加味定喘汤联合抗痨治疗对重症肺结核患者临床疗效及对患者血气的影响

Clinical Effects of Modified Dingchuan Decoction Combined with Anti-Tuberculosis Therapy for Severe Pulmonary Tuberculosis and Its Influence on Blood Gas Index

目的:探讨加味定喘汤联合抗痨治疗对重症肺结核患者临床疗效及对患者血气指标的影响。方法:选取2015年6月至2017年8月上海市浦东新区肺科医院收治的重症肺结核患者136例,按照随机数字表法随机分为对照组和观察组,每组68例。对照组采用抗痨治疗,观察组在对照组的基础上联合加味定喘汤进行治疗,1个月为1个疗程,2组均连续治疗3个疗程。统计2组患者临床疗效;比较2组治疗后病灶吸收情况、痰菌转阴率、病灶空洞闭合情况;检测并比较2组治疗前后血气指标及肺功能水平。结果:治疗后观察组与对照组的总有效率分别为85. 29%、69. 12%,观察组总有效率高于对照组,差异有统计学意义(P <0. 05)。治疗后观察组痰菌转阴率高于对照组,差异有统计学意义(P <0. 05);治疗后观察组病灶空洞闭合的患者比例高于对照组,差异有统计学意义(P <0. 05),病灶空洞增大的患者比例低于对照组,差异有统计学意义(P <0. 05)。与治疗前比较,治疗后2组PaCO_2水平下降,且观察组低于对照组,差异有统计学意义(P <0. 05);与治疗前比较,治疗后2组PaO_2、SpO_2、OI水平及FVC、PEF、FEV_1及MMEF水平显著升高,差异有统计学意义(P<0. 05),且观察组均高于对照组,差异有统计学意义(P <0. 05)。结论:加味定喘汤联合抗痨治疗可有效缓解重症肺结核患者临床症状,提升对致病菌的清除率,促进病灶空洞闭合,改善患者血气指标及肺功能,临床疗效突出。

Objective To investigate the effects of Modified Dingchuan Decoction combined with anti-tuberculosis therapy for severe pulmonary tuberculosis and its influence on blood gas index. Methods： A total of 136 patients with severe pulmonary tuberculosis treated in Shanghai Pudong New District Pulmonary Hospital were selected as the study objects,and they were divided into observation group and control group with 68 cases in each group by random digital table method.The control group was given anti-tuberculosis therapy and observation group was treated with Modified Dingchuan Decoction based on the treatment of the control group.With one month taken as a course of treatment,and 2 groups were treated for 3 courses of treatment continuously.The clinical efficacy of 2 groups was counted.The changes of focus absorption,sputum negative rate and focal cavity closure of 2 groups after treatment were compared.The blood gas indexes and pulmonary function levels of 2 groups before and after treatment were compared and detected. Results： After treatment,the total effective rate of observation group and control group were 85.29% and 69.12% respectively,which showed that the total effective rate of observation group was significantly higher than control group （ P 〈0.05）.The sputum negative rate of observation group was significantly higher than that the rate of control group after treatment （ P 〈0.01）.After treatment,the proportion of patients with focal cavity closure in observation group was significantly higher than that in control group （ P 〈0.01）,and the proportion of patients with enlarged focal cavity closure was significantly lower than that in control group （ P 〈0.01）.Compared with before treatment,the level of PaCO 2 in 2 groups decreased significantly,and observation group was significantly lower than control group （ P 〈0.01）.Compared with before treatment,the levels of PaO 2,SpO 2,OI and the levels of FEV 1 and MMEF in 2 groups after treatment was significantly higher than that before treatment （ P 〈0.01）,and the levels in observation group were significantly higher than these in control group （ P 〈0.05 or P 〈0.01）. Conclusion： Modified Dingchuan Decoction combined with anti-tuberculosis treatment can effectively relieve the clinical symptoms of patients with severe pulmonary tuberculosis,improve the clearance rate of pathogenic bacteria,promote the focal cavity closure,and improve the blood gas indexes and pulmonary function of patients,whose clinical curative effect is outstanding.