中國大陸新冠恢復期中醫治療共識建議綜述

目的：本研究旨在分析中國大陸發佈的臨床指南中針對新冠恢復期的中醫治療方式及其治療原則。 方法：系統性檢索由中國政府官方渠道公開發佈的與中醫治療新冠相關的指導性文件，總結針對新冠恢復期的中醫療法，並對不同中藥和方劑在相關適應症中的使用情況進行可視化分析。結果：共納入61種中醫證型，總結出了最常見的5種中醫證型、最常用的6個方劑和最常用的10種中藥。研究還發現了部分高度相關的中藥藥對，並對最常見的5種中醫證型的飲食療法也進行了探討。此外，還探究了新冠恢復期治療中最常用的穴位。結論：新冠恢復期的治療原則以補氣、滋陰、化痰、祛濕為主，中醫的整體觀念也為目前對抗新冠的臨床實踐和科學研究提供了寶貴的見解。

Objective: This study aims to analyze the treatment modalities and their treatment principles of traditional Chinese medicine (TCM) for the convalescence period of COVID-19, as delineated in clinical guidelines published in China.

Methods: A systematic search for guidance documents such as “Treatment Protocols”, “Prevention and Treatment Protocols”, and “Technical Guidelines” related to TCM for COVID-19 that were publicly released in official Chinese government channels from December 2019 to April 4, 2022 was conducted. The TCM patterns, Chinese herbal medicines (CHM), Chinese herbal formula (CHF) and external treatments for the convalescence period of COVID-19 were also compiled. Microsoft Excel (Version 2019), IBM SPSS Statistics 20, IBM SPSS Modeler 18.0, Tableau 2020.1 software were used to analyze and visualize the patterns of use of different CHMs and CHFs in the relevant indications.

Results: A total of 61 TCM protocols were included in this study, with the five most prevalent TCM patterns identified as “Dual deficiency in the lung and spleen”, “Qi and yin deficiency”, “Qi and yin deficiency with remnant pathogenic factors failing to be eliminated”, “Qi deficiency of the lung and kidney mixed with phlegm and stasis obstructing the internal” and “Yin deficiency of the lung and stomach”. The top six commonly used CHFs were Sha-Shen-Mai-Dong-Tang, Zhu-Ye-Shi-Gao-Tang, Si-Jun-Zi-Tang, Bu-Fei-Tang, San-Zi-Yang-Qin-Tang and Liu-Jun-Zi-Tang. Furthermore, the ten most frequently used CHMs were Fuling, Huangqi, Gancao, Maidong, Baizhu, Chenpi, Dangshen, Fabanxia, Wuweizi and Sharen. The study also identified highly supported drug combinations, such as Fuling-Fabanxia, Dangshen-Fuling-Chenpi, and Zhigancao-Taizishen-Maidong. Dietary therapy was explored for the top five patterns and accompanying symptoms, including fatigue, insomnia, and cough. Additionally, the analysis revealed ST36 as the most frequently used acupoint.

Conclusion: The treatment principles for the convalescence period of COVID-19 primarily focus on boosting qi, nourishing yin, addressing phlegm, and eliminating dampness. The findings derived from this review hold significant importance for addressing management of Long COVID in China and hold promise for widespread application globally. The holistic approach of TCM provides valuable insights for both clinical practice and scientific research in the ongoing fight against COVID-19.