慢性结核病营养支持再研究与探讨

Further study on nutritional support for chronic tuberculosis (CTB)

目的结核病专家着重倾向研究药物对结核病的治疗，而对营养支持疗法有所忽视。现着重研究探讨结核病营养支持问题。方法吸入带有结核菌的微滴核到达肺泡，菌繁殖并进入淋巴血液循环，形成原发综合症及血行播散。此时机体产生对结核菌的免疫力。少数菌转为潜性病灶，病灶内含有休眠状态的菌，菌不受抗结核药物的灭菌作用。菌可以继续存在于巨噬细胞内（L型），菌在宿主内可终生存活，并且在免疫功能低下时引发活动性结核，营养支持就成为预防结核病重要问题之一。结果结核病患者每天应多摄入鸡蛋、牛奶、瘦肉、鱼虾类动物性蛋白质，黄豆、面筋、花生、谷类、蔬菜及水果植物性蛋白质以补充消耗。结核病人体内维生素B、C含量降低，维生素C排泄量减少，并且排泄量和病情的轻重成反比。这是病灶需要大量维生素C的缘故，因此应大量补充维生素B、C。维生素C能调整神经系统机能减低血管渗透作用。临床证明维生素C对渗出性TB病人可有良好的治疗效果。无机盐的钙、磷、矿物质较为重要；钙能致密血管壁，降低渗透性，磷对肌肉及神经系统机能有促进作用。结论营养支持对结核病灶的修复能起到辅助作用，与抗结核药物同时应用将事半功倍。

Purpose Currently, tuberculous specialists of often emphasize on the application of medicine, ignoring nutritional support. This study stressed a research into the question of nutrition support for TB. Methods Inhaled corpusde nucleus of tuberculous bacillus get to pulmonary alveolus, bacillus breed and enter blood circulation, lead to original syndrome and spread through blood. At this moment, the host develops immunity from tuberculous bacillus. A few bacillus turn into insidious focus, in the focus it contains bacillus of dormancy. Anti-tuberculosis drugs don't have effect on it. It may live all its life in the host. When immunity is impaired, active tuberculosis is developed. Nutrition support becomes one of the issues for preventing tuberculosis. Results Tubercle patients should take more nourishment such as egg, milk, lean meat, shrimp, animal protein and soybean, gluten, peanut, millet, vegetables and fruits and plant protein fOr supplamentary consuming. The vitamin B, C content in the body of tubercle patients reduces, capacity for draining of vitamin decreases, and capacity for draining has a inverse ratio with the severity of the disase. This is reason why the TB focus needs large amount of Vitamin C. Vitamin C can regulate the fuction of nervous system and reduce permeability of blood vessel. It has been proved clinically that Vitamin C is worthy for the treatment of TB patients. Minerals, inorganic calcium and phosphorus are very important. Calcium can compact the wall of blood vessels and decrease their permeability, phaphorus can promote the function of muscle and nervous system. Conclusions Nutrition support can have a indirect auxiliary effect for repairing tubercle focus, making concomitant using of medication more efficiently.