Background:An outbreak of influenza A (H1N1) occurred in Mexico in late March 2009 and later spread globally. The main symptoms of influenza A (H1N1) are similar to those of other influenzas, but in some severe cases, deterioration is rapid, with some patients progressing to bacterial pneumonia, respiratory failure, multiple organ failure and even death.Objective:To carry out clinical research on mild cases in high risk group and severely infected cases of pandemic influenza A (H1N1); to summarize the high risk factors and clinical characteristics; to evaluate the clinical efficacy of TCM (traditional Chinese Medicine) treatment; to certify that the incidence of critically ill cases can be reduced by the integrated Chinese and western medicine; to provide scientific basis for the effect of TCM treatment on influenza A (H1N1).Methods:Both the prospective, randomized, multi-centric methods and the practical, stratified randomized, photographic study methods are used in this study. A total of 122 confirmed influenza A (H1N1) patients hospitalized in Shanghai Public Health Clinical Centre, China-Japan Friendship Hospital, Shanxi Hospital of Integrated Traditional and Western Medicine and 14 other hospitals between Sept2009 to Feb2010 were selected to evaluate the efficacy of TCM in the interventional treatment.Results:Of these 122 patients,18 were mild cases in high-risk group (male 44%,female 56%), age ranged from 2-87, average age (29.06±20.19), among them, there were 10 cases of middle aged<19-44years old > (55.6%), associated with 8 cases of chronic diseases,6 pregnancy cases, 10 overweight cases (BMI> 24). The main clinical manifestations were fever (94.4%), cough (72.2%), nasal conges t ion & runny nose (55.6%), headache (55.6%) and sore throat (55.6%). The results showed the time differences of influenza A H1N1 virus nucleic acid negative conversion between these two groups (P=0.026). The other 104 severe cases ranged in age from7-82 years old, with the average of (40.94±15.31). Among them there were 47 youth cases (18-40years old) (55.6%) and 46 cases of middle ages (41-64years old). These were associated with 53 cases of chronic diseases,3 pregnancy cases,45 overweight cases (BMI≥24). The main clinical manifestations were cough (95.2%), expectoration (76.0%), fever (75.0%), wheezing & shortness of breath (51.0%), fatigue (45.2% and), and bloody sputum (19.2%). The results showed there is no time differences of influenza A (H1N1) virus nucleic acid negative conversion between these two groups(P=0.308).Compared with the western medicine treatment group, the duration of symptoms such as cough, expectoration, wheezing, shortness of breath, and bloody sputum are shorter, and the incidence of severely ill cases is lower as well in the integrated Chinese & western medicine treatment group.Conclusion:Flu-like symptoms can be found in influenza A (H1N1) clinical manifestations. The early intervention of TCM can relieve cough, expectoration, wheezing, shortness of breath, bloody sputum etc, and reduce the incidence of critical illness as well. |