滋阴润肺抗痨方中药雾化治疗对耐多药肺结核病理状态改善效应及对患者细胞免疫功能的影响

Ziyin Runfei Kanglao prescription on the improvement of pathological state and cellular immune function in patients with multi-drug resistant pulmonary tuberculosis

目的:观察滋阴润肺抗痨方中药雾化治疗对耐多药肺结核患者病理状态的改善效应及对细胞免疫功能的影响。方法:将84例耐多药肺结核患者按照随机数字表法分为观察组和对照组,每组各42例,对照组给予标准化抗结核方案治疗,观察组在对照组的基础上加用滋阴润肺抗痨方中药雾化治疗,两组连续治疗6个月。观察记录两组病理状态改善状况(痰菌转阴率、病灶吸收有效率、空洞闭合有效率)、中医证候量化积分(咳痰咯血、盗汗潮热、神疲无力、咽燥口干)、免疫指标(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)改善状况,评估两组临床疗效,并统计两组用药安全性。结果:观察组总有效率90.5%,明显高于对照组总有效率73.8%(χ^2=3.977,P<0.05);观察组治疗后空洞闭合有效率、病灶吸收有效率及痰菌转阴率均明显高于对照组(P<0.05);两组治疗后咳痰咯血、盗汗潮热、神疲无力、咽燥口干积分均显著下降(P<0.05),且观察组治疗后以上中医证候量化积分降低更明显(P<0.05);观察组治疗后CD3^+、CD4^+、CD4^+/CD8^+水平均明显高于本组治疗前及对照组治疗后(P<0.05),CD8^+水平均低于本组治疗前及对照组治疗后(P<0.05),对照组治疗前后以上细胞免疫功能指标差异均无统计学意义(P>0.05);两组治疗期间均未出现严重的不良反应事件,部分患者血常规出现异常经对症治疗后恢复正常。结论:滋阴润肺抗痨方中药雾化能够有效调节耐多药肺结核患者的细胞免疫功能,改善患者临床症状,提高痰菌转阴率、病灶吸收有效率及空洞闭合有效率,有助于改善患者病理状态,且用药安全性较高。

Objective:To observe the effect of aerosol therapy of Ziyin Runfei Kanglao prescription on the improvement of pathological state and cellular immune function in patients with multi-drug resistant pulmonary tuberculosis.Methods:84patients with MDR-TB were divided into observation group and control group according to random number table method.42patients in each group were treated with standardized anti-tuberculosis regimen.The observation group was treated with traditional Chinese medicine aerosol of Ziyin Runfei Kanglao prescription on the basis of the control group.The two groups were treated for six months continuously.The improvement of pathological condition(sputum negative rate,focus absorption efficiency,cavity closure efficiency),quantified integral of TCM syndromes(expectoration and hemoptysis,night sweat and tide fever,fatigue,dry throat and mouth),immune indicators(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+)of the two groups were recorded and observed,and the clinical efficacy and the safety of medication of the two groups were evaluated.Results:The total effective rate of the observation group was 90.5%,which was significantly higher than that of the control group(χ^2=3.977,P<0.05);the focus absorption efficiency,cavity closure efficiency and sputum negative conversion rate of the observation group were significantly higher than those of the control group(P<0.05);the sputum hemoptysis,night sweat fever,fatigue and dry throat scores of the two groups were significantly decreased after treatment(P<0.05),and the quantified integral of TCM syndromes in the observation group decreased more significantly(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in the observation group were significantly higher than those before treatment and after treatment in the control group(P<0.05),and the levels of CD8^+were lower than those before treatment and after treatment in the control group(P<0.05).There was no significant difference in the above cellular immune function indexes before and after treatment in the control group(P>0.05).There were no serious adverse reactions during the treatment in both groups.Conclusion:Aerosol therapy of Ziyin Runfei Kanglao prescription can effectively regulate the cellular immune function of MDR-TB patients,improve their clinical symptoms and sputum negative conversion rate,focus absorption efficiency and cavity closure efficiency,which help to improve the pathological state of patients,with higher drug safety.