評論
打印
It was a randomized trial of 67 patients with pulmonary tuberculosis
它是67名肺結核患者的隨機試驗
All of whom received standard therapy
所有人都接受標準療法
And by standard therapy, I mean they got the best antibiotic regimen that was known to be appropriate under the circumstances
所謂標準療法，我是說該情況下公認的最好抗生素療法
but in addition they were randomized to either vitamin D 10,000 IU/day or a matching placebo
除此之外，隨機選部分患者每天服用1萬IU/天的維生素D或類似的安慰劑
and they use sputum conversion that is the absence of the infectious organism in sputum at the end of treatment under the circumstances
他們使用痰轉陰率——也就是治療后痰內無病菌的比率
That's a standard way to respond
這是標準的做法
The placebo treated people got a 77% sputum conversion rate
安慰劑服用者是77%的痰轉陰率
which is what my infectious disease colleagues tell me what to expect with TB today with contemporary therapy
我傳染病方面的同事說這是當今肺結核病治療的標準結果
Vitamin D supplemented individuals had no treatment failures
維生素D服用者則沒有治療失敗
Now this is level one evidence
這是一級證據
So it's a randomized controlled trial, double-blind placebo-controlled
隨機對照試驗，雙盲安慰劑對照
This is not to suggest for a moment that tuberculosis is caused by vitamin D deficiency
這說明維生素D在肺結核病治療中的重要意義
It's just that when you get the disease
患病的時候
your body should be trying to fight it
身體會同疾病抗爭
And if you don't give enough vitamin D, it can't do it
如果不提供足夠維生素D，身體就辦不到
You can't rely totally on the pharmacotherapy under the circumstances
不能完全依賴藥物療法
So a take-home message that I tried to give to all my students is that whatever your patient has, whatever disease you're treating
我總讓所有學生都記住的關鍵信息是：不管什么患者，不管治療什么病
the body is trying to overcome it and your job is to help it do that
身體都要斗爭，而你需要幫助身體
You can do that with pharmacotherapy
藥物治療是一方面
In many cases, it's absolutely necessary but you'll do a better job if you repair the vitamin D deficiency
很多時候，這很有必要，不過你還需要修復維生素D的缺乏
