卡提素辅助治疗重症菌阳肺结核疗效观察

Observation of curative effect for BCG's extract agent assistance treating far-advanced bacteria pulmonary tubrculosis

目的观察和评价卡提素注射液辅助治疗重症菌阳肺结核的疗效。方法选取初复治菌阳肺结核患者(慢性排菌病人除外)病灶总面积≥3个肺野共153例,随机分为2组。试验组(卡提素+化疗)77例,初治61例,复治16例,初治方案2SHRZ/4HR(S为链霉素,H为雷米封,R为利福平,Z为吡嗪酰胺,连用2个月;H、R连用4个月)、复治方案2SHRZE/6HRE(E为乙胺丁醇,S、H、R、Z、E连用2个月;H、R、E连用6个月),并加用卡提素注射液;对照组(单纯化疗)初治61例、复治15例,化疗方案同试验组。结果试验组和对照组疗程结束时痰菌阴转率分别为92.2%、78.9%(P<0.05);胸部X线病灶吸收好转率分别为93.5%、80.3%(P<0.05);空洞闭合率分别为87.5%、68.4%(P<0.05);2年随访,试验组无一例复发,对照组有4例(5.3%)复发。结论卡提素辅助治疗重症菌阳肺结核患者能提高痰菌阴转率,促进病灶吸收、空洞闭合,加速患者康复,远期疗效好,值得推广。

Objective To observe and evaluate the effect of far - advanced bacteria pulmonary tubrculosis treated with BCG＇s extract agent assistant therapy. Methods To choose 153 primary and re - treated patients suffering from bacteria pulmonary tuberculosis （chronic excretory eases were not included） whose focus area in the lungs was more than or equal half lungs and divided them into two groups at random. The experiment group （treated with BCG＇s extract agent and chemotherapy） was composed of 61 primary patients and 16 re -treated patients, 77 patients in totality . Primary patients were treated with 2SHRZ/4HR plan while re -treated patients 2SHRZE/6HRE plan plus with BCG＇s extract agent. The contrast group （treated with chemotherapy only） consists of 61 primary patients and 15 re - treated patients with the same chemotherapy plan as in the experiment group. Results At the end of treatment, the sputum germs negative conversion rate in the experiment and contrast groups was 92.2% and 78.9% （ P 〈0.05） respectively; the foci absorption rate shown in the chest X -ray films was 93.5% and 80.3% （ P 〈 0. 05 ） respectively; pulmonary cavity close up rate was 87.5 % and 68.4% （ P 〈 0.05 ） respectively. After making observations for two years, we found no recurrence case in the experiment group while 4 recurrence cases in the contrast group （8.2%）. Conclusion BCG＇s extract agent assistance treating far - advanced bcteria pulmonary tubrculosis can improve the sputum germs negative conversion rate , accelerate the loci absorption and pulmonary cavity close up and quicken patients＇recovery. Therefore, it is really worth recommending with its good forward curative effect.