关键词:
Non-drug measures
Prone positioning
COVID-19
Oxygen saturation
Traditional Chinese medicine
摘要:
Background The outbreak of coronavirus disease 2019 (COVID-19) infection posed a huge threat and burden to public healthcare in late 2022. Non-drug measures of traditional Chinese medicine (TCM), such as acupuncture, cupping and moxibustion, are commonly used as adjuncts in China to help in severe cases, but their effects remain unclear. Objectives To observe the clinical effect of TCM non-drug measures in improving respiratory function and symptoms among patients with severe COVID-19. Design, setting, participants and interventions This study was designed as a multicenter, assessor-blind, randomized controlled trial. Hospitalized patients with COVID-19 were randomly assigned to the treatment or control group. The treatment group received individualized TCM non-drug measures in combination with prone position ventilation, while the control group received prone position ventilation only for 5 consecutive days. Main outcome measures The primary outcome measures were the percentage of patients with improved oxygen saturation (SpO 2 ) at the end of the 5-day intervention, as well as changes of patients’ respiratory rates. The secondary outcome measures included changes in SpO 2 and total score on the self-made respiratory symptom scale. The improvement rate, defined as a 3-day consecutive increase in SpO 2 , the duration of prone positioning, and adverse events were recorded as well. Results Among the 198 patients included in the intention-to-treat analysis, 159 (80.3%) completed all assessments on day 5, and 39 (19.7%) patients withdrew from the study. At the end of the intervention, 71 (91%) patients in the treatment group had SpO 2 above 93%, while 61 (75.3%) in the control group reached this level. The proportion of participant with improved SpO 2 was significantly greater in the intervention group (mean difference [MD] = 15.7; 95% confidence interval [CI]: 4.4, 27.1; P = 0.008). Compared to the baseline, with daily treatment there were significant daily decreases i