中西医结合治疗初治继发性肺结核30例

30 Cases of Secondary Pulmonary Tuberculosis Treated with Integrated Chinese and Western Medicine

目的观察滋阴润肺免煎颗粒对中医辨证为肺阴亏虚的初治继发性肺结核的治疗效果。方法将60例经中医辨证为肺阴虚肺结核患者随机分为两组,对照组30例(其中痰涂片阳性14例、痰涂片阴性16例),采用2HRZE/4HR[异烟肼(H)、利福平(R)、吡嗪酰胺(Z)、乙胺丁醇(E)]每日用药方案:强化期:异烟肼、利福平、吡嗪酰胺和乙胺丁醇,每日顿服,2个月;巩固期:异烟肼、利福平,每日顿服,4个月。实验组30例(其中痰涂片阳性17例、痰涂片阴性13例),在2HRZE/4HR方案上加用滋阴润肺免煎颗粒,规格每袋20 g,每次1/2袋,每日2次,口服。疗程为6个月。观察临床症状、肺部X线影像的变化、痰液细菌学检查及药物副作用。结果治疗2个月后实验组在改善临床症状、肺部阴影吸收及降低抗痨药物毒性方面均优于对照组(P<0.05);在痰菌阴转方面经统计学处理差异无统计学意义,考虑与观察时间有关,需继续追踪后续研究。结论滋阴润肺免煎颗粒能明显增强抗痨药物治疗作用,促进肺部病灶吸收并减少化疗药物毒性作用,这可能与该颗粒增强机体免疫力有关。

Objective To observe the effect of ziyin runfei mianjian granules on secondary pulmonary tuberculosis （TB） differentiated as lung yin deficiency in Chinese medicine. Methods 60 cases of TB differentiated as lung yin deficiency were randomized into two groups. In a control group（30 cases,including 14 cases of sputum smear positive and 16 cases of sputum smear negative ） , the daily medication program of 2 HRZE/4HR [ isoniazid （ H）, rifampicin （ R）, pyrazinamide （ Z ） and ethambutol （ E ） I was adopted. In intensive period：isoniazid, rifampicin, pyrazinamid and ethambutol were taken once a day for 2 months;isoniazid and rifampicin were taken once a day for 4 months. In an experimental group （30 cases,including 17 cases of sputum smear positive and 13 cases of sputum smear negative） ,on the basis of 2HRZE/4HR program,ziyin runfei mianjian granules were supplemented ,20 g each bag in specification, 1/2 bag each time, twice a day for oral administration. The treatment lasted 6 months. The clinical symptom, changes in lung X - ray image, sputum bacteriology test and drug side effects were observed. Results After the treatment for 2 months, the improvements in clinical symptom, absorption of the shadows in the lung and toxicity resistance of anti - tuberculosis drug in experimental group were all superior to control group（ P 〈 0.05 ）. In terms of negative rever- sion of sputum bacteria, the statistical management did not present significant difference. Concerning to the duration of observation involved, the trace follow - up study was required. Conclusion Ziyin runfei mianjian granules enhance apparently the effect of anti - tuberculosis drug, promote the absorption of the loci in the lung and reduce the toxicity of drug in chemotherapy. The effect of the granules is probably relevant with the strengthening of body immunity.