养阴补肺中药治疗耐多药肺结核疗效及对免疫功能的影响

Effect of traditional Chinese medicine for nourishing yin and tonifying the lung in the treatment of multi drug resistant pulmonary tuberculosis and its influence on immune function

目的探讨养阴补肺中药治疗耐多药肺结核疗效及对免疫功能的影响。方法将120例耐多药肺结核患者随机分为2组,对照组60例给予常规西药抗结核治疗,观察组60例在此基础上加用养阴补肺中药治疗。观察2组治疗3个月和6个月后痰结核菌培养结核菌转阴率、胸部CT影像好转率,比较2组治疗前后中医证候积分及CD3^+、CD4^+、CD8^+水平,统计2组近期疗效和不良反应发生情况。结果观察组随访3个月和6个月痰结核菌培养结核菌转阴率和胸部CT影像好转率均显著高于对照组(P均<0.05);2组治疗后咳嗽、咳痰、咯血、潮热、盗汗及发热积分均显著低于治疗前(P均<0.05),且观察组治疗后各项积分均显著低于对照组(P均<0.05);对照组治疗前后CD3^+、CD4^+及CD8^+水平比较差异无统计学意义(P均>0.05),观察组治疗后CD3^+、CD4^+及CD8^+水平均显著改善(P均<0.05),且观察组显著优于对照组(P均<0.05);观察组近期治疗总有效率显著高于对照组(P<0.05),不良反应发生率显著低于对照组(P<0.05)。结论养阴补肺中药治疗耐多药肺结核可有效提高病原菌清除率,缓解临床症状体征,改善机体免疫功能,并有助于减少不良反应。

Objective It is to investigate the curative effect of traditional Chinese medicine for nourishing yin and tonifying the lung in the treatment of multi drug resistant pulmonary tuberculosis and its influence on immune function. Methods 120 patients with multi drug resistant pulmonary tuberculosis were randomly divided into 2 groups, 60 cases in the control group were given anti tuberculosis treatment with conventional western medicine, and the other 60 cases in the observation group were treated with traditional Chinese medicine for nourishing yin and tonifying the lung on the basis of the treatment of the control group. The sputum pathogen clearance rate, and the improvement rate of chest CT images in the two groups were observed af- ter treatment for 3 months and 6 months, and the TCM syndrome scores, the levels of CD3 ~ , CD4 ~ , CD8 ＋ were compared before and after treatment, the curative effect and the incidence of adverse reactions of two groups were accounted. Results Af- ter followed up for 3 months and 6 months, the sputum pathogen clearance rate and improvement rate of CT chest images in the observation group were significantly higher than those in the control group （ all P 〈 0.05 ） ; and the scores of cough, expectora- tion, hemoptysis, fever, night sweats, hot flashes in the two groups after treatment were significantly lower than before treat- ment （ all P 〈 0.05） , and the scores of the observation group were significantly lower than that of the control group （ P 〈 0. 05 ） ; the levels of CD3 ~ , CD4 ~ and CD8 ~ after treatment in the observation group were significantly improved and signifi- cantly higher than those of the control group （ all P 〈 0.05 ） , but there was no significant difference in the control group before and after treatment （ P 〉 0.05 ） ; the total effective rate of treatment in the observation group was significantly higher and the incidence of adverse reactions was significantly lower than that in the control group （P 〈 0.05 ）. Conclusion Traditional Chi- nese medicine for nourishing yin and tonifying the lung can effectively improve the clearance rate of the pathogenic bacteria in the treatment of multi drug resistant pulmonary tuberculosis, relieve clinical symptoms, improve immune function, and helps to reduce adverse reactions.