扶正抗痨方辅助治疗耐多药肺结核的痰菌阴转率及对免疫功能的影响

Effect of the Fuzheng Kanglao decoction on sputum negative conversion and immune function for treatment of multi-drug-resistant tuberculosis

目的观察扶正抗痨方辅助治疗耐多药肺结核的痰菌阴转率及对免疫功能的影响。方法将90例耐多药肺结核患者按照随机数字表法分为对照组和观察组,对照组给予常规药物治疗,观察组在常规治疗的基础上加用扶正抗痨方治疗。治疗6个月后以对照组作比较,根据综合疗效、CT疗效、痰菌阴转率、免疫功能及可能发生的不良反应对扶正抗痨方的辅助治疗效果作出评价。结果治疗6个月后,观察组患者痰菌阴转率为84.4%,对照组为51.1%,差异有统计学意义(χ2=4.52,P<0.05);胸部CT检查好转率观察组为88.9%,对照组为55.6%,差异有统计学意义(χ2=5.06,P<0.05);治愈率观察组为44.4%,对照组为33.3%差异有统计学意义(χ2=6.11,P<0.05);外周血CD3+,CD4+百分率观察组分别为(61.8±7.2)%和(36.2±6.9)%,对照组分别为(53.3±5.5)%和(32.1±5.4)%,差异有统计学意义(t=2.96、3.04,P<0.05);肝功能异常及白细胞减少发生率观察组分别为13.3%(6/45)和4.4%(2/45),对照组分别为24.4%(11/45)和17.7%(8/45),差异有统计学意义(χ2=4.81、5.33,P<0.05);不良反应发生次数观察组共59次,对照组共166次。结论扶正抗痨方辅助治疗耐多药肺结核效果显著,可提高患者免疫功能,促进病原菌清除,且安全性良好,是临床耐多药肺结核较理想的辅助治疗方法。

Objectives To observe the effect of the Fuzheng Kanglao decoction on sputum negative conversion and immune function for treatment of multi-drug-resistant tuberculosis（MDR-TB）. Methods Ninety patients with MDR-TB were randomly divided into a control group and an observation group using a random number table.Patients in the control group received conventional chemotherapy.Based on the treatment of the control group,patients in the observation group were also administered a modified Fuzheng Kanglao decoction.Course of treatment in those two groups were both six months.After 6 months of treatment,overall efficacy,efficacy according to CT,the sputum negative conversion rate,immune function,and other aspects were compared in the two groups.Adverse reactions were recorded. Results The sputum negative conversion rate was 84.4%in the observation group,which was better than that of 51.1%in the control group after 6 months of treatment（χ2=4.52,P〈0.05）.Efficacy according to a chest CT in the observation group was88.9%,which was better than that of 55.6%in the control group during 6 months of treatment（χ2=5.06,P〈0.05）.The cure rate in the observation group was 44.4%,which was superior to that of 33.3% in the control group during 6 months of treatment（χ2=6.11,P〈0.05）.Levels of CD3＋and CD4＋in the observation group（61.8±7.2% and 36.2±6.9%）were higher than those in the control group（53.3±5.5% and 32.1±5.40%）,（t=2.96,3.04,P〈0.05）,while levels of CD8＋in the observation group（21.1±6.8）were lower than those in the control group（26.5±6.3）,（t=3.26,P〈0.05）.The incidence of abnormal liver function and leukopenia in the observation group（13.3%（6/45）and 4.4%（2/45））was lower than that in the control group（24.4%（11/45）and 17.7%（8/45））,（χ2=4.81,5.33,P〈0.05）.Fiftynine adverse reactions occurred in the observation group,which was lower than 166 that occurred in the control group.Conclusion The Fuzheng Kanglao decoction had a marked effect on the treatment of MDR-TB.The decoction improved patients＇ immune function,it helped to clear pathogens,and it was safe.The Fuzheng Kanglao decoction is a relatively ideal adjuvant therapy for the clinical treatment of MDR-TB.