中西医结合治疗SARS对T淋巴细胞亚群的影响

目的 探讨中西医结合治疗对SARS患者的外周血T淋巴细胞亚群与病情的疗效。方法 对2003年4-5月住北京地坛医院的133例确诊的SARS患者，按治疗方法分为3组进行比较，基本治疗组、加小量激素组、加大量激素组，对上述3组又分为加用中药和未用中药，共6组。其中中药治疗按辨证论治，给予清热化湿、解毒化瘀、益气养阴的中药。对上述6组患者的外周血T淋巴细胞亚群治疗前后的变化进行回顾性统计学显著性检验。结果所有病例的CD3^+、CD4^+、CDR8^+T淋巴细胞计数治疗前明显下降，治疗3周后T淋巴细胞亚群较治疗前显著上升，小量激素组CD3^+、CD4^+、CD8^+上升治疗前后差值显著高于未用激素组。所有服中药患者的CD3^+、CD4^+、CD8^+上升幅度均明显大于未服中药者。结论 激素和中药治疗可加速T淋巴细胞水平的恢复，合理应用糖皮质激素及中药是有效的治疗方法。

Effect of Integrative Chinese and Western Medicine on T-Lymphocyte Subsets in Treating Patients with Severe Acute Respiratory Syndrome

ObjectiveTo investigate the therapeutic effect of integrative Chinese and western medicine (ICWM) in treating severe acute respiratory syndrome (SARS) and its influence on T lymphocyte subsets. MethodsComparative study was conducted in 133 SARS inpatients in Beijing Ditan Hospital, who were divided into 3 groups according to the treatment applied, the basic treated group, the low dose steroid group and the high dose steroid group, and all the 3 groups were subdivided into two groups, Chinese herbs and non Chinese herbs added, respectively. Chinese drugs for clearing up heat, dispelling dampness, detoxication, removing stasis, supplementing Qi and nourishing Yin were selected according to patients' syndrome and given additionally to all the three ICWM groups. Retrospective analysis for significance test on changes of T lymphocyte subsets before and after treatment were carried out. ResultsT lymphocyte counts, including CD 3 , CD 4 , CD 8 , lowered in all patients before treatment, but increased significantly after treated for 3 weeks, the increment in all the low dose steroid treated groups was higher than that in the basic treated groups, and that in ICWM groups was higher than that in non ICWM groups, respectively. ConclusionGlycocorticosteroid and Chinese herbal medicine treatments could promote the recovery of T lymphocyte profile, rationally use of them is the effective therapeutic method.