探讨新型冠状病毒肺炎不同阶段的处方用药规律

Prescription Law of New Coronavirus Pneumonia in Different Stages

摘要:

目的 基于“因时制宜”，探讨新型冠状病毒肺炎不同阶段的中医药防治规律，尤其是其中的处方用药规律。方法 检索并整理2020年2月17日前（含）国家及各省市政府以及各专家制定和发表的新型冠状病毒肺炎指南及建议，按照预防期、临床观察期、临床前期、临床中期、临床后期和恢复期分期录入，对处方中药及其功效、成方和中成药进行频数分析，再对处方中药进行因子分析和聚类分析以获取合理药物组合。结果 共纳入来自24个官方和24个专家的172条中药处方建议，50个成方建议和31个中成药建议，涉及147个中药，44个方剂和16个中成药；中药处方方面，无论是药物类别选择还是具体药物选择，不同阶段的用药规律均不相同；成方和成药方面，观察期可予藿香正气胶囊、疏风解毒胶囊、连花清瘟胶囊、金花清感胶囊，中期可予宣白承气汤加减，后期可辨证予安宫牛黄丸、苏合香丸或紫雪丹；另外，清肺排毒汤在各时期均可使用。结论 新型冠状病毒肺炎各阶段用药规律各有特色，临床需随疾病进展，及时变更处方。

Abstract:

Objective To study the clinical medication regulation for the prevention and treatment of new coronavirus pneumonia with traditional Chinese medicine（TCM），especially prescriptions，on the basis of "treatment in accordance with seasonal conditions".Method The guidelines and suggestions on novel coronavirus pneumonia formulated and published by national，provincial and municipal governments and experts before February 17，2020, were retrieved and summarized. Data was recorded in stages according to "prevention period，clinical observation period，pre-clinical period，middle clinical period，late clinical period and recovery period". The frequency analysis of TCM and its efficacy，prescription and proprietary Chinese medicine was carried out，and then the factor analysis and cluster analysis of TCM were carried out to obtain rational drug combinations.Result Totally 172 suggestions on combined structure of drugs，50 suggestions on prescriptions and 31 suggestions on proprietary Chinese medicine were involved in the study，and provided by 24 official agencies and 24 medical experts， 147 kinds of herbs，44 prescriptions and 16 proprietary Chinese medicines were collected. No matter for the drug category or for the specific drug selection，the law of drug use in different stages was not the same. Huoxiang Zhengqi capsule，Shufeng Jiedu capsule，Lianhua Qingwen capsule and Jinhua Qinggan capsule can be used in the observation period. Xuanbai Chengqitang can be used in the middle of the disease. Angong Niuhuangwan，Suhexiangwan or Zixuedan, and Angong Niuhuangwan can be selected in the middle of the disease. And Qingfei Paidu decoction can be used in all stages of the disease.Conclusion Doctors need to adjust their prescriptions along with the progress of the disease，because the law of medication in each stage of the new coronavirus pneumonia is different.