胸腔内注射山莨菪碱联合口服“活血利水汤”治疗结核性渗出性胸膜炎的临床观察

Clinical observation on anisodamine intrathoracic injection and oral “huo xue li shui” decoction treating tuberculotic exudative pleurisy

目的：探讨胸腔内注射山莨菪碱联合口服“活血利水汤”治疗结核性渗出性胸膜炎的疗效。方法：在抗结核治疗的基础上，将１１６例结核性渗出性胸膜炎患者随机分为胸腔内注射山莨菪碱联合口服“活血利水汤”治疗组６０例和糖皮质激素（泼尼松）对照组５６例进行对照研究。结果：治疗组胸水消失时间（１２．０±２．１）日，对照组（１６．０±２．８）日（ｔ＝２．８０６，Ｐ＜０．０１）；治疗组胸膜增厚、粘连的发生率为１０％，对照组为２５％（χ２＝３．９７２，Ｐ＜０．０５）。结论：胸腔内注射山莨菪碱联合口服“活血利水汤”治疗结核性渗出性胸膜炎能明显缩短胸水消失时间，降低胸膜增厚和粘连的发生率。

Objective:To explore the therapeutic efficacy of anisodamine intrathoracic injection combined use of oral “huo xue li shui” decoction in treatment of tuberculotic exudative pleurisy(TEP).Methods:One hundred and sixteen cases of TEP were divided randomly into treatment group and control group on the basis of antituberculosis therapy.The treatment group (n=60) was treated with anisodamine intrathoracic injection combined with oral “huo xue li shui” decoction and control group (n=56) was treated with prednisone.Results:The time for hydrothorax absorption was (120±21) days in treatment group and (160±28) days in control group (t=2806,P<001);the thickening and adhesion rates of pleura were 10% and 25% in treatment group and control group respectively (χ2=3.972,P<005).Conclusions:TEP patients treated with anisodamine intrathoracic injection combined use of oral “huo xue li shui” decoction can shorten the absorption time of hydrothorax significantly,decrease the thickening and adhesion rate of pleura.