微卡辅助治疗耐多药肺结核的临床研究

The observation of the effect of the treatment of multi?drug resistant pulmonary tuberculosis with M Vaccae

目的探讨评价微卡(母牛分枝杆菌菌苗)治疗耐多药肺结核的疗效。方法60例耐多药肺结核患者按入院先后顺序分为微卡加化疗组即治疗组,与单纯化疗组即对照组。化疗方案均为3PaL2AKZThV/15PaL2ZThV。治疗组为病人头3个月每15 d肌注微卡(22.5μg),随后的3个月每月肌注1次微卡。观察2组治疗后肺部病灶吸收情况、痰菌阴转情况、症状改善情况、免疫功能变化情况。结果治疗组与对照组3个月时痰菌阴转率分别为56.6%和26.6%,18个月时为93.3%和73.3%有显著差异(P<0.05);X线吸收率及空洞缩小、闭合率均有明显差异P<0.05;CD4+、CD4+/CD8+9个月时治疗组与同组治疗前及对照组均有显著差异P<0.05。结论微卡能调节免疫功能,提高痰菌阴转率,有助于病灶吸收空洞闭合,可作为耐多药肺结核化疗的辅助治疗。

To evaluate the assistant value of Vaccae on treatment of multi - durg resistance pulmonary tuberculosis. Method Sixty cases with multi - durg resistance pulmonary tuberculosis were divided randomly into the treatment group and the control group.The cases in 2 groups were treated by the same chemotherapy regimen with 3PaL2AkZThV/15PaL2ZThV. in the same time.The treatment group cases were injected vaccae （22.5μg） every 15- day in the first three month, then observe the change of the market absorption, sputum conversion, symptom improvement, immune function in the two groups after the treatment. Results There was significant difference on the rates of sputum smear negative conversion.In the two groups, they were 56.6 % and 26.6 % at the end of 3 months, 93.3 % and 73.3 % at the end of 18months respectively, there were obvious difference of CD4, CD4/CD8 focus absorption and closure rates of cavities at the end of 9 months between the treatment group and control group. ConclusionVaccae is helpful to the immune function, sputum negative conversion and the absorption of focus,it has a adjustment treatment of multi - drug cases.