活血化瘀方治疗结核性胸膜炎临床研究

Clinical study on Huoxue Huayu Decoction in treatment of tuberculous pleurisy

目的探讨活血化瘀方治疗结核性胸膜炎的临床效果及对患者胸水中纤维蛋白原(FIB)水平的影响。方法 92例结核性胸膜炎患者按治疗意愿不同分为对照组(n=48)和研究组(n=48),对照组采用抗结核药物化疗联合胸腔穿刺抽液治疗,研究组在对照组治疗的基础上加用活血化瘀方治疗,在治疗前后分别检测2组患者胸水FIB水平,比较治疗前后中医证候积分、治疗效果和不良反应情况。结果治疗前2组患者的胸水FIB水平及中医证候积分差异无统计学意义(P均>0.05)。治疗后2组患者胸水FIB水平明显降低(P均<0.05),咳嗽、咯血、咳痰等证候积分明显改善(P均<0.05),且研究组较对照组改善更明显(P均<0.05);研究组总有效率明显高于对照组(P<0.05);2组不良反应比较差异无统计学意义(P>0.05)。结论活血化瘀方用于治疗结核性胸膜炎可显著降低患者胸水中FIB水平,有效改善临床症状,疗效显著,且不良反应少,值得临床推广。

Objective It is to investigate the clinical effect of Huoxue Huayu Decoction in the treatment of tuberculous pleurisy, and observe the influence on the level of fibrinogen in pleural effusion. Methods 92 cases of tuberculous pleurisy pa- tients were randomly divided into control group and study group with 48 cases in each group. The patients were treated with an- ti tuberculosis drug chemotherapy combined with pleural fluid drainage in the control group. On the basis of the control group, the patients were treated with Huoxue Huayu Decoction. Before and after the treatment, the levels of FIB in pleural effusion of the 2 groups were detected, and the symptom score, treatment effect and adverse reaction were compared before and after treat- ment. Results There was no significant difference in the level of FIB and the symptom score of TCM between the both groups before treatment （ all P 〉 0. 05 ）. After treatment, the levels of FIB in pleura1 effusion of the two groups were significantly de- creased （ all P 〈 0.05）, and the symptom score of cough, expectoration and hemoptysis were improved significantly （ all P 〈 0. 05 ） , there were significant difference between the two groups （ all P 〈 0. 05 ）. The total effective rate in the study group was significantly higher than that in the control group （P 〈 0. 05 ）. There was no significant difference in adverse reactions between the two groups （ P 〉0. 05 ）. Conclusion Huoxue Huayu Decoction for the treatment of tuberculous pleurisy can significantly reduce the level of FIB in pleural fluid, effectively improve symptoms, the curative effect is significant, and with less adverse reactions.