芩部通络方联合2HRZS/4HR方案对耐多药肺结核患者症状改善及血清T淋巴细胞亚群的影响

The Influence of Qinbu Tongluo Formula Combined with 2HRZS/4HR Scheme on the Improvement of Symptoms and Serum T Lymphocyte Subsets in Patients with Multi-Drug Resistant Tuberculosis

目的:观察芩部通络方联合2HRZS/4HR方案对耐多药肺结核(multi-drug resistant tuberculosis,MDR-PTB)患者症状改善及血清T淋巴细胞亚群的影响。方法:选取本院MDR-PTB患者84例,按照随机数字表法分为对照组和观察组各42例。对照组给予2HRZS/4HR方案治疗,观察组在对照组治疗的基础上予以芩部通络方治疗。比较两组患者临床疗效、治疗前后中医证候积分、血清T淋巴细胞亚群(CD3^+、CD8^+、CD4^+/CD8^+)水平、治疗6个月、12个月、18个月后痰菌转阴率。结果:两组肺结核患者治疗18个月后中医证候积分均降低,且观察组中医证候积分较对照组低,差异有统计学意义(P<0.05);对照组有效率为71.43%,观察组有效率为90.48%,两组有效率比较,差异有统计学意义(P<0.05);两组肺结核患者治疗18个月后观察组痰菌转阴率较对照组高,差异有统计学意义(P<0.05);两组肺结核患者治疗18个月后血清CD3^+、CD8^+水平降低、CD4^+/CD8^+水平增高,与治疗前比较,差异均有统计学意义(P<0.05),且观察组治疗后血清CD3^+、CD8^+水平较对照组高,血清CD4^+/CD8^+水平较对照组低(P<0.05)。结论:芩部通络方联合2HRZS/4HR方案治疗MDR-PTB,可改善患者临床症状,提高痰菌转阴率,增强患者免疫功能。

Objective: To observe the influence of Qinbu Tongluo Formula ( QBTLF) combined with 2HRZS /4HR scheme on the improvement of symptoms and serum T lymphocyte subsets in patients with multi-drug resistant tuberculosis ( MDR-TB). Methods: Eighty-four patients with MDR-PTB treated in our hospital were divided into the control group and the observation group according to random number table method,with 42 cases in each group. The control group was treated with 2HRZS /4HR scheme, while the observation group was treated with QBTLF on the basis of the control group. The clinical efficacies,TCM syndrome scores before and after the treatment,serum T lymphocyte subsets ( CD3^+,CD8^+,CD4^+/CD8^+) levels,sputum negative conversion rate after 6,12 and 18 months of treatment were compared between the two groups respectively. Results: After 18 months of treatment,the scores of TCM syndromes in both groups decreased,and the scores of TCM syndromes in the observation group were lower than those in the control group ( P < 0. 05). The effective rate was 71. 43% in the control group and 90. 48% in the observation group. There was a significant difference between the two groups ( P < 0. 05). After 18 months of treatment,the sputum negative rate of the observation group was higher than that of the control group,and the difference was statistically significant ( P < 0. 05). After 18 months of treatment,the levels of CD3^+ and CD8^+ decreased,CD4^+/CD8^+ increased in the serum of the two groups,and all the differences were statistically significant compared with those before the treatment ( P < 0. 05). And the levels of CD3^+ and CD8^+ in the observation group were higher than those in the control group ( P < 0. 05),while the levels of CD4^+/CD8^+ in the serum of the observation group were lower than those in the control group ( P < 0. 05). Conclusion: QBTLF combined with 2HRZS /4HR scheme has a remarkable efficacy on MDR-TB,can improve the clinical symptoms of patients,improve their negative rate of sputum bacteria,and enhance their immune function.