat,anorexia,poor mental state,and poor sleep quality in the observation group was higher than that in the control groupP<0.05,and the difference in the disappearance rate of expectoration and chest distress was insignificant. For the cases with the disappearance of symptoms,the main symptomsfever, cough,fatigue,dry throat,anorexia,chest distressdisappeared earlier in the observation group than in the control groupP<0.01. After 7 days of treatment,the scores of the TCM symptom scale of both groups decreasedP<0.01,and the decrease of the observation group was larger that of the control groupP<0.01. All patients in the two groups were cured and discharged. The average hospitalization duration in the observation group12.79+/-2.68dwas shorter than that in the control group15.27+/-3.11dP<0.01. The effective rate in the observation group92.31%,24/26was higher than that in the control group76.92%,20/26. After 7 days of treatment,the lymphocyteLYMcount increasedP<0.05,and white blood cellWBCcount and neutrophilNEUTcount decreased insignificantly in the two groups. Moreover,levels of C-reactive protein CRP,erythrocyte sedimentation rateESR,and procalcitoninPCTreduced in the two groups after treatmentP<0.01and the reduction in the observation group was larger than that in the control group P<0.01. Through 7 days of treatment,the total effective rate on pulmonary shadow in the observation group 90.00%,18/20was higher than that in the control group77.27%,17/22P>0.05and the improvement of lung shadow in the observation group was better than that in the control groupP<0.01. Conclusion(s):Modified Sanxiaoyin can significantly alleviate fever,cough,fatigue,anorexia,chest distress,poor sleep quality,and other symptoms of patients with mild or moderate COVID-19,improve biochemical indicators,and promote the recovery of lung function. This paper provides clinical evidence for the application of modified Sanxiaoyin in the treatment of mild or moderate COVID-19.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
RESUMEN
［］ Objective： To retrospectively analyze the clinical data of 52 patients with coronavirus disease-2019 （COVID-19） and explore the clinical efficacy of modified Sanxiaoyin on mild/moderate COVID-19 patients. Method： The propensity score matching method was used to collect the clinical data of mild or moderate COVID-19 patients enrolled in the designated hospital of the Second Hospital of Jingzhou from December 2019 to May 2020. A total of 26 eligible patients who were treated with modified Sanxiaoyin were included in the observation group，and the 26 patients treated with conventional method were the regarded as the control. The disappearance of clinical symptoms，disappearance time of main symptoms，efficacy on traditional Chinese medicine（TCM）symptoms，hospitalization duration，laboratory test indicators，and CT imaging changes in the two groups were compared. Result： The general data in the two groups were insignificantly different and thus they were comparable. After 7 days of treatment，the disappearance rate of fever，cough， fatigue，dry throat，anorexia，poor mental state，and poor sleep quality in the observation group was higher than that in the control group（P<0.05），and the difference in the disappearance rate of expectoration and chest distress was insignificant. For the cases with the disappearance of symptoms，the main symptoms（fever， cough，fatigue，dry throat，anorexia，chest distress）disappeared earlier in the observation group than in the control group（P<0.01）. After 7 days of treatment，the scores of the TCM symptom scale of both groups decreased（P<0.01），and the decrease of the observation group was larger that of the control group（P<0.01）. All patients in the two groups were cured and discharged. The average hospitalization duration in the observation group［（12.79±2.68）d］was shorter than that in the control group［（15.27±3.11）d］（P<0.01）. The effective rate in the observation group（92.31%，24/26）was higher than that in the control group（76.92%，20/26）. After 7 days of treatment，the lymphocyte（LYM）count increased（P<0.05），and white blood cell（WBC）count and neutrophil（NEUT）count decreased insignificantly in the two groups. Moreover，levels of C-reactive protein （CRP），erythrocyte sedimentation rate（ESR），and procalcitonin（PCT）reduced in the two groups after treatment（P<0.01）and the reduction in the observation group was larger than that in the control group （P<0.01）. Through 7 days of treatment，the total effective rate on pulmonary shadow in the observation group （90.00%，18/20）was higher than that in the control group（77.27%，17/22）（P>0.05）and the improvement of lung shadow in the observation group was better than that in the control group（P<0.01）. Conclusion：Modified Sanxiaoyin can significantly alleviate fever，cough，fatigue，anorexia，chest distress，poor sleep quality，and other symptoms of patients with mild or moderate COVID-19，improve biochemical indicators，and promote the recovery of lung function. This paper provides clinical evidence for the application of modified Sanxiaoyin in the treatment of mild or moderate COVID-19. © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
RESUMEN
BACKGROUND Coronavirus disease 2019 (COVID-19) is spreading around the world, presenting mainly as respiratory symptoms. Some patients have obvious digestive system symptoms, or even present with only digestive system symptoms. Therefore, it is of great significance to clarify the digestive system manifestations in COVID-19 patients. AIM To explore the digestive system manifestations of 350 patients with COVID-19 hospitalized at our hospital, to provide reference for the diagnosis and treatment of COVID-19. METHODS The data of 350 COVID-19 inpatients at our hospital, such as general conditions, initial symptoms, disease severity, digestive system symptoms, and liver function, were retrospectively analyzed. The digestive system symptoms and liver function indexes were compared between non-critically ill patients and critically ill patients. Statistical methods involved independent sample median test, continuity correction chi-square test, and one-way analysis of variance. RESULTS All the 350 patients were definitely diagnosed with COVID-19, including 176 (50.3%) males and 174 (49.7%) females. They ranged in age from 17 to 94 years, with a median age of 59 years. There were 254 (72.6%) non-critically ill patients and 96 (27.4%) critically ill patients. The initial symptoms were mainly fever, dry cough, fatigue, and chest tightness;262 (74.9%) cases showed fever, 189 (54.0%) showed dry cough, 237 (67.7%) showed fatigue, and 195 (55.7%) showed chest tightness. Seventy-nine (22.6%) cases showed digestive system symptoms, mainly diarrhea, vomiting, and abdominal pain;42 (12.0%) cases showed diarrhea, 48 (13.7%) showed vomiting, and 3 (0.9%) showed abdominal pain. Five (1.4%) cases presented with digestive system symptoms as the initial symptoms. One hundred and fifty (42.9%) cases had abnormal liver function indexes (increase in at least one of ALT, AST, TBIL, and DBIL), of which 73 (20.9%) had elevated ALT, 98 (28.0%) had elevated AST, 60 (17.1%) had elevated DBIL, and 27 (7.7%) had elevated TBIL. Serum albumin (ALB) was reduced in 275 (78.6%) patients. The percentage of non-critically ill patients with digestive system symptoms (52/254, 20.5%) was not statistically significant from that of critically ill patients (52/254 [20.5%] vs 27/96 [28.1%],χ 2 = 2.334, P > 0.05). The abnormal rate of liver function indexes (87/254, 34.3%) was significantly lower in non-critically ill patients than in critically ill patients (87/254 [34.3%] vs 63/96 [65.6%], χ 2 = 28, P < 0.05). The percentage of patients with ALB decline was significantly lower in non-critically ill patients than in critically ill patients (182/254 [71.7%] vs 93/96 [96.9%],χ 2 = 26.322, P < 0.05). In both non-critically ill and critically ill patients, the increase in liver function indexes was mostly not more than 2 × upper limit of normal, and ALB was mostly in the range of 30-40 g/ L. Compared with the non-diarrhea group (236/308, 76.6%), the percentage of patients with ALB reduction in the diarrhea group (39/42, 92.9%) was statistically lower (χ 2 = 5.785, P < 0.05). There was no statistically significant difference in duration of onset between groups with different albumin concentrations (P > 0.05). CONCLUSION Hospitalized COVID-19 patients may show some digestive system symptoms, with diarrhea and vomiting being most common. A few patients present with digestive system symptoms as the initial manifestation, which is more likely to cause misdiagnosis. Some patients with COVID-19 show liver injury, although most of cases are mild, and no liver failure occurs. Compared with non-critically ill patients, the incidence of digestive system symptoms is generally similar to that of non-critically ill patients, but the incidence and degree of abnormal liver function indexes are higher in critically ill patients. Most patients with COVID-19 may have decreased serum albumin, and patients with diarrhea are more likely to have serum albumin decline. The above conclusions may help increase the awareness of COVID-19 among clinicians and improve their treatment skill .