3种服用抗结核药物方式的效果对比分析

Comparative analysis of effect of 3 anti-tuberculosis medication plans

目的了解3种常用的抗结核药物服用方式导致结核病患者不良反应、中断治疗的差异,论证其临床实用价值。方法初治结核病住院患者使用固定剂量复合制剂的设为Ⅰ组,使用板式组合药的设为Ⅱ组,使用散装药的设为Ⅲ组,回顾性调查治疗后的不良反应、中断治疗情况以及疗效。结果Ⅰ组和Ⅲ组药物不良反应发生率差异无统计学意义(P>0.05),Ⅱ组与Ⅰ组、Ⅲ组比较差异有均统计学意义(P值均<0.05),差异主要表现在胃肠反应及神经系统异常。中断原治疗方案率3组两两比较,差异均有统计学意义(P值均<0.05)。肺部病变明显吸收率3组差异无统计学意义(P>0.05)。结论抗结核固定剂量复合制剂或板式抗结核组合药属于国家提供的免费药物政策,有利于督导人员发药与管理,前者更容易被结核病患者接纳,是目前适宜推广使用的结核病化疗药物。抗结核散装制剂尽管相对科学合理,但不利于我国DOTS策略覆盖。

Objective To investigate adverse reactions and difference among treatment interruption caused by 3 common an- ti-tuberculosis （TB） medication plans; to evaluate clinical value of above 3 medication plans. Methods Initial stage of tubercu losis treatment inpatients were divided into 3 groups. Group Ⅰ used FDC, group Ⅱ used assembled drug combination, and group Ⅲ used bulk drug for treatment. Retrospective study was used to analyze adverse reactions, treatment interruptions and treatment effect of 3 groups. Results There was no statistical difference between adverse reaction incidence of Group I and group Ⅱ （P〉0. 05）,while statistical differenee was observed between those of group Ⅰ and group Ⅱ , group Ⅱ and group Ⅲ （all P〈0.05）, major difference was observed for gastrointestinal reaction and neurological abnormality. Treatment interrup- tion rate showed statistical difference between every 2 groups （all P〈0.05）. No statistical difference was observed for lung le- sions absorption rate among 3 groups （P〉0.05）. Conclusion Anti-TB FDC treatment and assembled drug combination treat ment were free national policy, which were easy for supervisory personnel to dispense drugs and manage. FDC treatment was more easily to be accepted by TB patients which made it the most suitable medication plan to be promoted for TB chemothera- py. The bulk anti-TB drug treatment was scientifically reasonable; however it is not conductive for DOTS coverage in China.