中西医结合治疗耐药性肺结核的疗效观察
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摘要
目的探讨中西医结合治疗耐药性肺结核的疗效。方法选择2016年1月～2017年1月我院收治的治疗前痰涂片、抗酸染色或培养阳性、耐药的复治肺结核病患者64例,分为观察组与对照组,各32例。对照组予3HREZ(S)/6HRE,或根据药敏试验结果调整用药方案,同时适量给予保肝辅助治疗。观察组同时加用养阴润肺汤,每天1剂,水煎,早晚各服1次。两组均治疗1个月。治疗后对两组的疗效及治疗前后的各项免疫功能指标进行比较。结果治疗后,观察组患者治疗后的临床疗效明显优于对照组,组间差异具有统计学意义(χ~2=5.738,P<0.05)。治疗后,观察组的CD3~+、CD4~+及CD~4+/CD8~+水平显著高于对照组,CD8~+水平显著低于对照组,组间比较差异有统计学意义(P<0.05)。结论中西医结合治疗耐药性肺结核可以明显提高临床疗效,改善患者的免疫功能,值得广泛推广和应用。
Objective To investigate the effectiveness of treatment combining traditional Chinese medicine and western medicine on drug-resistance tuberculosis. Methods 64 patients with tuberculosis who were retreated because of positive results of sputum smear before treatment, acid-fast strain or culture in our hospital from January 2016 to January2017 were selected and divided into observation group and control group with 32 patients in each. Patients in control group were treated with 3 HREZ(S)/6 HRE, or medication regimen adjusted according to the results of drug sensitivity test, and moderate adjuvant therapy protecting liver. Patients in observation group were treated with additional Yangyinrunfei decoction, one potion per day, boiled with water, once in the morning and evening. Treatments in two groups lasted one month. Effectiveness after treatments in two groups and indicators of immunologic function before and after treatment were compared. Results After treatment, the clinical effectiveness in observation group was significantly better than control group(χ~2=5.738, P<0.05). After treatment, the levels of CD3~+, CD4~+and CD4~+/CD8~+in observation group were significantly higher while the level of CD8+was significantly lower than control group(P<0.05). Conclusion Combined treatment of traditional Chinese medicine and western medicine on drug-resistance tuberculosis could improve the clinical effectiveness significantly. It could improve the immunologic function of patients and it is worth promotion and application.
Objective To investigate the effectiveness of treatment combining traditional Chinese medicine and western medicine on drug-resistance tuberculosis. Methods 64 patients with tuberculosis who were retreated because of positive results of sputum smear before treatment, acid-fast strain or culture in our hospital from January 2016 to January2017 were selected and divided into observation group and control group with 32 patients in each. Patients in control group were treated with 3 HREZ(S)/6 HRE, or medication regimen adjusted according to the results of drug sensitivity test, and moderate adjuvant therapy protecting liver. Patients in observation group were treated with additional Yangyinrunfei decoction, one potion per day, boiled with water, once in the morning and evening. Treatments in two groups lasted one month. Effectiveness after treatments in two groups and indicators of immunologic function before and after treatment were compared. Results After treatment, the clinical effectiveness in observation group was significantly better than control group(χ~2=5.738, P<0.05). After treatment, the levels of CD3~+, CD4~+and CD4~+/CD8~+in observation group were significantly higher while the level of CD8+was significantly lower than control group(P<0.05). Conclusion Combined treatment of traditional Chinese medicine and western medicine on drug-resistance tuberculosis could improve the clinical effectiveness significantly. It could improve the immunologic function of patients and it is worth promotion and application.
引文
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[18]王小华.中西医联合用药治疗耐药肺结核39例[J].中国中医药现代远程教育,2013,11(24):58-59.
[19]郑丽华.中西医结合治疗耐多药肺结核的疗效观察[J].中国医药科学,2015,5(12):43-44.
[20]欧阳成林.中西医结合治疗耐多药肺结核疗效观察[J].亚太传统医药,2013,9(12):107-108.
[21]何瑛.中西医结合治疗耐药性肺结核48例疗效观察[J].中国当代医药,2013,20(9):127-128.
[22]陈定锋.中西医结合治疗复治耐药性肺结核近期疗效观察[J].中国热带医学,2012,12(8):965-966.
[2]胡莉莉.中西医结合治疗肺结核的临床观察[J].中国冶金工业医学杂志,2017,34(2):200-201.
[3]周玲霞,黄金鹏,楼敏.中西医联合治疗耐多药肺结核病的临床疗效观察[J].中华中医药学刊,2013,31(4):942-943.
[4]刘林刚,李爱民.黄芪注射液辅治复治肺结核疗效观察[J].临床合理用药杂志,2012,5(1):65-66.
[5]刘树梅.中医治疗肺结核病临床观察[J].光明中医,2010,25(8):1391-1392.
[6]郑莉,孙昕,刘恩顺.中医药辅助治疗肺结核的临床研究现状[J].医学综述,2013,19(12):2199-2200.
[7]张志娟,周玉文.中西医结合治疗耐药性肺结核病的临床观察[J].临床肺科杂志,2011,16(10):1546-1547.
[8]肖洁,田华,张怡瑞.中药治疗耐多药肺结核研究进展[J].中国感染控制杂志,2012,11(2):158-160.
[9]王书明.中西医结合治疗肺结核36例[J].中国中医药现代远程教育,2014,12(4):54-55.
[10]刘忠达,张尊敬,李权,等.中西医结合治疗肺结核临床研究[J].中华中医药学刊,2013,31(4):758-760.
[11]殷爱华.中西医结合治疗肺结核病临床疗效观察[J].湖北中医杂志,2013,35(12):10-11.
[12]范立东,魏建林.中药结核丸治疗初治菌阳肺结核疗效观察[J].河北医药,2013,35(3):461-462.
[13]郭菊,杜先智.耐多药结核病的治疗进展[J].国际检验医学杂志,2015,3(3):375-376.
[14]弓显凤,张熙祎,张锦博,等.中医辨证配合化疗治疗肺结核54例[J].陕西中医,2012,33(2):183-184.
[15]苏宏正.中西医结合治疗对耐药性肺结核病患者的临床研究[J].辽宁中医药大学学报,2015,17(11):190-191.
[16]刘嵋松,孙良梅,王胜圣,等.中西医结合疗法治疗初治继发性肺结核病的临床疗效及安全性评价[J].中国中医药信息杂志,2013,20(9):6-9.
[17]陈定锋.中西医结合治疗复治耐药性肺结核近期疗效观察[J].中国热带医学,2012,12(8):965-966.
[18]王小华.中西医联合用药治疗耐药肺结核39例[J].中国中医药现代远程教育,2013,11(24):58-59.
[19]郑丽华.中西医结合治疗耐多药肺结核的疗效观察[J].中国医药科学,2015,5(12):43-44.
[20]欧阳成林.中西医结合治疗耐多药肺结核疗效观察[J].亚太传统医药,2013,9(12):107-108.
[21]何瑛.中西医结合治疗耐药性肺结核48例疗效观察[J].中国当代医药,2013,20(9):127-128.
[22]陈定锋.中西医结合治疗复治耐药性肺结核近期疗效观察[J].中国热带医学,2012,12(8):965-966.