中医药影响新型冠状病毒肺炎密接者转阳率的研究:一项大样本队列研究

  目的  观察中医药对新型冠状病毒肺炎(COVID-19)密切接触者的核酸检测转阳率的影响，为中医药预防新型冠状病毒肺炎的应用提供依据。  方法  将扬州隔离点中使用和未使用中药(清肺排毒汤、扶正益清方)的COVID-19密接者纳入本研究，通过倾向性评分匹配和logistic回归分析对核酸扩增试验(NAATs)的阳性率、核酸阳性者的病毒载量、阳性者的病情等级进行分析，以评估中医药预防新型冠状病毒肺炎的作用。  结果  共收集了30 000余例观察对象，基于数据筛选、核对，以1 286例密接者作为研究对象，包括中医组1 016例(79.00%)和对照组270例(21.00%)，共有转阳患者55例。在倾向性评分匹配分析前后，结果均显示在男性和大于60岁的老年人群中，中药组的转阳率低于对照组，差异具有统计学意义(P＜0.05)。多因素logistic回归(不纳入N值和O值)结果显示中药组转阳的风险与对照组相比降低了0.547倍。另外，密接者转阳后，中药组的总体和女性的病毒CT值高于对照组，差异具有统计学意义(P＜0.05)。  结论  中医药有利于降低COVID-19密接者的转阳率和病毒载量。 

Effectiveness of Traditional Chinese Medicine in Reducing the Positive Rate of COVID-19 Close Contacts: A Large Population Cohort Study

  OBJECTIVE  Corona-virus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2 virus. The variant of corona-virus first identified in India, known as Delta, has become the dominant strain in China. Unfortunately, more contagious and unknown variants are coming, leading to a number of close contacts under quarantine. Chinese medicine (TCM) has been recommended to prevention and treatment due to the satisfactory therapeutic effects. However, the effect of TCM to decrease positive rate in close contacts remains unknown.  METHODS  We conducted an retrospective cohort study in Yangzhou, China to assess the effect of Chinese medicine on decreasing positive rate in close contacts under quarantine. The primary observation outcome was positive rate of Nucleic Acid Amplification Tests (NAATs). The secondary observation outcome was a composite of viral load of positive NAATs, severity levels of confirmed cases (asymptomatic, mild, moderate, or severe), daily body temperature, and levels of close contact (primary or secondary).  RESULTS  A total of 1 286 subjects were collected, of which 1 016 (79.00%) in TCM group and 270 (21.00%) in control group with 55 participants tested positive. The incidence of the primary outcome, positive rate of NAATs was significantly lower in the Chinese medicine group than in the control group, occurring in male and age≥60 years subjects. Multi-variable logistic regression (excluding NO viral load) indicated that the risk of testing positive was reduced by 0.547 times in TCM group compared to control group. CT value of TCM group was higher than that of control group in all subjects and female subjects, and the result showed statistically significant difference.  CONCLUSIONS  In our study involving close contacts under quarantine, Chinese medicine resulted in lower positive rate of NAATs and viral load than control.