Study on traditional Chinese medical diagnosis and treatment based on differentiation of syndromes and signs in 30 severe acute respiratory syndrome patients

Objective:To investigate the traditional Chinese medical features of the different symptomatic types of severe acute respiratory syndrome(SARS) and assess the effects of integrated traditional Chinese and western medicine. Methods: According to the different symptomatic types of 30 SARS patients in Dongzhimen Hospital from April 19 to May 1, 2003, they were treated by traditional Chinese medicine herbs based on general treatment including steroid, antivirus medicine, mechanical ventilation, symptomatic messure and so on. Results:At initial stage 30 cases all had Qifen(气分) syndrome such as high fever. They seldom had light fever as Weifen(卫分) syndrome. Four cases of them suffered diarrea. As traditional Chinese medicine theory SARS patients had three stages: heatevil at Qifen, flaming of heatevil at Qifen and Yingfen(营分), heatevil at Xuefen(血分). Patients of Qifen type were treated with clearing away the heatevil at Qifen, releasing inhabited lungenergy and dissipating phlegm, clearing away heat and toxic materials. The Chinese medicine prescriptions were Wuhu decoction(五虎汤) and Tingli Dazao Xiefei decoction(葶苈大枣泻肺汤). Patients of QiYingfen(气营分) type were treated with clearing away the heatevil and phlegm located at QiYingfen. The Chinese medicine prescriptions were Qingwen Baidu drink(清瘟败毒饮) and Mengshi Guntan decoction(礞石滚痰汤). Patients of Xuefen type were treated with cooling blood and clearing away the heatevil, phlegm in the pericardium and waking up the patients from unconsciousness. The Chinese medicine prescriptions were Xijiao Dihuang decoction(犀角地黄汤) and Taohong Siwu decoction (桃红四物汤) . Salvia miltiorrhiza injection(丹参注射液) were used in YingXuefen syndrome. Shengmai injection(生脉注射液) were used in shortage of energy and blood. They were very effective. Up to May 1 among 30 SARS patients, 3 cases recoverd and discharged, 4 cases were dead, the others were transferred to the special hospital, they felt much better. Severe patients had weaning from mechanical ventilation, and the changes in clest Xray radiogram were improved. Conclusion: According to traditional Chinese medicine theory , SARS belongs to seasonal febrile disease. Its development follows Wei, Qi, Ying, Xue(卫气营血) regulation . The symptom of SARS patients can be obviously improved by the treatment of integrated traditional Chinese and western medicine. The method of activating blood circulation to dissipate blood stasis can be used at every stage.