强力阿莫仙治疗耐多药肺结核病探讨

Discussion on the treatment of multiple drug-resistant tuberculosis with amoxicillin sodium and clavulanate potassium

目的评价强力阿莫仙治疗耐多药肺结核的情况。方法采用中华医学会结核病分会耐多药肺结核诊断标准[1]。随机分组,69例耐多药肺结核病用强力阿莫仙治疗,为治疗组;66例耐多药肺结核采用常规抗痨药,为对照组。结果治疗2个月末痰菌阴转两组差异具有非常显著性(P<0.01)。3个月末、6个月和12个月末痰涂阴转差异均无显著性。3个月末胸部X线检查差异有显著性(P<0.05),6个月末和12个月末其差异分别有非常显著性(P<0.01)。初始耐药率为52.2%,而获得性耐药率为47.8%。69例病例中,60例是暂住户口居民,9例为常住户口居民。结论强力阿莫仙对治疗肺结核治疗有效。在初结核病例中,治疗6个月末X线检查病灶吸收低于90%,或病灶边缘仍模糊,应考虑是初始耐多药病例。建议药敏试验列为肺结核综合治疗前的常规项目。

Objective To evaluate the effect of amoxicillin/patassium calauvlanic acid on multidrug resistant pulmonary tuberculosis.Methods There 69 multidrug resistant pulmonary tuberculosis cases was treated with amoxicillin/potassium calauvlanic acid（experiment proup）.MDR-TB of 66 cases was treated with conventional anti-TB drug（control group）.Results There no significanly statistical differences were observed 3 months,6 months and 12 months after treatment in sputum negativce conversion rates in the two groups.There was significantly statistical difference in chest X-ray 3 months after treatment（P〈0.05） and very significant statistical differece 6 and 12 months after treatment in the two groups（P〈0.01）.The initial drug resistance was 52.2% and acquired drug resistance was 47.8%.There 60 out of the 69 cases were temporary residents and 9 were permanent residents.Conclusion Amoxicllin/potassium cclauvlanic acid is effective for treatmetn of pulmonary tuberculosis.In case the absorption of lesions of foci was less than 90% as showed by X-ray 6 months after treatment,then initial drug resistance be considered.