百合固金汤联合2HRZE/4HR方案治疗耐多药肺结核临床研究

Clinical Study on Baihe Gujin Tang Combined with 2HRZE/4HR Regimen for Multidrug Resistant Pulmonary Tuberculosis

目的:观察百合固金汤联合2HRZE/4HR方案对耐多药肺结核(MDR-PTB)患者症状改善及血清T淋巴细胞亚群水平的影响。方法:纳入86例MDR-PTB患者,依据随机数字表法分为2组各43例。对照组予以2HRZE/4HR方案治疗,试验组在对照组基础上予以百合固金汤治疗,2组均治疗6个月。统计2组治疗1、2、6个月末痰菌转阴情况、治疗总有效率及不良反应发生率,比较2组治疗前后T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)及γ-干扰素(IFN-γ)水平。结果:试验组治疗总有效率为90.70%,高于对照组的72.09%(P<0.05)。治疗1、2、6个月末,试验组痰菌转阴率均较对照组高(P<0.05)。治疗前,2组血清T淋巴细胞亚群水平、IFN-γ水平比较,差异无统计学意义(P>0.05)。治疗后,试验组血清CD8^+水平较对照组低,CD3^+、CD4^+、CD4^+/CD8^+、IFN-γ水平较对照组高(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:对MDR-PTB患者予以2HRZE/4HR方案联合采用百合固金汤治疗,可有效提高痰菌转阴率,显著调节血清T淋巴亚群细胞及IFN-γ水平,效果较为显著,且安全性高。

Objective:To observe the effect of Baihe Gujin tang combined with 2 HRZE/4 HR regimen on symptom improvements and levels of serum T lymphocyte subsets of patients with multi-drug resistant pulmonary tuberculosis(MDRPTB).Methods:Enrolled 86 cases of patients with MDR-PTB,and divided them into two groups randomly,43 cases in each group.The control group received 2 HRZE/4 HR regimen,while the experiment group additionally received Baihe Gujin tang.The treatment of both groups lasted for 6 months.Statistically analyzed the status of sputum bacteria turning negative,the total effective rate and the incidence of adverse reactions in both groups in the end of 1,2 and 6 months of treatment,and compared the levels of T lymphocyte subsets(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+)and interferon-γ(IFN-γ)in both groups before and after treatment.Results:The total effective rate was 90.70%in the experiment group,being higher than 72.09%in the control group(P<0.05).At the end of 1,2 and 6 months of treatment,the negative rate of sputum bacteria in the experiment group was higher than that in the control group(P<0.05).Before treatment,comparing the levels of serum T lymphocytes and IFN-γin both groups,there was no significant difference being found(P>0.05).After treatment,the level of serum CD8^+in the experiment group was lower than that in the control group,and the levels of CD3^+,CD4^+and CD4^+/CD8^+were higher than those in the control group(P<0.05).Comparing the incidence of adverse reactions in both groups,there was no significant difference being found(P>0.05).Conclusion:Baihe Gujin tang combined with 2 HRZE/4 HR regimen has relatively significant effect in treating patients with MDR-PTB,which can evidently regulate the levels of serum T lymphocyte subsets and IFN-γwith high safety.