用利福喷丁或利福平治疗菌阳肺结核的疗效观察

OBSERVATION OF CURATIVE EFFECT OF POSITIVE BACTERIA PULMONARY TUBERCULOSIS TREATED WITH RIFAPENTINE AND RIFAMPICIN.

目的 :观察和评价化疗并用利福喷丁与利福平治疗菌阳肺结核的疗效。方法 :将 178例初、复治菌阳肺结核患者随机分为 4组 ,A组 (4 3例 )、 C组 (5 0例 )分别用 2 H3 L1 Z3 S3 /4H3 L1 和 2 H3 L1 Z3 E3 S3 /6 H3 L1 E3 方案治疗 ;B组 (4 0例 )、 D组 (4 5例 )分别用 2 H3 R3 Z3 S3 /4H3 R3 和 2 H3 R3 Z3 E3 S3 /6 H3 R3 E3 方案治疗。观察治疗后痰菌阴转、肺部病灶吸收及毒副反应情况。结果 :痰菌阴转率 :2月末 A、 B组分别为 95 .3%和 77.5 % ;C、 D组分别为 88.0 %和 6 6 .7% ;疗程结束时 ,痰菌阴转率 :A、B组分别为 10 0 .0 %和 82 .5 % ;C、D组分别为 94.0 %和 80 .0 % ;胸部 X线改善有效率 :A、 B组分别为90 .7%和 72 .5 % ;C、 D组分别为 82 .0 %和 5 5 .6 %。空洞闭合率 :A、 B、 C、 D组分别为 89.5 % ,70 .0 % ,6 8.8%和 5 2 .2 %。毒副反应 :观察组和对照组肝功能损害发生率分别为 15 .1%和 38.8% ,胃肠反应发生率分别为 2 9.0 %和 45 .9%。结论 :利福喷丁具有高效、低毒的特点 ,在提高痰菌阴转率、促进病灶吸收、空洞闭合及症状消除方面均优于利福平 。

Objective:To observe and evaluate the curative effect of positive bacteria pulmonary tuberculosis treated with chemotherapy,and the part of them instead RFP with rifapentine.Methods:178 primary and re-treated positive bacteria,pulmonary tuberculosis cases were separated into groups A?B?C?D at random.Group A(43 cases) and group C(50 cases) were treated with 2H 3L 1Z 3S 3/4H 3L 1 and 2H 3L 1Z 3E 3S 3/6H 3L 1E 3.Group B(40 cases) and group D(45 cases) were treated with 2H 3R 3Z 3S 3/4H 3R 3 and 2H 3R 3Z 3E 3S 3/6H 3R 3E 3.Then observe the foci absorption,the sputum negative conversion and poison side effect reaction.Results:After two months,the sputum negative conversion rate to groups A?B?C?D was 95.3%,77.5%,88.0% and 66.7%,respectively.At the end of treatment,the sputum negative conversion rate to groups A?B?C?D was 100.0%,82.5%,94.0% and 80.0%,respectively;the foci absorption rate to groups A?B?C?D was 90.7%,72.5%,82.0% and 55.6%,respectively;cavity close up was 89.5%,70.0%,68.8% and 52.2%,respectively.Poison side effect reaction:Observation groups and constrast groups,liver function damage rate were 15.1% and 38.8%;gastroenter reaction rate were 29.0% and 45.9%.Conclusion:Rifapentine has the characters of high effection and low poison,lifting the sputum negative conversion,and promoting the foci absorbtion,cavity close and the symptom eliminating were much better than rifampicin,it was one of the ideal antituberculosis medicine.