关于中医,我说说我的观点

  • Corticosteroids were commonly prescribed to SARS patients with worsening pulmonary disease or progressing abnormalities on chest X-rays. Treatment regimens varied widely but can be classified into two groups, early treatment and rescue treatment given at a later stage of illness. It is difficult to make a clear recommendation about whether corticosteroids should be used to treat SARS-associated lung injury in any stage of illness, particularly as the drug is immunosuppressive and may delay viral clearance if given before viral replication is controlled [21]. Of added concern are infectious complications, avascular necrosis, and steroid-induced psychosis—recognized adverse effects of corticosteroid use. Fungal superinfection and aspergillosis have been noted in case reports and autopsy findings of SARS patients given corticosteroids at high doses or for prolonged periods [32,33]. This review has found evidence of avascular necrosis and steroid-induced psychosis in SARS patients
    皮质类固醇通常用于肺部疾病恶化或胸部x光检查出现进展异常的非典患者。治疗方案差异很大,但可以分为两组,早期治疗和疾病后期的抢救治疗。很难就皮质类固醇是否应用于治疗任何疾病阶段的非典相关肺损伤做出明确的建议,特别是因为该药物具有免疫抑制作用,如果在病毒复制得到控制之前使用,可能会延迟病毒清除[21]。更令人担忧的是感染性并发症、缺血性坏死和类固醇诱导的精神病——使用皮质类固醇的公认副作用。在病例报告和尸体解剖发现中,已经注意到给予高剂量皮质类固醇或长期给予皮质类固醇的非典患者出现真菌双重感染和曲霉病,[32,33]。这篇综述发现了非典型肺炎患者出现缺血性坏死和类固醇诱导性精神病的证据。
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    皮质类固醇激素的评价要贴全啊,把不利的部分截掉,断章取义可不好。
    给部分SARS幸存者造成严重后遗症的就是糖皮质激素,不但对SARS疗效存疑,反而有害。

回复1

  • WHO的专家关于激素类药物的结论很清楚,即:“很难就是否应该在任何疾病阶段使用激素类药物治疗SARS相关的肺损伤提出明确的建议。”后面说的就是他无法给出明确建议的理由。因为在病例中,发现了激素类药物的一些不良反应。要都是正面消息或者负面消息,他干嘛这么纠结于不敢给出明确建议。
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