新冠肺炎治疗新手段:静注高剂量维C、肠道菌群移植均在临床试验之列

2020-02-15 Walter 转化医学网

近日,各地纷纷启用血浆疗法,利用肺炎康复者的抗体抵御新冠病毒。除此之外,许多治疗手段正在紧锣密鼓地测试当中。

导读:武汉封城20多天以来,全国的新冠肺炎的传播得到了有效控制,但湖北省境内,疫情势头正劲,目前确诊突破50000人。面对如此庞大的感染基数,有效治疗,成为了首须攻克的难关。近日,各地纷纷启用血浆疗法,利用肺炎康复者的抗体抵御新冠病毒。除此之外,许多治疗手段正在紧锣密鼓地测试当中。

美国临床试验数据库ClinicalTrials.gov是WHO认证的首批一级临床试验注册机构,由美国国立医学图书馆(NML)与美国食品与药物管理局(FDA)于1997年开发。目前,在ClinicalTrials网站上共有25项2019-nCoV相关的药物、治疗方法和检测手段正在进行临床试验申报,为新冠肺炎的治疗提供希望。
 


这些临床试验主要分为以下几类:1. 瑞德西韦、奥司他韦、洛匹那韦等抗病毒药的单用及合用;2. PD-1抗体和免疫球蛋白γ等增强免疫系统功能试验;3. 激素辅助治疗;4. 重组酶辅助扩增(RAA)和聚合酶链式反应(PCR)等病毒临床诊断的方法。其中也不乏跳出常规的临床治疗手段。



武汉大学中南医院:静注高剂量维C或可抗击肺炎?

前期研究表明,维生素C能有效减少败血症激活的细胞因子,减少肺中的中性粒细胞的蓄积,减轻肺泡毛细血管的损伤。此外,维生素C能阻止嗜中性粒细胞的活化,减少肺泡上皮水通道的破坏并帮助消除肺泡液。国外曾有用大剂量维生素C治疗急性呼吸窘迫综合征等肺损伤病人的先例。

武汉大学中南医院的彭志勇教授团队,正在试验大剂量维生素C(24g/天,共7天)对新冠肺炎的治疗效果,通过注射泵对病人进行缓慢的静脉注射,以减小对血管的刺激性。由于服用维生素C确实可以使感冒持续时间缩短,彭志勇教授认为可以尝试使用维生素C预防新冠肺炎,但临床试验正在进行当中,尚未有数据支持。



南京医科大学二院:肠道菌群移植发挥抗病毒作用?

动物实验证明,抗生素将削弱肠道菌群和肺基质干扰素的信号,并促进流感病毒在肺上皮细胞中的早期复制。然而,这种负面影响能通过粪便微生物菌群移植(FMT)来逆转,显著改善呼吸道感染的症状。此外,微生物群能引发对病毒逃逸的免疫反应,特别对病毒感染(例如流感病毒和呼吸道合胞病毒)的患者机体提供保护。

新冠肺炎患者常并发肠道营养不良,有时发展为继发性细菌感染和抗生素相关性腹泻。最近菌群移植作为腹泻危重患者的抢救疗法的研究,表明其具有重要的临床益处和安全性。南京二院的这项临床试验,旨在评估新冠肺炎患者的肠道菌群移植与标准疗法相结合的效果,观察是否能改善患有营养不良等并发症的患者状况。

科研团队对新冠肺炎提出了全方位的治疗策略和诊断手段,目前正在积极试验当中。虽然以上假设均未经证实,我们应乐观、理性、辩证地看待这些治疗方法,相信经过实战的考验,其中必将出现新冠肺炎的解药和曙光,让我们拭目以待!

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    2020-02-15 amy0550
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    2020-03-01 dangious
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    2020-02-15 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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