芪甲利肺胶囊辅助治疗复治肺结核合并2型糖尿病的疗效及T淋巴细胞亚群的变化

发布时间：2018-10-12 21:28

【摘要】：目的探讨芪甲利肺胶囊辅助治疗复治肺结核合并2型糖尿病患者的疗效及T淋巴细胞亚群的变化。方法将280例经细菌学确诊的复治肺结核合并2型糖尿病患者按入院先后顺序随机分为观察组和对照组,每组140例。2组患者均应用3HRZES/9HRE(H:异烟肼,R:利福平,Z:吡嗪酰胺,E:乙胺丁醇,S:链霉素)方案抗结核治疗,观察组患者在此基础上加用芪甲利肺胶囊辅助治疗,每次3粒,口服,每日3次,疗程8个月。比较2组患者痰菌转阴情况、病灶及空洞变化情况、中医证候疗效及细胞免疫功能的差异。结果观察组患者强化期治疗结束时和疗程结束时痰菌阴转率分别为73.72%(101/137)、91.24%(125/137),对照组患者分别为57.97%(80/138)、80.43%(111/138),观察组患者强化期治疗结束时和疗程结束时痰菌阴转率均高于对照组(P0.05)。观察组患者强化期结束时和疗程结束时病灶吸收的显效率分别为68.62%(94/137)、87.59%(120/137),对照组患者分别为45.65%(63/138)、69.57%(96/138),观察组患者强化期结束时和疗程结束时病灶吸收的显效率均高于对照组(P0.05)。观察组患者强化期结束时和疗程结束时空洞闭合率分别为21.9%(30/137)、54.01%(74/137),对照组患者分别为10.87%(15/138)、28.26%(39/138),观察组患者强化期结束时和疗程结束时空洞闭合率均高于对照组(P0.05)。疗程结束时观察组和对照组患者中医证候疗效总有效率分别为89.78%(123/137)、79.71%(110/138),观察组患者中医证候疗效总有效率高于对照组(P0.05)。与对照组比较,观察组患者强化期结束时和疗程结束时CD3~+、CD4~+水平及CD4~+/CD8~+升高(P0.05);2组患者强化期结束时和疗程结束时CD8~+水平比较差异无统计学意义(P0.05)。结论芪甲利肺胶囊辅助治疗复治肺结核合并2型糖尿病能提高痰菌转阴率、病灶显效率和空洞闭合率,并能提高中医证候疗效和细胞免疫功能。
[Abstract]:Objective to investigate the curative effect and the changes of T lymphocyte subsets in patients with pulmonary tuberculosis complicated with type 2 diabetes mellitus treated with Qijia Lifei capsule. Methods 280 patients with recurrent pulmonary tuberculosis complicated with type 2 diabetes were randomly divided into observation group and control group according to the order of admission. One hundred and forty patients in each group were treated with 3HRZES/9HRE (H: isoniazid, R: rifampicin, Z: pyrazinamide, E: ethambutanol, S: streptomycin) regimen. Three times a day for 8 months. The change of sputum bacteria, the changes of focus and cavity, the curative effect of TCM syndrome and the function of cellular immunity were compared between the two groups. Results the sputum negative conversion rates were 73.72% (101 / 137), 91.24% (125 / 137) at the end of intensive treatment and 80.43% (111 / 138) at the end of treatment in the observation group and 57.97% (80 / 138) and 80.43% (111 / 138) in the control group, respectively. The sputum negative conversion rate in the observation group was higher than that in the control group at the end of intensive treatment and at the end of the course of treatment (P0.05). At the end of the intensive phase and the end of the course of treatment, the effective rates of the focus absorption in the observation group were 68.62% (94 / 137), 87.59% (120 / 137), 45.65% (63 / 138) and 69.57% (96 / 138) in the control group, respectively. The effective rate of the focus absorption at the end of the intensive phase and the end of the course of treatment in the observation group was higher than that in the control group (P0.05). The cavity closure rates were 21.9% (30 / 137), 54.01% (74 / 137) and 10.87% (15 / 138), 28.26% (39 / 138) at the end of the intensive period and the end of the course of treatment in the observation group and the control group, respectively. The rate of cavity closure at the end of the intensive period and the end of the course of treatment in the observation group was higher than that in the control group (P0.05). At the end of treatment, the total effective rate of TCM syndromes in observation group and control group was 89.78% (123 / 137) and 79.71% (110 / 138), respectively. The total effective rate of TCM syndrome in observation group was higher than that in control group (P0.05). Compared with the control group, the levels of CD3~, CD4~ and CD4~ / CD8~ increased at the end of the intensive period and at the end of the course of treatment in the observation group (P0.05); there was no significant difference in CD8~ level between the two groups at the end of the intensive period and the end of the course of treatment (P0.05). Conclusion Qijialifei capsule can improve the sputum negative rate, focus apparent rate and cavity closure rate, and improve the curative effect of TCM syndrome and cellular immune function in the treatment of pulmonary tuberculosis with type 2 diabetes.
【作者单位】：新乡医学院第一附属医院结核内科二病区;新乡医学院第一附属医院结核内科四病区;
【分类号】：R521;R587.1

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