康复新液联合胸腺五肽治疗肺结核患者的效果及对免疫功能的影响

Effect of Kangfuxin Solution combined with thymopentin on pulmonary tuberculosis and immune function

目的评价康复新液联合胸腺五肽用于肺结核的临床疗效及其对血清中CXC趋化因子配体10(CXCL-10)水平的影响。方法选取2015年4月—2017年4月于无锡市第五人民医院治疗的结核分枝杆菌聚合酶链式扩增试验(TB-PCR)阳性或痰菌涂片阳性的初治肺结核患者140例,随机分为对照组(70例)和研究组(70例)。在治疗的最初2个月,研究组患者给予胸腺五肽+康复新液+利福平+异烟肼+乙胺丁醇+吡嗪酰胺,对照组给予利福平+异烟肼+乙胺丁醇+吡嗪酰胺。2个月后,研究组与对照组均给予利福平+异烟肼治疗4个月。观察2组患者的临床疗效及治疗过程中的不良反应发生率。比较2组患者治疗前后免疫功能指标(CD8+、CD4+、CD3+和CD4+/CD8+)及CXCL-10水平。结果研究组的临床有效率为88.57%,对照组为75.71%,研究组高于对照组,差异有统计学意义(P<0.05)。2组患者不良反应发生率的差异无统计学意义(P>0.05)。治疗前2组患者CD8+、CD4+、CD3+、CD4+/CD8+、CXCL-10水平的差异无统计学意义(P>0.05)。治疗后2组患者CXCL-10、CD8+均明显下降,差异有统计学意义(P<0.05),且研究组明显低于对照组,差异有统计学意义(P<0.05);2组患者CD4+、CD3+、CD4+/CD8+均明显升高,差异有统计学意义(P<0.05),且研究组明显高于对照组,差异有统计学意义(P<0.05)。结论康复新液联合胸腺五肽治疗肺结核具有较好的临床疗效,可显著降低患者的炎症反应,提高患者的免疫功能,且安全性高,可在临床上推广应用。

Objective To evaluate the clinical efficacy of Kangfuxin Solution combined with thymopentin in the treatment of pulmonary tuberculosis and its effect on the serum level of CXC motif chemokine 10(CXCL-10).Methods From April 2015 to April 2017,140 patients with TB-PCR positive or sputum smear positive pulmonary tuberculosis treated in Wuxi Fifth People′s Hospital were selected and randomly divided into a control group and a study group(n=70 in each group).During the first two months of treatment,the study group were given thymopentin,Kangfuxin Solution,rifampin,isoniazid,ethambutol,and pyrazinamide,while the control group was given rifampin,isoniazid,ethambutol,and pyrazinamide.Two months later,the study group and the control group were treated with rifampicin and isoniazid for 4 months.The clinical effect and the incidence of adverse reactions were observed.The levels of CD8+,CD4+,CD3+,CD4+/CD8+and CXCL-10 were compared between the two groups before and after treatment.Results The clinical effective rate was 88.57%in the study group and 75.71%in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no significant difference in the levels of CD8+,CD4+,CD3+,CD4+/CD8+and CXCL-10 between the two groups before treatment(P>0.05).After treatment,the levels of CXCL-10 and CD8+decreased significantly in both groups(P<0.05),with these indexes significantly lower in the study group than in the control group(P<0.05).At the same time,the levels of CD4+,CD3+,CD4+/CD8+in the two groups increased significantly(P<0.05),with these indexes significantly higher in the study group than in the control group(P<0.05).Conclusions Kangfuxin Solution combined with thymopentin has a good clinical effect in the treatment of pulmonary tuberculosis,can significantly reduce the inflammatory response,improve the immune function,and has a high safety,which can be promoted in clinical application.