研究疾病:
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新型冠状病毒肺炎(COVID-19)
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研究疾病代码:
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Target disease:
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Novel Coronavirus Pneumonia (COVID-19)
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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选择COVID-19重症患者、在其治愈出院且不排除病原体后、且肺纤维化的研究对象,通过随机对照双盲试验,分别给予西医+中医的治疗方案和西医+中医安慰剂的治疗方案,通过比较两组疗效的差别,探索中医是否改善西医在治疗COVID-19相关的肺纤维化时的效果,形成有效改善肺纤维化的中医综合治疗新方案,为COVID-19相关的肺纤维化改善生命质量提高科学参考。
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Objectives of Study:
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Select the patients with severe disease of covid-19, who are cured and discharged without excluding pathogens, and who have pulmonary fibrosis. Through the randomized controlled double-blind test, respectively, give the western medicine + traditional Chinese medicine treatment plan and Western medicine + traditional Chinese medicine placebo treatment plan. By comparing the difference between the two groups, explore whether traditional Chinese medicine can improve the effect of Western medicine in the treatment of covid-19-related pulmonary fibrosis, and form The new comprehensive treatment plan of traditional Chinese medicine for improving pulmonary fibrosis is a scientific reference for improving the quality of life of covid-19-related pulmonary fibrosis.
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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①曾经被诊断为重型、危重症的新冠肺炎患者,且已经治好出院,不排除病原体的人,康复者。
②符合上述西医诊断标准及中医辨证分型诊断标准;
③肺功能检测指标符合以下标准肺功能指标符合一下:①用力肺活量占预计值百分比(FVC%)介于50%-90%;②一氧化碳弥散量占预计值百分比(DLCO%)介于30%-90%;③1秒内用力呼气容积占FVC百分比(FEV1/FVC)不低于80%;患者休息且呼吸室内空气时氧分压不低于50mmHg。
④肺纤维化诊断标准:X线见双肺弥漫性、不对称性、网状或网状结节状阴影, 纤维条索状阴影、条片状或点片状阴影,多发性透光区(蜂窝肺);CT见两肺下叶,特别是胸膜下网状阴影;肺功能检查示限制性通气功能障碍,肺总量、功能残气量下降,1秒钟用力肺容积/用力肺活量正常或增加,单次呼吸法一氧化碳降低;开胸或经胸腔镜肺活检被认为是诊断肺纤维化的“金标准”。
⑤ 年龄》18岁。
⑥ 签署知情同意书。
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Inclusion criteria
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1. The novel coronavirus pneumonia, once diagnosed as a severe or critical illness, has been cured and discharged without any pathogen or rehabilitation;
2. It conforms to the above diagnostic standards of Western medicine and TCM syndrome differentiation;
3. The lung function indexes meet the following standards:
(1) the percentage of forced vital capacity in predicted value (FVC%) is between 50% - 90%;
(2) the percentage of carbon monoxide diffusion capacity in predicted value (DLCO%) is between 30% - 90%;
(3) the percentage of forced expiratory volume in FVC (FEV1 / FVC) within one second is not less than 80%; the oxygen partial pressure of the patient when resting and breathing indoor air is not less than 50mmhg;
4. Diagnostic criteria of pulmonary fibrosis: X-ray showed diffuse, asymmetric, reticular or reticular nodular shadows in both lungs, Fibrous cord shadow, strip or spot shadow, multiple light transmission area (honeycomb lung); CT showed two lower lobes of lung, especially the reticular shadow under pleura; pulmonary function examination showed restrictive ventilation dysfunction, decreased total lung volume and functional residual gas volume, normal or increased forced lung volume / active lung capacity in one second, decreased carbon monoxide in one breath method; thoracotomy or transthoracic lung biopsy It is considered as the "gold standard" for the diagnosis of pulmonary fibrosis;
5. Over 18 years of age;
6. Sign informed consent.
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排除标准:
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①患有支气管扩张、肺结核、支气管哮喘、慢性阻塞性肺疾病,肺癌等其他原发性肺部疾病者;
②既往6个月呼吸困难症状进行性加重者;
③处于肺纤维化的急性加重期者;
④随机血糖水平>11.1mmol/L;
⑤患有严重心、脑、消化系统和精神疾病者;呼吸衰竭、严重消化道溃疡病、恶性肿瘤、艾滋病和自身免疫疾病等患者;
⑥有出血倾向,或严重肝肾功能不全者;
⑦既往3个月曾接受或正在使用糖皮质激素、免疫抑制剂等药物治疗肺纤维化或其他疾病者;
⑧既往3个月曾接受或正在使用具有调补肺肾、活血破瘀、消痰散结功效中药治疗肺纤维化或其他疾病者;
⑨怀孕、计划怀孕或哺乳期妇女,法律上的伤残人士,判定患者因其他疾病存在生存风险,不能完成试验期治疗;
⑩既往3个月内或正在参与其他临床试验者,过敏体质或对使用中药过敏者,不签署知情同意的患者,及无法判断疗效或资料不全等影响疗效或安全性判断者。
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Exclusion criteria:
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1. Patients with bronchiectasis, tuberculosis, asthma, chronic obstructive pulmonary disease, lung cancer and other primary lung diseases;
2. Progressive exacerbation of dyspnea symptoms in the past 6 months;
3. In the acute exacerbation stage of pulmonary fibrosis;
4. The random blood glucose level was more than 11.1mmol/l;
5. Patients with severe heart, brain, digestive system and mental diseases; patients with respiratory failure, severe peptic ulcer, malignant tumor, AIDS and autoimmune diseases;
6. Patients with bleeding tendency or severe hepatorenal insufficiency;
7. Those who have received or are using glucocorticoids, immunosuppressants and other drugs to treat pulmonary fibrosis or other diseases in the past 3 months;
8. In the past 3 months, he has received or is using traditional Chinese medicine with the functions of tonifying lung and kidney, promoting blood circulation and breaking blood stasis, eliminating phlegm and resolving stasis to treat pulmonary fibrosis or other diseases;
9. Pregnant, planned pregnant or lactating women, legally disabled persons, determine that the patients have survival risks due to other diseases and cannot complete the trial treatment;
10. In the past 3 months or in other clinical trials, those who are allergic to constitution or who are allergic to the use of traditional Chinese medicine, those who do not sign the informed consent, and those who are unable to judge the curative effect or incomplete information, which affect the judgment of curative effect or safety.
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研究实施时间:
Study execute time:
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从From
2020-06-01
至To
2025-05-31
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征募观察对象时间:
Recruiting time:
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从From
2020-06-01
至To
2025-05-31
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