耐多药结核病治疗的反思——整体观的必要性

发布时间：2019-07-18 16:36

【摘要】：本文从医源性、患者自身、社会因素等角度分析耐多药结核病(multidrug-resistant tuberculosis,MDR-TB)的发生因素,回顾MDR-TB治疗策略从标准短程化疗方案到整体干预策略基础上个体化治疗的演变过程,分析中医抗结核的历史与现阶段研究特点,指出中医学不但重视病原体,肯定"杀虫"之必要,更需关注病原体作用于人体后产生的级联反应,将其与患者自身状况、气候、地理、心理、社会等因素结合起来"整体"地看待MDR-TB的发生、发展。笔者认为中医整体观指导下的治则对MDR-TB治疗有着积极意义和启发,治疗应重视患病个体的整体特征和治疗方案的个体化,并强调"整体观"是提高MDR-TB疗效的基本策略,避免采用单一的"对抗"方式。
[Abstract]:This paper analyzes the occurrence factors of multi-drug resistant tuberculosis (multidrug-resistant tuberculosis,MDR-TB) from the angles of iatrogenic, patient itself and social factors, reviews the evolution of MDR-TB treatment strategy from standard short course chemotherapy regimen to overall intervention strategy, analyzes the history and characteristics of anti-tuberculosis in traditional Chinese medicine, and points out that traditional Chinese medicine not only attaches importance to pathogens, but also confirms the necessity of "insecticidal". It is necessary to pay more attention to the cascade reaction produced by pathogens acting on the human body, and to combine it with the patient's own condition, climate, geography, psychology, society and other factors to look at the occurrence and development of MDR-TB as a whole. The author believes that the treatment under the guidance of the holistic view of traditional Chinese medicine is of positive significance and inspiration to the treatment of MDR-TB. The treatment should pay attention to the overall characteristics of the sick individuals and the individualization of the treatment plan, and emphasize that the "holistic view" is the basic strategy to improve the curative effect of MDR-TB and avoid the use of a single "antagonistic" way.
【作者单位】：兰州市疾病预防控制中心结核病防治所;甘肃中医药大学中医临床学院;
【分类号】：R52

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