益肺抗痨方雾化治疗在耐多药肺结核患者中的临床疗效观察

发布时间：2018-09-12 12:11

【摘要】：目的：通过观察益肺抗痨方雾化疗法对耐多药肺结核患者的临床症状与体征、痰结核杆菌培养、x线所示肺部病灶变化、免疫学指标(CD3、CD4、CD4/CD8)的影响,探讨益肺抗痨方对耐多药肺结核患者的疗效及可能作用机制,为耐多药肺结核的临床治疗提供理论依据。方法：将符合纳入标准的60例耐多药肺结核患者,采用随机数字表法分为两组,治疗组和对照组各30例。对照组采用西医常规治疗,予6Z-Lfx-Am(Cm)-PAS-E (Pto)/18Z-Lfx-PAS-E (Pto);治疗组在对照组的基础上,加用益肺抗痨方雾化治疗。比较两组患者在临床症状与体征、痰结核杆菌培养、X线所示肺部病灶变化、免疫学指标(CD3、CD4、CD4/CD8)的变化。结果：1.一般资料：对两组年龄、性别、病程、中医证候总积分进行组间比较,差异无统计学意义(P0.05),故可认为两组患者具有可比性。2.安全性分析：两组患者治疗前后血细胞分析中白细胞、中性粒细胞百分比均有所下降,但两组无统计学意义(P0.05),尿常规、大便常规、肝功能、肾功能、心电图在治疗前后均无明显差异。3.有效性评价：两组比较,在痰结核分枝杆菌培养、中医证候疗效、病灶吸收情况、免疫学评价(CD3、CD4、CD4/CD8)方面,差异具有统计学意义(P0.05),说明治疗组疗效优于对照组；在空洞大小方面,两组差异不具有统计学意义(P0.05),说明治疗组与对照组疗效相当。结论：运用益肺抗痨方雾化治疗联合西医常规治疗耐多药肺结核患者,临床疗效优于单纯西药治疗组：益肺抗痨方雾化治疗联合西医常规治疗可改善耐多药肺结核患者总的临床症状和体征,提高痰培养阴转率;可提高耐多药肺结核患者的病灶吸收；可改善耐多药肺结核患者的CD4/CD8免疫学指标。
[Abstract]:Objective: to observe the effects of the atomization therapy of Yifei Kangtai recipe on the clinical symptoms and signs of multi-drug resistant pulmonary tuberculosis patients, the changes of pulmonary lesions, and the immunological index (CD3,CD4,CD4/CD8) of tuberculosis bacillus sputum culture X ray. To explore the therapeutic effect and possible mechanism of Yifei Kangtai recipe on multidrug resistant pulmonary tuberculosis, and to provide theoretical basis for the clinical treatment of multidrug resistant pulmonary tuberculosis. Methods: sixty patients with multidrug resistance pulmonary tuberculosis were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The control group was treated with routine western medicine and treated with 6Z-Lfx-Am (Cm) -PAS-E (Pto) / 18Z-Lfx-PAS-E (Pto);. The changes of pulmonary lesions and immunological indexes (CD3,CD4,CD4/CD8) were compared between the two groups in clinical symptoms and signs, tuberculosis bacillus sputum culture X ray. The result is 1: 1. General data: the two groups of age, sex, course of disease, TCM syndromes total integral comparison between groups, the difference is not statistically significant (P0.05), so the two groups of patients can be considered comparable. 2. Safety analysis: the percentage of leukocytes and neutrophils in blood cell analysis decreased in both groups before and after treatment, but there was no significant difference between the two groups (P0.05), urine routine, stool routine, liver function, renal function, There was no significant difference in ECG before and after treatment. Effectiveness evaluation: there were significant differences between the two groups in the culture of Mycobacterium tuberculosis in sputum, the curative effect of TCM syndromes, lesion absorption and immunological evaluation (CD3,CD4,CD4/CD8) (P0.05), which indicated that the therapeutic effect of the treatment group was better than that of the control group, and the size of the cavity in the treatment group was better than that in the control group. The difference between the two groups was not statistically significant (P0.05), indicating that the treatment group and the control group have the same curative effect. Conclusion: the atomization treatment of Yifei Kangtai prescription combined with western medicine routine treatment of multi-drug resistant pulmonary tuberculosis patients, The clinical effect was better than that of western medicine group: the atomization treatment of Yifei Kangtai Fang combined with routine western medicine treatment could improve the total clinical symptoms and signs of multi-drug resistant pulmonary tuberculosis patients and improve the negative rate of sputum culture. It can improve the focus absorption of MDR-TB patients and improve the CD4/CD8 immunological index of MDR-TB patients.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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