联合应用中药结核丸的短程化疗方案强化期疗效观察

Clinical observation on therapeutic effect of Jiehe Pills in TCM combined with the augmented stage of short-course chemotherapy

[目的]研究中西医结合治疗肺结核,应用结核丸(JHW)的短程化疗方案临床研究。[方法]分为治疗组69例和观察组45例,年龄18～75岁,初治肺结核患者。治疗组为JHW+异烟肼(INH)+利福平(RFP)+吡嗪酰胺(PZA)+乙胺丁醇(EMB),对照组为4种西药联合应用。强化期疗程3个月。观察两组患者治疗前后症状的变化,菌阳患者痰菌阴转率和X线胸片病变范围吸收情况来评定其疗效。[结果]在改善症状方面治疗组显效率为87.2%,总有效率为100%,对照组显效率为72.3%,总有效率为96.3%,治疗后两组综合症状积分比较,有显著性差异(P<0.01)。痰菌阴转情况治疗组第2个月显效,对照组第3个月显效。胸片病变吸收情况治疗组第3个月显效,对照组第3个月有效。[结论]治疗组在缓解症状,杀灭结核菌,促进病变吸收均优于对照组。中药辅助治疗肺结核可以提高疗效。

[Objective] To research the effect of short-course chemotherapy of Jiehewan（JHW,pills for treating tuberculosis） integrated with Chinese medicine and western medicine in treating pulmonary tuberculosis （TB）. [Methods] The patients from TB were randomly divided into the treatment group and observation group. The patients of treatment group were treated with combined application of JHW＋INH＋RFP＋PZA＋EMB and that of control group were with combined application of INH＋RFP＋PZA＋ EMB. The augmented treatment course was three months. The symptoms change, the negative conversion rate of bacterial sputum and absorption extent of disease exhibited in X-ray before and after treatment in both groups were evaluated as the curative effect on pulmonary tuberculosis. [Results] The excellent cure rate was 87.2% and total effective rate was 100% in the improvement of symptom in treatment group. They were 72.3% and 96.3% respectively in control. The curative effect of treatment group was obviously higher than that of control group （P〈0.01）. The negative conversion time of bacterial sputum happened at the second month in treatment group and that at the third month in control group. The obvious absorption of disease was seen at the third month in treatment and effective absorption at the same time in control group. [Conclusions] The curative effect of treatment group was obviously higher than that of control group on the relieving symptoms, killing tuberculosis bacteria and en- hancing absorption extent of the disease. The JHW may increase curative effect in treating pulmonary tuberculosis.