中药联合西药对初治继发性肺结核病的临床效果研究

Clinical effect study of TCM combined with western medicine on initial treatment of secondary pulmonary tuberculosis

目的探讨中药联合西药治疗初治继发性肺结核病的临床效果。方法选取全国14家医院门诊2009年5月-2010年10月收治的符合西医初治继发性肺结核病和中医肺痨（肺阴亏虚证）诊断标准的患者695例。将患者随机分为试验组340例和对照组355例。试验组给予中药联合西药方案治疗,对照组给予西药方案治疗。疗程均为6个月。比较两组的中医证候治愈率、痰涂片转阴率、X线改变情况等。结果试验组的中医证候治愈率为92.10%,对照组为75.42%;试验组的X线病灶明显吸收率为82.82%,对照组为63.97%,两组的上述指标比较差异有统计学意义（P〈0.01）;试验组的空洞闭合率为69.23%,对照组为63.08%,两组差异无统计学意义（P〉0.05）;两组的痰涂片阴转率差异无统计学意义（P〉0.05）;试验组的胃肠道反应、白细胞减少发生率低于对照组（P〈0.05）。结论中药联合西药治疗初治继发性肺结核病（肺阴亏虚证）,可明显减轻临床症状,提高X线病灶明显吸收率和空洞闭合率,且安全性较高。

Objective To explore TCM combined with western medicine treating initial treatment of secondary pulmonary tuberculosis. Methods From May 2009 to October 2010,695 patients conforming to the diagnosis criteria of initial treatment of secondary pulmonary tuberculosis by western medicine and tuberculosis of TCM（pulmonary yin-deficiency syndrome） were selected in the outpatient of 14 nationwide hospitals from.Patients were randomly divided into experiment group（n=340） and control group（n=355）.Experiment group was treated by treatment plan of TCM combined with western medicine,while control group was treated by western medicine.The course of treatment was 6 months.The cure rate of TCM syndrome,the negative rate of sputum smear and change of X-ray and so on between two groups was compared respectively. Results The cure rate of TCM syndrome of experiment group was 92.10%,and control group was75.42%;the absorption rate of X-ray lesion of experiment group was 82.82%,control group was 63.97%,and there was a statistical difference of above-mentioned indexes（P〈0.01）;the closing rate of cavity in experiment group was 69.23%,control group was 63.08%,and there was no statistical difference between two groups（P〈0.05）.There was no statistical difference of the negative rate of sputum smear between two groups（P〈0.05）.The incidence rate of gastrointestinal reaction and white blood cell reduction in experimental group was lower than that in control group respectively（P〈0.05）.Conclusion TCM combined with western medicine treating initial treatment of secondary pulmonary tuberculosis（pul-monary yin-deficiency syndrome） can obviously reduce the clinical symptom,improve the absorption rate of X-ray lesion and the closing rate of cavity,and its safety is higher.