中药熏蒸辅助治疗结核性胸膜炎的疗效观察

Therapeutic effect of Chinese medicine fumigation adjuvant therapy on tuberculous pleurisy

目的探讨中药熏蒸辅助治疗结核性胸膜炎的临床疗效。方法选择2017年3月~2018年10月在我院诊断治疗的结核性胸膜炎患者60例为研究对象。对照组采用2HRZE/10HR方案抗结核治疗,观察组在此基础上给予中药熏蒸治疗。比较两组临床疗效,治疗前后中医证候积分,治疗前后胸腔积液TNF-α、FIB及TGF-β1水平。结果观察组总有效率为100.0%,显著高于对照组,差异有统计学意义(P<0.05)。治疗2周后,两组胸水TNF-α、FIB及TGF-β1水平较治疗前均显著下降,差异有统计学意义(P<0.05);治疗2周后,观察组TNF-α、FIB及TGF-β1水平显著低于对照组,差异有统计学意义(P<0.05)。治疗4周,观察组发热、胸胁痛、气促、咳嗽等中医证候积分显著低于治疗前及对照组治疗后,差异有统计学意义(P<0.05);对照组治疗后发热、胸胁痛、气促、咳嗽等中医证候积分显著低于治疗前,差异有统计学意义(P<0.05)。结论中药熏蒸辅助治疗结核性胸膜炎能显著改善症状,提高临床疗效。

Objective To explore the clinical efficacy of traditional Chinese medicine fumigation adjuvant therapy on tuberculous pleurisy. Methods 60 patients with tuberculous pleurisy diagnosed and treated in our hospital from March2017 to October 2018 were selected as subjects. The control group was treated with 2 HRZE/10 HR anti-tuberculosis treatment, and the observation group was given traditional Chinese medicine fumigation treatment on this basis. The clinical efficacy, the TCM syndrome score before and after treatment, and the levels of TNF-α, FIB and TGF-β1 in pleural effusion before and after treatment between the two groups were compared. Results The total effective rate of the observation group was 100.0%, which was significantly higher than that of the control group.The difference was statistically significant(P<0.05). After 2 weeks of treatment, the levels of TNF-α, FIB and TGF-β1 in pleural effusion of the two groups were significantly lower than those before treatment, and the difference was statistically significant(P<0.05).After 2 weeks of treatment, the level of TNF-α, FIB and TGF-β1 in the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05). After 4 weeks of treatment, the TCM syndrome scores of fever, chest pain, shortness of breath and cough in the observation groups were significantly lower than those before treatment and those of the control group after treatment(P<0.05). The scores of TCM syndromes such as fever, hypochondriac pain, shortness of breath and cough in the control group were significantly lower than those before treatment, and the difference was statistically significant(P<0.05). Conclusion Chinese medicine fumigation adjuvant therapy for tuberculous pleurisycan significantly improve symptoms and improve clinical efficacy.