71例SARS患者中医药介入治疗的临床研究

Clinical investigation of traditional Chinese medicine in treatment of 71 patients with severe acute respiratory syndrome

目的 :研究严重急性呼吸综合征 (SARS)中医药介入治疗效果。方法 :回顾分析 2 0 0 2年 12月 2 2日—2 0 0 3年 5月 30日入院的 71例 SARS患者中医药介入治疗结果 ,其中中医药介入全程治疗 36例 ,后期康复治疗 35例。根据病变及病程 ,将 SARS分为 3期按中药辨证方、中药针剂、中成药配合西医治疗。1发热期治法为清肺解毒 ,凉血行气 ,透邪外达 ;方用抗炎 号方、鱼腥草注射液、穿琥宁注射液、天龙茶袋泡剂 (我院制剂 )。 2喘憋期治法为清热平喘 ,透营败毒 ,宣通疫浊 ;方用抗炎 号方、参附注射液、参麦注射液、莪术油注射液。 3恢复期治法为清化余毒 ,益气养阴 ,调补肺脾 ;方用抗炎 号方、参麦注射液、黄芪注射液、天龙喘咳灵胶囊 (我院制剂 )。结果 :71例 SARS患者住院天数 9～ 78d,平均 (2 7.1± 14 .4 ) d;临床治愈 70例 ,治愈率为 98.6 % ;死亡1例 ,病死率 1.4 %。所有患者发病初期均发热 ,入院前发热天数 (6 .3± 5 .5 ) d,体温 37.3～ 4 0 .5℃ ,其中 39℃以上者 78.5 % ,入院退热天数 1～ 15 d,平均 (5 .7± 3.4 ) d。结论 :中西医结合治疗组患者临床症状严重程度改善显著 ,且时间较早 ,重症患者病死率低。应强化对患者个体化辨证治疗 ,早用清气清营之品 ,解热为先。

Objective: To observe the therapeutic efficacy of traditional Chinese medicine(TCM) in treatment of severe acute respiratory syndrome(SARS). Methods: The therapeutic efficacy of TCM in treatment of 71 patients with SARS from December 22, 2002 to May 30, 2003 were reviewed. The therapy was divided into three periods according to the pathological changes and course of diseases. ①Fever period: the means of cure were clearing away lung-heat and removing toxic agents (), cooling the blood and activating Qi (), leting out the evil factors and reaching the exterior (). The medicines were Kangyan I recipe(), Yuxingcao injection(), Chuanhuning injection(), Tianlong tea(). ②Losing one's breath period: the means of cure were clearing away heat and relieving asthma (), eliminating the heat of Ying system and counteracting toxin , clearing epidemic disease and turbid . The medicines were Kangyan Ⅱ recipe, Shenfu injection, Shenmai injection, Eshuyou injection. ③Convalescence: the means of cure were clearing away the remaining poisonous substances , replenishing Qi and nourishing Yin , regulating and nourishing the lung and spleen . The medicines were Kangyan Ⅲ recipe, Shenmai injection, astragalus injection, Tianlong Chuankeling capsule . Results: The days of hospitalization for 71 patients of SARS were 9-78 days 〔mean (27 1±14 4)days〕 and the patients of clinical cure were 70 (the heal rate was 98 6 percent). One patient died, the mortality was 1 4 percent. All patients were fever in the early stage, and the days of fever were (6 3±5 5)days before being in hospital. The temperature was 37 3-40 5 ℃ and most patients' temperature was over 39 ℃, the average days of fever reduce through medicine was (5 7±3 4)days (ranged 1-15 days). Conclusion: Integrated TCM and western medicine therapy could improve the clinical symptoms and reduce the mortality of severe patients. It is very important to use the clearing Qi and heat in the Ying system medicine expecially reducing fever in the early stage.