抗痨汤治疗耐多药肺结核的临床疗效观察

Clinical research of the effect of Kanglao decoction in treatment of multi-drug resistance tuberculosis(MDR-TB)

目的探讨抗痨汤治疗耐多药肺结核的临床疗效。方法将该院64例耐多药肺结核患者随机分为治疗组和对照组,应用相同化疗方案(6个月阿米卡星,盐酸左氧氟沙星,对氨基水杨酸钠,吡嗪酰胺,丙硫异烟胺/18个月盐酸左氧氟沙星,对氨基水杨酸钠,吡嗪酰胺,丙硫异烟胺),治疗组在该基础上加抗痨汤,对照组在该基础上加中药复方模拟剂,以随机、单盲、安慰剂平行对照,比较两组证候积分、痰菌阴转率、X线吸收率、空洞闭合率、中医证候临床疗效的情况。结果疗程结束,治疗组的证候积分较对照组均明显减少(P<0.01),治疗组痰菌阴转率为78.1%,明显高于对照组的62.5%(χ2=5.497,P<0.05)。治疗组、对照组病灶吸收率分别为81.25%和56.25%,空洞闭合率分别为96.6%和71.4%,中医证候临床疗效分别为100%和81.25%,差异均有统计学意义(P<0.05)。结论治疗组疗效优于对照组,在化疗基础上加用抗痨汤可提高耐多药肺结核的治疗效果,值得临床进一步推广。

[Objective] To discuss the effect of Kanglao decoction in the treatment of multi-drug resistance tuberculosis. [Methods] A total of 64 tuberculosis patients in our hospital were divided into treatment group and control group at random, used the same chemotherapy regimen （6 Am, Lfx, P, Z, Pro/ 18 Lfx, P, Z, Pro）. The treatment group take the added Kanglao decoction, and the control group take the traditional Chinese medicine compound. Use randomized, single-blind, and placebo-contrulled. Compare the two group＇s symptom score, the sputum culture negative conversion rate, focus absorption of chest X-ray, cavity closure rate, and the clinical effect of traditional Chinese medicine. [Results] At the end of the treatment, the treatment group＇s syndrome score is significantly lower than control group （P〈0.01）. The sputum culture negative conversion rate in treatment group was 78.1%, which is higher than control group 62.5% （χ^2= 5.497, P〈0.05）. The focus absorption of chest X-ray was 81.25% in treatment group and 56.25% in control group, and the cavity closure rate was 96.6% in treatment group and 71.4% in control group. The clinical effect of traditional Chinese medicine was 100%, 81.25% in treatment group and control group respectively. All of this with a significant difference between the two groups （P〈0.05）. [Conclusion] The clinical effect of treatment group is better than control group, on the basis of chemotherapy regimen combined with Kanglao decoction can improve the clinical effect of the treatment of MDR-TB, which is worthy of further clinical promotion.