中药参与对SARS治疗中肾上腺糖皮质激素用量的影响  

Effect of glucocorticoid with traditional Chinese medicine in severe acute aespiratory syndrome(SARS)

作　　者：刘保延[1] 何丽云[1] 梁志伟[2] 童新元[3] 胡镜清[4] 倪青[4] 刘喜明[4] 焦强[5] 谢雁鸣[1] 李平[4] 高凡珠[1] 文天才[1] 刘为民[1] 

机构地区：[1]中国中医研究院,北京100700 [2]广东省中医院,广东广州510120 [3]解放军301医院,北京100853 [4]中国中医研究院广安门医院,北京100053 [5]中国中医研究院望京医院,北京100108

出　　处：《中国中药杂志》2005年第23期1874-1877,共4页China Journal of Chinese Materia Medica

基　　金：国家科技部"十五"863计划重大项目(2003AA208101);国家中医药管理局临床研究特别专项;北京市重大科技计划项目(H020920010031)

摘　　要：目的:通过对461例SARS患者激素使用剂量的分析,评价中医药介入对SARS治疗中激素用量的影响。方法:应用前瞻性多中心临床对照试验研究方法,在使用激素治疗的情况下,比较中西医结合组与单纯西医组住院时间和肺炎吸收时间、死亡率等重要终点指标的变化以及激素总用量、日均用量和使用时间情况。结果:研究结果表明:中西组与西医组相比,平均住院时间减少,肺炎吸收时间缩短,死亡率降低;中西医结合组激素总量中位数1 277.00 mg.d-1,西医组1 680.00 mg.d-1,中西医结合组激素日均用量中位数84.40 mg.d-1,西医组中位数115.33 mg.d-1;分型分期比较发现,早期入组的病例中西医结合组激素用量少,其中普通型患者两组比较,中西医结合组146.43 mg.d-1,西医组183.64 mg.d-1,重型患者两组比较,中西医结合组137.71 mg.d-1,西医组177.86 mg.d-1。结论:与西医组相比,中西医结合组平均住院时间减少,肺炎吸收时间缩短,死亡率降低,同时中西医结合组激素用量明显减少,而且中医药早期介入治疗能够减少激素用量。Objective： To evaluate the effects of traditional Chinese medicine in 461 eases of severe acute respiratory syndrome（SARS） on glucocorticoid＇ s dosage. Method： By using the polycentric nonrandomized concurrent controled trial and under the condition of glucocorticoid use, the patierts were divided into two groups： the integrated traditional Chinese and western mendicine（ITCWM） and simplicity western mendicine alone（WM）. The observation indexes were time in hospital, pneumonia duration, mortality, glucocorticoid＇s gross dosage, glucocorticoid＇s average dosage of days and glucocorticoid use time. Result： In the ITCWM group, average time in hospital was shortened （P = 0.058） ,pneumonia duration was shortened （P= 0.057）, mortality fell （P = - 0.001）. The median of glucocorticoid＇s gross dosage was 1 277.0 mg＇d^-1 in the ITCWM group, and that was 1 680.0 mg·d^-1 in the WM group （P= 0.083）. The median of glucocorticoid＇s average dosage of days was 84.40 mg·d^-1 in the ITCWM group , and that was 115.33 mg·d^-1 in the WM group （ P = 0.025）. According to the analysis of 461 cases divided by stages and different ponderance, within 7 days after illness, in the ITCWM group, the glucoconicoid＇ s average dosage decreased. In the common type, the dosage in the ITCWM and in the WM was 146.43 mg·d^-1, and 183.64 mg·d^-1, respectively （P =0.057）, in the severe type, that was 137.71 and 177.86 mg·d^-1, respectively （P= 0.001）. Conclusion： Compared with the group of simplicity western mendicine, in the group of integratived Chinese and western mendicine, time in hospital shorten, pneumonia duration shorten, mortality fall, simultaneity, glucocorticoid＇s average dosage is decreased. The use of TCM in the forepart of treatment can be capable of decreasing glucocorticoid＇s dosage.

关 键 词：中药 SARS 激素 

分 类 号：R285.5[医药卫生—中药学]