全程间歇短程板式组合药物治疗初治涂片阳性肺结核的疗效分析

Effects of full-course intermittent short-term combined antituberculous chemotherapeutics in treatment of smear-positive patients

目的评价组合抗结核药物短程间歇化疗方案治疗初治涂片阳性肺结核的疗效。方法将109例初治涂片阳性肺结核患者分为治疗组51例和对照组58例。治疗组采用2H3R3E3Z3/4H3R3(H为异烟肼、R为利福平、E为乙胺丁醇、Z为吡嗪酰胺,隔日1次口服)进行短程化疗;对照组采用2HREZ/4HR(H、R、E每日1次口服,Z每日3次口服)进行短程化疗。结果治疗组和对照组2个月痰菌阴转率分别为92.2%和91.3%,6个月满疗程时分别为96.1%和96.6%;两组X线胸片均明显改善,治疗组和对照组病灶吸收有效率分别为94.1%和94.8%;治疗组和对照组药物不良反应发生率分别为6.1%和9.5%;两组痰菌阴转率、X线胸片改变情况、药物不良反应发生率的差异均无显著性(P>0.05)。结论组合抗结核药短程间歇化疗方案治疗初治涂片阳性肺结核具有简便、经济、安全、高效的实用价值。

Objective To evaluate the effects of intermittent short-term combined antituberculous chemotherapeutics in treatment of smear-positive tuberculosis patients. Methods One hundred and nine newly found smear-positive pulmomary tuberculosis patients were allocated into treated group （51 cases; receiving 2H3R3E3Z3/4H3R3 regimen; H, R, E, Z： qod, po） and control group （58 cases; 2HREZ/4HR; H, R, E： qd po, Z： rid, po）. Results The negative conversion rates of sputum at the 2nd month and 6th month in the treated group and the control group were 92.2% and 91.3% vs 96.1% and 96.6% respectively. Chest radiography showed remarkable improvement. The resolution of pulmonary lesions in the treated group and the control group were 94.1% and 94.8%, respectively. The rates of adverse effects were 6.1% in the treated group and 9.5% in the control group. Conclusions Intermittent short-term chemotherapy of combined antituberculous drugs on the treatment of smear-positive pulmonary tuberculosis patients is simple economic, safe and effective for tuberculosis control program. （Shanghai Med J, 2005,28：694-696）