内消瘰疬丸联合左氧氟沙星治疗耐多药肺结核的临床疗效分析

Clinical Efficacy Analysis of Neixiao Luoli Pills Combined Levofloxacin in the Treatment of Multi-drug Resistant Tuberculosis(MDR-TB)

目的:观察内消瘰疬丸与左氧氟沙星联合治疗耐多药肺结核(MDR-TB)的效果。方法:复治涂阳的573例耐多药肺结核患者,随机分为对照组(278例)和治疗组(295例);治疗方案:吡嗪酰胺、盐酸乙胺丁醇、对氨基水杨酸异烟肼和利福喷汀,治疗组联合内消瘰疬丸和左氧氟沙星,对照组只联合左氧氟沙星,疗程均为12个月。结果:治疗中途因药物不良反应终止治疗13例,其中治疗组5例(2.81%),对照组8例(2.18%),治疗组中以胃肠道反应为主,对照组以肝功能损伤为主,对照组实际完成275例,治疗组实际完成285例。疗程结束时,对照组的痰菌阴转率为55.6%,治疗组痰菌阴转率为78.6%,治疗组高于对照组(P<0.05);治疗组病灶吸收有效率(显著吸收和吸收)为78.9%,空洞闭合有效率(闭合和缩小)为83.9%,病灶吸收有效率及空洞闭合有效率均明显高于对照组(P<0.05)。结论:内消瘰疬丸联合左氧氟沙星等二线抗痨药治疗耐多药肺结核,有利于痰菌阴转、病灶吸收和空洞闭合,并且药物不良反应发生率低。

Objective：To observe and evaluate the clinical effect of neixiao luoli pills combined levofloxacin in milti-drug resistant tuberculosis（MDR-TB）.Methods： 573 cases of retreatment smear-positive MDR-TB patients were randomly divided into treatment group（295） and control group（278）;chemotherapy：the treatment group based on neixiao luoli pills and levofloxacin,associated with pyrazinamide,ethambutol,aminosalicylic acid isoniazid and rifapentine. The control group based on levofloxacin,combination therapy is same with the treatment group;The treatment course of all sase is 12 months.Results：13 patients were terminated because of adverse drug reactions in the course of treatment,the treatment group actually completed 285 patients,the control group actually completed 275 patients.To the end of treatment,sputum conversion rate of treatment group and control group separately was 78.6% and 55.6%,sputum conversion rate in the treated group was significantly higher than the control group（P〈0.05）;foci effective rate of treatment group was 78.9%,cavity closure rate was 83.9%,foci effective rate and cavity closure rate in treatment group were significantly haigher than the control group （P〈0.05）.Conclusion：Neixiao luoli pills combined Levofloxacin in the treatment of multi-drug resistant tuberculosis was contribute to sputum conversion and absorption of the lesion,adverse drug reaction was low.