母牛分枝杆菌菌苗对复治性肺结核的辅助治疗作用

Analysis of therapeutic effects of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis

目的观察母牛分枝杆菌菌苗(微卡)在复治性肺结核治疗中的疗效。方法将146例痰抗酸杆菌(AFB)阳性复治肺结核患者分成微卡治疗组(n=90)和对照组(n=56)疗程各6个月,前者采用复治化疗方案加用微卡治疗,后者仅用复治方案治疗。结果疗程结束时微卡治疗组和对照组痰阴转率分别为85.56%(77/90)、67.86%(38/56),差异有显著性(P<0.05)。微卡治疗组和对照组有效率分别为81.11%(73/90)、44.64%(25/56),两组比较差异有显著性(P<0.001)。结论微卡能改善难治性肺结核患者的细胞免疫功能,有助于痰菌阴转和病灶吸收,可作为复治性肺结核化疗的辅助药物。

Objectives To assess the effects of Mycobacterium vaccae in treating multi-drug resistant （MDR） pulmonary tuberculosis. Methods 146 cases of MDR pulmonary tuberculosis with bacteriological sputum being positive were divided into immunotherapy group（ n =90） and control group （n = 56）. The former group was treated by chemotherapy and M. vaccae for consecutive 6 months, whereas the latter was treated by chemotherapy only for 6 months. Results After the 6-month treatment, the sputum negative conversion rates for the immunotherapy group and for the chemotherapy-only group were, respectively, 85.56% （77/90） and 44.64% （25/56） ： P 〈 0.05. The effective rates for the immunotherapy group and for the chemotherapy-only group were, respectively, 81.11% （73/90） and 44.64% （25/56） ： P 〈 0. 001. Conclusions M. vaccae, as a supplement to chemotherapy, has a beneficial effect on the treatment of MDR pulmonary tuberculosis by improving the cell-medicated immunity, sputum negative conversion and X-ray manifestations.