穿心莲内酯类制剂抗新型冠状病毒肺炎的相关理论依据和作用特点

2019年12月以来,新型冠状病毒肺炎(COVID-19)在中国迅速蔓延。中华人民共和国国家卫生健康委员会及各地相关部门陆续发布多个针对COVID-19的诊疗方案。部分方案推荐喜炎平注射液用于COVID-19的临床治疗。该药的有效成分为穿心莲内酯总磺化物,为穿心莲内酯的衍生物。其具有清热解毒、抗菌消炎等功能,对包括病毒性肺炎、上呼吸道感染在内的呼吸系统疾病疗效确切,且积累了大量临床数据。穿心莲内酯在COVID-19治疗中具有潜在的抗病毒作用,且能降低患者炎症水平,改善呼吸道症状,抑制并发细菌感染,提升机体免疫力。同时亦不会带来激素类药物的免疫抑制作用,不良反应发生率低。除此之外,穿心莲内酯有一定的保肝作用和治疗心血管疾病的临床使用经验,提示其可能会对由COVID-19引发的肝损伤、心脏损伤以及药物性肝损伤有一定的保护作用,但还有待临床进一步验证。对穿心莲内酯的药理作用和临床应用进行总结梳理,从中医角度分析COVID-19的病因病机和辨证治法,为穿心莲内酯用于COVID-19的治疗提供理论基础。

Theoretical basis and effect characteristics of andrographolide against COVID-19

Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly in China. National Health Commission of the People''s Republic of China and local departments have released a number of diagnosis and treatment plans for COVID-19. Some plans recommend Xiyanping Injection for the clinical treatment of COVID-19. The active component of the drug is the total sulfonate of andrographolide, which is a derivative of andrographolide. This paper summarized the pharmacological action and clinical application of andrographolide, and proposed that it has the functions of clearing heat and detoxification, anti-bacterial and anti-inflammatory, and definite therapeutic effect on respiratory system diseases including viral pneumonia and upper respiratory tract infection, and a large number of clinical data have been accumulated. Andrographolide has a potential antiviral effect on the treatment of COVID-19, and can reduce the level of inflammation in patients, improve respiratory symptoms, inhibit concurrent bacterial infection, and improve the body immunity. At the same time, it will not bring the immunosuppressive effect of hormone drugs, and the incidence of adverse reactions is low. In addition, Andrographolide has certain hepatoprotective effects and clinical value for treating cardiovascular diseases in clinical experience, suggesting that it may have some protective effects on drug-induced liver injury, heart injury and liver injury caused by durgs against COVID-19, but further clinical verification is needed. The pharmacological action and clinical application of andrographolide are summarized. This paper also analyzes the etiology, pathogenesis and dialectical treatment of COVID-19 from the perspective of traditional Chinese medicine, and points out that the treatment of COVID-19 with andrographolide is consistent with the theory of traditional Chinese medicine.