骨痨汤联合抗结核治疗对四肢骨结核患者的临床疗效及对其炎性因子水平的影响

The effect of GUTB decoction combined with antituberculous drugs on the level of inflammatory factors and the cure rate in patients with bone tuberculosis of extremities

目的观察骨痨汤联合抗结核治疗对四肢骨结核患者的临床疗效及对炎性因子水平的影响。方法选取湖南省直中医医院2017年4月—2017年11月收治的四肢骨结核患者82例,按照随机数字表法分为观察组和对照组,每组41例。对照组给予抗结核药物异烟肼进行治疗,观察组在对照组治疗的基础上联合骨痨汤进行治疗,治疗3个月后观察两组临床疗效,并记录治疗前、治疗2周、治疗4周后血浆中白细胞介素-2(IL-2)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量变化及疼痛评分、腋下体温、血沉、骨密度变化,观察两组患者治疗期间不良反应发生情况。结果治疗3个月后观察组总有效率显著高于对照组(P<0.05),差异有统计学意义。两组治疗前血浆IL-2、IL-10、IL-6、TNF-α含量比较差异无统计学意义(P>0.05);两组治疗后血浆IL-2、IL-10含量较本组治疗前上升(P<0.05),IL-6、TNF-α含量下降(P<0.05);观察组治疗2周、4周后IL-2、IL-10含量均显著高于对照组,IL-6、TNF-α含量均显著低于对照组(P<0.05),差异有统计学意义。两组治疗2周、4周后腋下体温、疼痛评分、血沉与本组治疗前比较明显下降(P<0.05),骨密度明显上升(P<0.05);观察组治疗2周、4周后腋下体温、疼痛评分、血沉均显著低于对照组,骨密度显著高于对照组(P<0.05),差异有统计学意义。结论骨痨汤联合抗结核治疗四肢骨结核疗效显著,且能降低炎性因子,安全性高,具有较高的临床应用价值。

Objective To study the value of Guluo Decoction combined with anti-tuberculosis treatment for bone tuberculosis of extremities.Methods 82 patients with bone tuberculosis of extremities admitted to our hospital from April 2017 to November 2017 were selected as the study subjects,according to the scheme of randomized grouping,41 cases in observation group and 41 cases in control group were divided into two groups.The control group was treated with isoniazid,an anti-tuberculosis drug;the observation group was treated with Guluo Decoction on the basis of the control group.To observe the clinical effect of the two groups after 3 months of treatment,the changes of serum inflammatory factors[interleukin-2(IL-2),interleukin-10(IL-10),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)]and pain scores,axillary body temperature,erythrocyte sedimentation rate and bone mineral density were recorded before treatment,2 weeks after treatment and 4 weeks after treatment,the incidence of adverse reactions during treatment was also observed in the two groups.Results After 3 months of treatment,the total effective rate of the observation group(95.12%)was significantly higher than that of the control group(70.73%),and the difference was statistically significant(P<0.05).There was no significant difference in the levels of IL-2,IL-10,IL-6 and TNF-αbetween the two groups before treatment(P>0.05);after treatment,the serum levels of IL-2 and IL-10 increased(P<0.05),while the levels of IL-6 and TNF-αdecreased(P<0.05),after 2 and 4 weeks of treatment,the contents of IL-2 and IL-10 in the observation group were significantly higher than those in the control group,while the contents of IL-6 and TNF-αin the observation group were significantly lower than those in the control group(P<0.05).After 2 and 4 weeks of treatment,axillary temperature,pain score and ESR in both groups showed a downward trend(P<0.05),while bone mineral density showed an upward trend(P<0.05);bone mineral density showed an upward trend(P<0.05);the axillary temperature,pain score and erythrocyte sedimentation rate in the observation group were significantly lower than those in the control group after 2 and 4 weeks of treatment,and the bone mineral density was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was 2.44%and that in the control group was 2.44%,there was no significant difference between the two groups(P>0.05).Conclusions Guluo Decoction combined with anti-tuberculosis treatment can improve the cure rate of extremity bone tuberculosis patients,reduce inflammatory factors,and have high safety,thus it has high clinical application value.