初治涂阳肺结核不固定化疗期全程间歇短化效果观察

The effect observation of initial smear-positive pulmonarytuberculosis cases treated with short-course intermittent unfixed-course chemotherapy regimen

目的 观察不固定化疗期全程间歇短化方案治疗初治涂阳肺结核病人的近远期疗效及缩短疗程的可能性。方法 选取 440例初治涂阳肺结核病人 ,随机分为新方案组和原方案组。新方案组病人采用不固定化疗期全程间歇短化方案 (2～3 )H3 R3 Z3 S3 (E3 ) /(2～ 6)H3 R3 ,原方案组病人采用 6个月疗程的全程间歇短化方案 2H3 R3 Z3 S3 (E3 ) /4H3 R3 。结果 两组病人满疗程痰菌阴转率分别为 98.6%和 98.2 %。随访一年复发率分别为 1 .5 %和 2 .0 %。以上两组结果比较无显著性差异 (P >0 .0 5 )。新方案组平均疗程为 4.8个月。比原方案组疗程缩短 1 .2个月。结论 不固定化疗期全程间歇短化方案治疗初治涂阳肺结核病人 ,获得与固定化疗期方案相同的近远期疗效。不固定化疗期疗法可使6个月固定化疗期方案疗程缩短 ,减少服药次数 ,节省病人医药费用、使病人易于配合。

Objective To understand the therapeutic effect and chemotherapy course of intermittent unfixed course regimen with which the initial smear positive pulmonary tuberculosis cases were treated. Methods 440 cases of initial smear positive pulmonary TB cases were selected and divided randomly in the new regimen group and the old regimen group. The TB cases in the new regimen group were treated with the intermittent unfixed course chemotherapy regimen, (2～3)H 3R 3Z 3S 3(E 3)/(2～6)H 3R 3. The ones in the old regimen group were treated with the 6 month intermittent chemotherapy regimen, 2H 3R 3Z 3S 3(E 3)/4H 3R 3. Results The sputum conversion rates of the cases in two groups were 98.6% and 98.2% at the end of six months respectively. The relapse rates of one year were 1.5% and 2.0% respectively. There were not significant differences in all indexes between the two groups ( P >0.05). The average course of the new regimen group was 4.8 months. It is 1.2 months shorter than the olds. Conclusion The initial smear positive pulmonary TB cases that were treated with the intermittent unfixed course chemotherapy regimen had achieved the same effects as with the fixed one. The unfixed course method can shorten the course of the fixed course method. It posses the characteristics of less cost of patient's and the patients are easy to cooperate with the doctor.