和解通利法辅助治疗结核性包裹性胸腔积液58例临床观察

A Clinical Observation on Harmonizing and Freeing Treatment for 58 Cases of Tuberculous Encapsulated Pleural Effusion

目的观察西药抗结核方案联合和解通利法治疗结核性包裹性胸腔积液的临床疗效。方法选择结核性包裹性胸腔积液患者118例,随机分为治疗组58例,对照组60例。对照组给予西药抗结核方案3HRZE/6HRE。治疗组在对照组基础上加用和解通利法中药,每日1剂,两组疗程均为3个月。观察两组临床疗效及治疗1个月后胸腔积液中肿瘤坏死因子α(TNF-α)水平、胸腔积液吸收时间及治疗前和治疗后1、3个月胸膜厚度。结果治疗组胸腔积液吸收时间(36.05±9.32)d,明显短于对照组(47.18±11.64)d(P<0.01)。两组治疗后1、3个月胸膜厚度与治疗前比较均明显降低(P<0.05),两组治疗后3个月胸膜厚度均明显小于本组治疗后1个月(P<0.05);治疗组治疗后1、3个月胸膜厚度均小于同时间对照组(P<0.05)。治疗组治疗后1个月TNF-α(35.35±17.46)pg/L,明显低于对照组(47.16±8.89)pg/L(P<0.05)。治疗组显效率70.7%、对照组显效率45.0%,两组比较差异有统计学意义(P<0.05)。结论西药抗结核方案联合和解通利法治疗结核性包裹性胸腔积液可加快胸腔积液吸收,降低胸腔积液中TNF-α浓度,减小胸膜厚度,疗效确切。

Objective To observe the therapeutic effect of western medicine antituberculosis （anti-TB） program combined with harmonizing and freeing treatment for tuberculous encapsulated pleural effusion. Methods Totally 118 cases of tuberculous encapsulated pleural effusion were randomized into the treatment group and control group, with 58 and 60 in each. Both groups were given the western medicine anti-TB program： 3HRZE/6HRE. The treatment group was added with harmonizing and freeing formula one dosage and twice daily for 3 months. The therapeutic effect, tumor necrosis factor-α （TNF-α） level in the pleural effusion, pleural effusion absorption time and pleural thickness was observed in both groups before and after treatment. Results The pleural effusion absorption time in the treatment group i.e.（36.05±9.32）d, was significantly shorter than that in the control group i.e.（47.18±11.64）d after treatment （P0.01）. The pleural thickness was significantly decreased in both groups after 1-month and 3-month treatment （P〈0.05）, especially after 3-month treatment （P〈0.05）. Comparing with the control group, the pleural thickness was significantly decreased in the treatment group after 1-month and 3-month treatment （P〈0.05）. The TNF-α level in the treatment group i.e.（35.35±17.46）pg/L, was significantly lower than that in the control group i.e.（47.16±8.89）pg/L after 1-month treatment （P〈0.05）. The significant efficacy of the treatment group and control group was 70.7% and 45% respectively, with a significant difference between groups （P〈0.05）. Conclusion The western medicine anti-TB program combined with harmonizing and freeing treatment is effective for tuberculous encapsulated pleural effusion. It can shorten the time of the absorption of pleural effusion, decrease the concentration of TNF-α in the pleural effusion and reduce the pleural thickness.