中西医结合早期干预对SARS肺部炎症的影响

目的]以X线胸片为主要观察指标,对中西医结合治疗SARS的临床疗效进行客观评价,为SARS临床筛选有效的干预方案提出科学依据。方法]采用多中心前瞻性队列研究的方法,通过对参加国家863重大项目“中医结合治疗SARS临床研究”的北京地区11家医院361例确诊SARS患者的1561张X线胸片的研究,阐明中西医结合治疗对SARS肺部炎症的影响。结果]从总体疗效来看,X线胸片总积分西医组平均为5.85±6.5。中西医结合组为6.67±7.61;普通型西医组为4.79±5.6。中西医结合组为5.40±6.86;重型西医组为7.67±6.34,中西医结合组为8.16±7.60,以上两组间比较均未见显著性差异 (P>0.05)。但发病7d内开始干预的胸片总积分西医组平均为6.39±6.48、中西医结合组为4.40±4.97,中西医结合组X线胸片总积分明显低于西医组 (P=0.0004);普通型西医组为4.59±5.22、中西医结合组为3.99±4.67,两组间比较未见显著性差异 (P=0.12);重型西医组为9.14±7.24、中西医结合组为5.30±5.48,组胸片总积分明显低于西医组(P=0.034);说 明发病7 d内对SARS患者进行中西医结合治疗,肺部炎症的吸收明显优于西医组,总体疗效与重型患者的疗效均具有统计学意义。结论]中西医结合早期干预对SARS肺部炎症吸收的临床疗效具有明显的优势。

Effect of early intervention with integrated Chinese and Western Medicine on pulmonary inflammation in SARS

Objective] The study provided a scientific evidence for choosing a effective intervention in Severe acute respiratory syndrome(SARS).X-ray chest photograph was used for a main sign to evaluate the effect of TCM(Traditional Chinese medicine)integrating with western medicine in treating SARS.Methods] 1561chest films of361SARS patients,who came from11hospitals in Beijing,were summarized and analyzed to clarify the effect of TCM integrating with western medicine in treating pneumonia of SARS by multi-center prospective cohort study method.The chest x-rays sum integral(CSI)is introduced to evaluate the inflammation severity of the different areas of the lung,the severe type,the common type and the mild type.All patients were dispersed into two groups,the group of western medicine treating SARS and the group of TCM integrating with western medicine treating SARS.This program was supported by the national Key grant,the clinical research of TCM integrating with western medicine treating SARS.Results] Generally,in full period of treatment and in all types of lung inflammation,the chest x-rays sum integral in the group of western medicine was5.85±6.5(mean±SD)and 6.67±7.61(mean±SD)in the group of TCM integrating with western medicine,respectively.With the common type in the group of western medicine it was4.79±5.6in the group of TCM integrating with west medicine and was5.40±6.86;with the severe type in the group of western medicine it was7.67±6.34in the group of TCM integrating with western medicine was8.16±7.60.No statistic significance was found between all above two groups(P>0.05).In patients received treatment during the first7days,the chest x-rays sum integral in the group of western medicine was6.39±6.48and in the group of TCM integrating with western medicine was4.40±4.97.It was significant lower in the group of TCM integrating with western medicine than that in the group of west medicine(P=0.0004).With the common type,in the group of western medicine it was4.59±5.22and in the group of TCM integrating with western medicine it was3.99±4.67.No significance was found between these two groups(P=0.12);with the severe type in the group of western medicine it was9.14±7.24and in the group of TCM integrating with western medicine was5.30±5.48,It was significantly lower in the group of TCM integrating with western medicine than that in the group of western medicine(P=0.034).It was indicated that in patiects received treatment during the first7days the absorption of pneumonia in all patients and in the severe type was faster in the group of TCM integrating with western medicine than in the group of western medicine.Conclusion] In the early period of SARS(in the first7days)TCM integrating with western medicine can accelerate the absorption of pneumonia,and has an apparent predominance than western medicine.