阿莫西林克拉维酸钾联合化学药物治疗初治涂阳肺结核的临床观察

Clinical observation of Amoxicillin Sodium and Clavulanate Potassium combined with chemother-apy in treating new pulmonary tuberculosis

目的观察阿莫西林克拉维酸钾联合抗结核药物治疗初治涂阳肺结核患者的临床疗效和不良反应。方法将109例初治涂阳肺结核患者随机分为治疗组与对照组两组，治疗组58例采用阿莫西林克拉维酸钾＋2HREZ／4HR，对照组51例采用2HREz／4HR。结果治疗3周、1个月、2个月痰茵阴转率治疗组分别为44．8％、62．0％、89．7％，对照组分剐为25．5％、41．2％、76．0％；治疗2个月后肺CT显示治疗组与对照组病灶吸收率分别为37．9％、19．6％；空洞闭合率各为65．5％，38．7％（P〈0．05）；治疗组在治疗3周后临床咳嗽、发热、乏力消失率为48．3％、71．4％、59．3％，对照组为25．5％、50．0％、40．0％，以上观察指标两组比较差异均有统计学意义（P均〈0．05）；两组均无不良反应发生；治疗组在疗程结束后6、12个月痰茵复阳率和对照组相比差异无统计学意义（P〉0．05）。结论阿莫西林克拉维酸钾联合抗结核药物在初治茵阳肺结核的治疗上与单用抗结核药物治疗相比缩短了痰茵转阴率、肺CT病灶吸收和临床症状改善的时间。

Objective To study the efficacy and adverse reaction of Amoxicillin Sodium and Cla- vulanate Potassium in treating new smear positive tuberculosis （TB）. Methods One hundred and nine new smear positive pulmonary TB patients were randomly divided into treatment group, who received Amox- icillin Sodium and Clavulanate Potassium ＋ 2HRZE/4HR （58 cases）and control group, who received 2HRZE/4HR（51 cases）. Results The sputum negative conversion rate at the third week,the first and second month were 44. 8%, 62. 0% ,89. 7% in the treatment group and 25.5%, 41.2% ,76% in the con- trol group respectively, at the second month chest radiography showed the resolution of pulmonary lesions in the treatment group and control group were 37. 9% and 19. 6% respectively, with cavity closure rate of 65. 5% in the treatment group and 38.7% in the control group, at third week, the clinical symptoms such as cough, fever, fatigue disappeared at the levels of 48.3% ,71.4% ,59. 3% in the treatment group and 25.5% ,50. 0% ,40. 0% in the control group （P 〈0. 05）, there was no drug adverse reaction in the treat- ment group, there was no significant difference in the sputum positive conversion rate at the 6,12 month af- ter treatment between the treatment group and the control group （P 〉 0. 05 ）. Conclusions Amoxicillin Sodium and Clavulanate Potassium combined with chemotherapy shortens the time of sputum negative con- version, the resolution of pulmonary lesions and the improvement of clinical symptoms. The drug adverse reaction is little. It is a fairly good immune drug for TB treatment and is worth to be recommended.