中西医结合疗法对SARS患者肝、肾功能影响的观察

Observation on changes of hepatic and renal functions in patients with SARS after treatment with integrative traditional Chinese and western medicine

目的探讨中西医结合疗法治疗SARS的有效性与安全性。方法将我院47例SARS确诊患者随机分入中西医结合组与西医组,疗程3周,分别于治疗前及治疗后每周查血清肝功能指标ALT、AST、TBIL及肾功能指标CRE、BUN。结果所有患者均出现肝功能异常,结合组和西医组治疗前肝功能异常总例数分别为23例和21例,治疗后分别为13例和20例(P<0.01),其中尤以ALT显著。结合组和西医组治疗前ALT异常总例数分别为20例和8例,治疗后分别为13例和19例;结合组第7天ALT达最高值为81.54±49.25U/L,治疗后为46.92±29.20U/L(P<0.05);西医组治疗前为53.96±48.59U/L,治疗后达80.80±56.26U/L(P<0.05)。2组AST治疗前异常例数分别为9例和6例,治疗后分别为1例和3例。部分患者出现了肾功能异常,结合组15例,西医组10例,治疗后仍各有6例与4例(P>0.05)。结论 SARS患者在疾病发生、发展过程中存在肝、肾功能异常,尤以ALT显著。采用中西医结合疗法在减轻肝脏损害、促进肾功能好转、保护肾功能、加速患者病情恢复方面是有效的,中医药在治疗SARS的过程中是安全的。

To investigate the effectiveness and safety of the therapeutic strategy of integrative tradi- tional Chinese and western medicine (ICWM) in patients with SARS. Methods A total of 47 patients were randomized into the control group treated by western medicine alone and the test group treated by ICWM. The patients in the test group took traditional Chinese medicine for 3 weeks based on their conditions. The plasma levels of ALT, KST, TBIL, CRE and BUN were determined in all the 47 patients. Results Abnormal hepatic function was found in all the 47 pa- tients. After the treatments, the number of patients with abnormal hepatic function decreased from 23 to 13 in the test group and from 21 to 20 in the control group (P<0.01 ). The changes mainly exhibited as notable elevation of ALT. The number of patients with abnormal ALT decreased from 20 to 13 in the test group and increased from 8 to 19 in the control after the treatments. The number of patients with abnormal AST decreased from 9 to 1 in the test group and from 6 to 3 in the control group. The value of plasma ALT level decreased from 81.54 ± 49.25 U/L to 46.92± 29.20 U/L ( P < 0.05) in the test group but increased from 53.96± 48.59 U/L to 80.80 ± 56.26 U/L ( P < 0.05) in the control group. The number of patients with abnormal renal function decreased from 15 to 6 in the test group and from 10 to 4 in the control group (P>0. 05). Conclusions There are abnormal hepatic and renal functions in patients with SARS that mainly exhibit as notable elevation of ALT. The therapeutic strategy of ICWM is effective and safe for relieving hepatic damage, improving hepatic function and protecting renal function in patients with SARS to accelerate comprehensive reha- bilitation of the patients.