治疗初治涂阳肺结核与预防肝损伤的探讨

The exploration of curing new smear positive pulmonary and preventing hepatic injury.

目的观察微卡与化学药物联用在治疗初治涂阳肺结核中的效果以及保护肝脏功能的作用。方法将276例初治涂阳肺结核患者随机分为两组,治疗组为抗结核药与微卡(母牛分支杆菌)联用,对照组则单用抗结核药;观察治疗6个月末的痰菌变化以及治疗前后X线片和肝功能指标的比较。结果治疗组治疗6个月末痰菌阴转率为100%,对照组为95.5%(χ2=0.84,P>0.05);X线片显示:病灶显著吸收,治疗组为90.3%,对照组为84.8%,二者之间差异无统计学意义(χ2=0.29,P>0.05);治疗组的空洞缩小(100%)与对照组(50%)比较有统计学意义(χ2=0.007,P<0.01);在治疗组中,治疗后的肝功能损伤显著少于治疗前(χ2=0.002;P<0.01)。结论两组疗效差异虽然无统计学意义,但是微卡在一定程度上提高了抗结核药的效果,使肺部空洞明显缩小,并降低了肝脏的损伤率,对提高初治涂阳肺结核的治愈率有一定的作用。

Objective Observe the curing effect of combined-Vaccae-with-pharmacotherapy in new smear positive pulmonary cases and the protection of hepatic function.Methods Randomly divided 276 new smear positive pulmonary cases into two groups,treating the study group with combined-Vaccae-with-Pharmacotherapy,treating the control group with antitubercular agents only;then observed the sputum conversion after six months and compared the pre-treatment X-ray pictures and hepatic function indexes with the post treatment.Results The sputum negative conversion rate of the study group was 100%,the control group was 95.5%（χ2=0.84,P0.05）;X-ray pictures showed that： the remarkable lesion Absorption rate of the study group was 90.3%,the control group was 84.8%,there was no significance（χ2=0.29,P0.05）;the cavity of the study group（100%） was significantly reducing comparing with the control group（50%,χ2=0.007,P0.01）;the hepatic function indexes of the study group were significantly improving（χ2=0.002,P0.01）.Conclusion Although there was no significance in curing effect of the two groups,to a certain extent Vaccae could enhance the efficiency of the antitubercular agents.It could minimize pulmonary cavities significantly and lower hepatic injury,therefore it may has some effect on improving the curative rate of the new smear positive pulmonary cases.