中医治未病理念对控制新型冠状病毒肺炎无症状感染者传播风险的应用价值探讨

目的　观察中医“治未病”理念在新型冠状病毒肺炎（文中简称新冠肺炎，COVID-19）无症状感染者隔离管控中的应用及对阻断其传播风险的应用价值。方法　本文为前瞻性研究，选取2022年8月2日至23日商丘市示范区张阁镇方舱隔离点第一隔离区域收治的93例COVID-19无症状感染者为本次研究对象。经过所有隔离人员进入方舱时候的身体状态以及心理状态分析，将隔离人员分为观察组和对照组。观察组47例，男25例，女22例，年龄（39.26±0.12）岁。对照组46例，男26例，女20例，年龄（39.41±0.32）岁。对照组仅予以临床常规隔离管控措施，观察组基于中医“治未病”理念进行隔离管控。比较两组的转阴情况、管控效果、心理状态、症状改善情况。组间比较采用χ²、t检验。结果　在不同管控模式下，两组患者均解除隔离，核酸转阴率均为100.00%，但观察组内所有患者核酸转阴时间为（18.17±0.16）d，低于对照组的（19.82±0.71）d，两组比较，差异有统计学意义（t=15.536；P<0.001）；管控期间，观察组的传播率为4.26%（2/47），恶化率为2.13%（1/47），均低于对照组的17.39%（8/46）、15.22%（7/46）；轻微症状缓解率95.74%（45/47），高于对照组的80.43%（37/46），两组比较，差异均有统计学意义（χ²=4.180、5.066、5.225，P=0.041、0.024、0.022）。干预第1天时，观察组的焦虑自评量表（SAS）评分为（32.55±0.36）分，抑郁自评量表（SDS）评分为（33.14±0.35）分，均低于对照组（34.27±0.41）分、（35.11±0.25）分]，两组比较，差异均有统计学意义（t=21.510、31.175，均P<0.001）；干预第7天时，观察组的SAS评分为（28.45±0.33）分，SDS评分为（30.16±0.25）分，均低于对照组（30.16±0.41）分、（32.25±0.33）分]，两组比较，差异均有统计学意义（t=22.180、34.474，均P<0.001）；干预第14天时，观察组的SAS评分为（25.17±0.42）分，SDS评分为（26.44±0.35）分，均低于对照组（27.62±0.41）分、（27.95±0.33）分]，两组比较，差异均有统计学意义（t=28.459、21.397，均P<0.001）。管控1 d时，观察组的症状积分为（6.12±0.35）分，低于对照组的（7.88±0.24）分（t=28.223；P<0.001）；管控7 d时，观察组的症状积分为（4.17±0.25）分，低于对照组的（5.33±0.65）分（t=11.404；P<0.001）；管控14 d时，观察组的症状积分（3.23±0.11）分，低于对照组的（4.42±0.16）分（t=41.873；P<0.001）。结论　基于中医“治未病”理念对COVID-19无症状感染进行集中隔离管控可有效加快患者康复并抑制病情传播，对避免患者轻微症状加重、改善患者心理状态、提升管控满意度均有积极意义，可保证患者顺利接受医学隔离并康复出院，具有较高应用价值。

Concept of "preventive treatment of diseases" in traditional Chinese medicine in controlling transmission risk of asymptomatic infection of COVID-19

Objective　To observe the application of the concept of "preventive treatment of diseases" in traditional Chinese medicine in the control of asymptomatic infection of COVID-19 and its application value in blocking the risk of transmission. Methods　This is a prospective study. Ninety-three asymptomatic patients with COVID-19 who were admitted to the first isolation area of the shelter isolation site in Zhangge Town, Shangqiu Demonstration Area from August 2, 2022 to August 23, 2022 were selected as the study objects. According to the analysis of their physical and cardiac status when they entered the shelter, the patients were divided into an observation group (47 cases) and a control group (46 cases). There were 25 men and 22 women in the observation group, with an age of (39.26±0.12). There were 26 men and 20 women in the control group, with an age of (39.41±0.32). The control group took routine clinical isolation and control measures. The observation group were isolated and controlled based on the concept of "preventive treatment of diseases" in traditional Chinese medicine. The negative status, control effects, psychological state, and symptom improvement were compared between these two groups. χ² and t tests were applied for the comparison between these two groups. Results　Under different control modes, all the patients in the two groups were released from isolation, and the nucleic acid negative rates both were 100.00%, but the nucleic acid negative time in the observation group was shorter than that in the control group (18.17±0.16) d vs. (19.82±0.71) d; t=15.536, P<0.001]. During the control period, the transmission rate in the observation group was lower than that in the control group 4.26 (2/47) vs. 17.39% (8/46); χ²=4.180, P=0.041], the remission rate of mild symptoms was higher than that in the control group 95.74% (45/47) vs. 80.43% (37/46); χ²=5.225, P=0.022], and the deterioration rate was lower than that in the control group 2.13% (1/47) vs. 15.22% (7/46); χ²=5.066, P=0.024]. On the first day of intervention, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group were lower than those in the control group (32.55±0.36) vs. (34.27±0.41) and (33.14±0.35) vs. (35.11±0.25)], with statistical differences (t=21.510 and 31.175, both P<0.001). On the seventh day of intervention, the scores of SAS and SDS in the observation group were lower than those in the control group (28.45±0.33) vs. (30.16±0.41) and (30.16±0.25) vs. (32.25±0.33)], with statistical differences (t=22.180 and 34.474, both P<0.001). On the 14th day of intervention, the scores of SAS and SDS in the observation group were lower than those in the control group (25.17±0.42) vs. (27.62±0.41) and (26.44±0.35) vs. (27.95±0.33)], with statistical differences (t=28.459 and 21.397, both P<0.001). On day 1, 7, and 14 of isolation, the symptom scores in the observation group were lower than those in the control group (6.12±0.35) vs. (7.88±0.24), (4.17±0.25) vs. (5.33±0.65), and (3.23±0.11) vs. (4.42±0.16); t=28.223, 11.404, and 41.873; all P<0.001]. Conclusions　Centralized isolation and control of asymptomatic infection of COVID-19 based on the concept of " preventive treatment of diseases" in traditional Chinese medicine can effectively speed up the patients’ recovery and inhibit the disease spread, and has positive significance in avoiding the patients with mild symptoms getting worse and improving their psychological states and isolation satisfaction. It can ensure the patients have medical isolation, recover, and discharge, and has high application value.