中西医联合治疗耐多药肺结核病的临床疗效观察

Clinical Study of Combining Chinese Medicine with Chemical Medicine on MDR-TB

目的:观察中西医结合方法治疗耐多药肺结核病的临床疗效。方法:将116例耐多药肺结核病的患者随机分为两组,其中治疗组58例及对照组58例。两组均予常规抗痨治疗;治疗组在常规治疗基础上加服我院自制的中药养阴润肺益气健脾汤,疗程为6个月。治疗期间观察临床症状改善情况;观察两组患者治疗前后外周血T淋巴细胞亚群、白介素-12及干扰素水平变化;药物不良反应改善情况。结果:治疗组总有效率为91.4%,对照组总有效率为75.9%,治疗组疗效明显高于对照组(P<0.05);治疗后两组患者血T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+及血白介素-12、干扰素水平较治疗前均有不同程度上升、CD8+水平较治疗前均有不同程度下降(P<0.05),且治疗组上升、下降幅度明显优于对照组(P<0.05);治疗过程中出现的药物不良反应明显低于对照组(P<0.05)。结论:中西医结合方法治疗耐多药肺结核病的临床疗效优于单纯西医治疗。

Objective：To observe the effect of TCM and WM treatment on muhidrug - resistant tuberculosis （ MDR - TB） . Method：A total of 116 tuberculosis patients were randomized into 2 groups. Two groups used the anti -tuberculosis pharmacological treatment. In the conventional treatment group, the treatment was added Yangyin Runfei Yiqi Jianpi De- coction. The treatment course was 6 months. The differences in the efficacy of the two groups were observed. Changes in T- cell subsets ,changes of IFN -γ and IL- 12 of the patients who were observed before and after the treatment in both groups ; adverse reactions were also observed. Results ： In the patients of Chinese medicine treatment group, the total effec- tive rates of the two groups were 91.4% and 75.9% respectively, the total effective rate was higher than that in the con- trol group（ P 〈 0.05 ） ; the levels of CD3 ＋ ,CD4 ＋ ,IFN - γ ,IL - 12 and the ratio of CD4 ＋/CD8＋ raised significantly after treatment （ P 〈 0.05 ）, the level of CDs ＋ obviously dropped （ P 〈 0.05 ）. In comparison with the control group, the changes of the treatment groups were superior to those of the control group （ P 〈 0.05 ）. Adverse reaction obviously dropped （ P 〈 0. 05 ）. Conclusion：The TCM combined with WM treatment for MDR - TB is more effective than simply using westerm medicine.