结核性脑膜炎急性期应用大量糖皮质激素治疗期间中医症候研究

Study on symptoms of TCM in the acute stage of tuberculous meningitis treated with large amounts of glucocorticoid

目的探讨结核性脑膜炎（TBM）急性期应用大量糖皮质激素治疗期间中医症候。方法选取2014年7月至2017年7月该院收治的TBM患者32例作为研究对象，急性期给予异烟肼、利福平、乙胺丁醇、比嗪酰胺、莫西沙星常规五联抗结核治疗，给予甘露醇脱水，激素应用地塞米松0．4mg·kg-1·d-1，静脉入壶治疗7d。结果应用地塞米松治疗后阴虚火旺证、气阴两虚证、阴虚火旺证发生率明显下降，肝肾阴虚证、湿热证、瘀证、脾虚湿困证发生率明显上升，差异均有统计学意义（P〈0．05）。结论中医认为，激素属阳，与相火相关，阳常有余阴常不足，应用激素3d，以阴虚火旺及气阴两虚为主。

Objective To investigate the symptoms of traditional Chinese medicine（TCM） during the treatment of acute stage of tuberculous meningitis. Methods The application of dexamethasone in the acute stage of tuberculous meningitis in accordance with the inclusion criteria. Results After the application of dexamethasone in the treatment of Yin Huo Wang syndrome and Qi Yin deficiency syndrome with two incidence rate decreased, while the liver and kidney yin deficiency, damp heat, blood stasis, spleen deficiency and dampness syndrome incidence increased significantly, hyperactivity of fire due to yin deficiency decreased significantly （P 〈0.05）. Conclusion Hormone TCM belongs to Yang,which is related to phase fire, Yang excess,yin deficiency,hormone 3 days, yin deficiency fire hyperactivity and Qi and Yin deficiency.