摘要
世界范围内爆发的新型冠状病毒肺炎(corona virus disease 2019,COVID-19)给全球人民的健康和财产带来了巨大的损失,造成了数以百万计患者的死亡.“三药三方”是众多专家总结临床实践筛选出的能够有效防治COVID-19的中药方剂,包括金花清感颗粒、连花清瘟胶囊(颗粒)、血必净注射液和清肺排毒汤、化湿败毒方、宣肺败毒方.“三药三方”不仅能缓解发热、咳嗽、疲劳、咯痰、腹泻等症状,还可以缩短核酸转阴时间、阻止病情转重、改善CT影像特征、缓解肺部炎症、调节临床生化指标、减轻一系列并发症等.“三药三方”防治COVID-19的作用机制主要涉及抑制病毒入侵与复制、调节机体免疫和炎症以及多器官保护等.本文综合介绍了“三药三方”在临床上治疗COVID-19的研究进展,并对其潜在的作用机制进行了系统性梳理,旨在为认识“三药三方”在治疗COVID-19发挥的积极作用提供理论依据和参考.
The COVID-19 outbreak has resulted in extensive human casualties and serious economic losses worldwide.The main pathogenesis of COVID-19 is viral lung infection,which causes excessive immune response and cytokine storm,leading to acute respiratory distress syndrome and multiple organ dysfunction syndrome.Due to China’s long history of battling plagues,traditional Chinese medicine(TCM)has formulated herbal recipes and developed theories on infectious diseases.During the fight against COVID-19,“three medicines and three formulae”,including Jinhua Qinggan granules,Lianhua Qingwen capsules,Xuebijing injection,Qingfei Paidu decoction,Huashi Baidu decoction,and Xuanfei Baidu decoction,were recommended by leading TCM experts and academicians.These remedies were adopted in the national guidelines for the prevention and treatment of COVID-19.Guided by the TCM theory of heat removal,humidity reduction and detoxification,the scope of the“three medicines and three formulae”approach covers the entire course of a COVID-19 infection,including the phase of pre-symptomatic medical observation and the different diagnostic stages(mild,moderate,severe,and critical)of the disease.This study reviewed progress in clinical research as well as the mechanisms of action,concerning“three medicines and three formulae”for COVID-19.Clinical evidence suggests that the“three medicines and three formulae”are effective in preventing and treating COVID-19 by alleviating typical symptoms such as fever,coughing,fatigue,phlegm and diarrhea,shortening nucleic acid-negative conversion time,improving computed tomography images feature,inhibiting lung inflammation,normalizing clinical biomarkers,and reducing COVID-19-related complications.The pharmacological mechanisms of the“three medicines and three formulae”mainly include:binding with ACE2,3 CLpro,PLpro,and TMPRSS2 to inhibit virus invasion and replication;reducing the production and secretion of pro-inflammatory factors(such as IL-6,TNF-α,IL-1,IL-10,CXCL8,CXCL10,and CCL2)to regulate immune function;and decreasing clinical indicators(such as IL-6,CRP,and D-dimer)associated with the crosstalk of viral toxicity,endothelial damage,cytokine storm,excessive immune response,and microthrombosis to protect multiple organs against damage.In the future,it is necessary to collect further clinical evidence of the“three medicines and three formulae”for COVID-19 by conducting high-quality,large-scale randomized controlled trials.Trials targeting different Chinese medicine syndromes in specific patient populations are particularly desirable.Big data collection and analysis of the efficacy and safety of the“three medicines and three formulae”for COVID-19 can be facilitated by artificial intelligence and deep learning.In addition,the active components of these treatments,in various combinations with one another,should be identified,and their respective underlying mechanisms of action should be assessed using advanced technologies,such as multi-omics integration and human induced pluripotent stem cell-derived disease models.Moreover,more attention should be paid to the COVID-19 patients of post-infection,with common syndromes such as fatigue or muscle weakness,sleep deprivation,and anxiety or depression especially for low-immunity children and elderly with chronic diseases.TCM has many advantages and should be actively explored for patients with unmet medical needs.
作者
高洁
肖光旭
樊官伟
张晗
朱彦
吕明
Jie Gao;Guangxu Xiao;Guanwei Fan;Han Zhang;Yan Zhu;Ming Lü(State Key Laboratory of Component-based Chinese Medicine,Research Center of Traditional Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;College of Traditional Chinese Medicine,Hebei University,Baoding 071002,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)
出处
《科学通报》
EI
CAS
CSCD
北大核心
2022年第27期3296-3310,共15页
Chinese Science Bulletin
基金
国家自然科学基金(82104431,81973581)
组分中药国家重点实验室开放课题(CBCM2020201)
国家科技应急项目(2020YFC0841600)
国家重大科技专项(2018YFC1704502,2020YFA0708004)资助。
关键词
三药三方
新型冠状病毒肺炎
临床研究
药理研究
three medicines and three formulae
COVID-19
clinical research
pharmacological research
