复治涂阳肺结核2种治疗方案疗效分析

Comparisons of Two Therapies on Retreated Smear Positive Pulmonary Tuberculosis

目的比较2种治疗方案对复治涂阳肺结核的疗效,探讨现阶段复治肺结核患者的治疗方案。方法将188例复治涂阳肺结核病例中,以异烟肼、利福平、乙胺丁醇、吡嗪酰胺和链霉素进行治疗的分为标准组,以对氨基水杨酸异烟肼、利福喷丁、乙胺丁醇、吡嗪酰胺和链霉素进行治疗的分为非标准组,然后采取病例对照研究的方法比较2组的痰菌阴转率、不良反应和治疗效果。结果患者治疗后2月末、5月末、8月末痰菌阴转率非标准组分别为87.6%、88.7%、92.8%,标准组分别为70.3%、76.9%、78.0%;胃肠道反应和肝损非标准组为42.3%、7.2%,标准组为67.0%、17.6%;治疗效果显效率和总有效率非标准组85.6%、91.2%,标准组68.1%、79.1%。结论含对氨基水杨酸异烟肼、利福喷丁治疗方案治疗复治涂阳肺结核优越于现有的标准复治方案。

Objective To compare the efficacy of two therapies on retreated smear positive tuberculosis （TB） patients and to explore current treatment protocol. Methods A total number of 188 retreated smear positive TB cases were divided into standard and non - standard group, standard group treated with medicine of isoniazid,rifampicin, ethambutol, pyrazinamide and streptomycin while nonstandard group with isoniazidaminosalicylate, rifapentine, ethambutol, pyrazinamide and streptomycin; sputum negative conversion rate, side effects and treatment efficacy were compared with case -control -study method. Results By the end of February, May and August, the sputum negative conversion rates of non - standard group were 87.6%, 88.7% and 92.8%, compared with standard group of 70. 3%, 76. 9% and 78.0% respectively; the gastro- intestinal reaction and hepatic impairment rates of non - standard group were 42.3% and 7.2% compared with standard group of 67.0% and 17.6% respectively; the excellent and total effective rates of non - stand- ard group were 85.6% and 91.2%, compared with standard group of 68. 1% and 79. 1% respectively. Conclusion Method with isoniazid aminosalicylate and rifapentine for treating retreated smear positive tuberculosis is more preferable than current standard treatment protocol.