中西医结合联合支气管镜局部灌注治疗空洞型肺结核临床观察

Clinical Observation on the Treatment of Cavernous Pulmonary Tuberculosis with the Combination of Traditional Chinese Medicine and Western Medicine Combined with Bronchial Microscope

目的:探讨中西医结合联合纤维支气管镜局部灌注给药对空洞型肺结核治疗的意义、方法及并发症,并探讨其临床价值。方法:选取笔者所在医院呼吸内科2013年1月-2014年12月收治的164例确诊的空洞型肺结核患者,按照随机化分组表法分为对照组和观察组,各82例,对照组采用常规抗结核(3HRZE/6HRE)治疗,观察组在对照组治疗基础上分别辅以中医辨证分4型治疗及支气管镜引导局部灌注抗结核药介入治疗,疗程为9个月;治疗后,比较分析两组患者的支气管镜腔内部改善率、空洞病灶有效率、空洞闭合率、痰结核杆菌阴转率和并发症发生率。结果:治疗后观察组在3、6、9、12个月的支气管镜腔内部改善率、空洞病灶有效率、空洞闭合率、痰结核杆菌阴转率与对照组比较均改善,差异均有统计学意义(P<0.05);两组患者均无严重并发症发生,差异无统计学意义(P>0.05)。结论:中西医结合联合纤维支气管镜局部灌注给药治疗空洞型肺结核疗效显著优于单纯化疗,且无明显并发症发生,患者乐于接受,值得在临床上应用。

Objective： To explore the significance, methods and complications of traditional Chinese and Western medicine combined with the local infusion of the fiber bronchus mirror with the treatment of cavity type pulmonary tuberculosis, and to discuss the clinical value of the treatment.Method： 164 cases of patients with confirmed cavity type pulmonary tuberculosis were randomly divided into the control group and the observation group with 82 cases in the Hospital Respiratory Medicine from January 2013 to December 2014.The control group was treated with conventional anti tuberculosis（3HPtZE/6HRE） treatment, the observation group was treated with traditional Chinese medicine treatment of syndrome differentiation type 4 and the interventional therapy of local infusion of anti tuberculosis drugs based on the treatment of control group, the course of treatment was 9 months.After treatment, the bronchoscope cavity internal improvement rates, the efficiency of cavity lesion, the cavity closure rates, Mycobacterium tuberculosis by sputum negative conversion rate and the incidence rate of complications of the two groups were compared and analyzed.Result： After treatment, the bronchoscope inside the cavity to improve the rate, effective cavity lesion cavity closing rate of Mycobaeterium tuberculosis in sputum negative rate of observation group in 3, 6, 9, 12 months compared with control group were significantly improved, the difference was statistically significant （P〈0.05）.There were no serious complications in the two groups, the difference was no statistically significant（P〉0.05）.Conclusion： Combined treatment of traditional Chinese and Western medicine combined with the local infusion of the fiber bronchus mirror with the treatment of cavity type pulmonary tuberculosis has a significant effect, better than chemotherapy alone, and no obvious complications, patients are willing to accept, it is worthy of clinical application.