摘要
Objective To evaluate the efficacy and economic benefits of Chinese herbs(CHs)and immunomodulators in adjuvant treatment of initial smear positive pulmonary tuberculosis.Methods A prospective case-control study was used.Totally 275 initial smear positive pulmonary tuberculosis patients were assigned to 3 groups by random digit table,91 cases in the control group,92 cases in the immunomodulator group,and 92 cases in the CHs group.Patients in the control group received anti-tuberculosis chemotherapy(2HRZE/4HR).Patients in the immunomodulator group were additionally injected with mycobacterium tumefaciens F.U.36 injection.Those in the CHs group took Jiehe Pill(JHP)additionally.The course of treatment was 6 months for all.The sputum negative conversion rate,lung focus absorption rate,and cavity closure rate of the 3 groups were observed.The remission rate of clinical symptoms and the incidence of adverse drug reactions(ADRs)were observed and compared.The cost-effectiveness analysis method was used for economic evaluation.Results The sputum negative conversion rate,the total lung focus absorption rate,and the cavity closure rate in the immunomodulator group and CHs group were all higher than those in the control group(P<0.05).There were no statistically significant differences in the above rates between the immunomodulator group and the CHs group(P>0.05).After 2 months of treatment,the total effective remission rates of clinical symptoms were higher in the immunomodulator group and the CHs group than in the control group.There was no statistically significant difference between the immunomodulator group and the CHs group(P>0.05).The incidence of ADRs in the control group was 19.78%(18/91),16.30%(15/92)in the immunomodulator group,and 14.13%(13/92)in the CHs group.There was no statistically significant difference among the 3 groups(P>0.05).The average cost of treatment in the immunomodulator group,CHs group,and control group were 10964.92,10750.62,and 8554.84 yuan,respectively.The increment cost-benefit was 178.63 yuan in the immunomodulator group and 106.54 yuan in the CHs group.If the drug price decreased by 15%and the treatment effect was unchanged,it dropped to 151.83 yuan(15.00%decrement)in the immunomodulator group and 88.57 yuan(16.87%)in the CHs group.Conclusion CHs and immunomodulators could accelerate the sputum negative conversion,promote the absorption of the focus and cavity closure,alleviate clinical symptoms,and reduce ADRs.CHs was more effective in controlling the cost.
