肺结核合并糖尿病的不同给药方式对肺结核治疗临床疗效的影响

Influence of Different Administration Methods of Tuberculosis Complicated with Diabetes on the Clinical Efficacy of Tuberculosis Treatment

目的分析肺结核合并糖尿病的不同给药方式对肺结核治疗临床疗效的影响。方法该研究以2018年6月—2019年1月在该院行诊疗的84例肺结核合并糖尿病患者为对象,将之随机分成泵入组(n=42)与注射组(n=42),均施以3HRZS(E)/6-12HREB结核治疗方案,其中泵入组以泵持续皮下注射给予胰岛素,注射组以多次皮下注射给予胰岛素,比较两组患者的痰菌转阴、肺部病灶吸收情况及症状改善时间。结果泵入组4、6、8周的痰菌转阴率分别为64.29%、80.95%、95.24%,高于注射组的38.10%、59.52%、61.90%,泵入组痰菌转阴率显著高于注射组,差异有统计学意义(χ^(2)=5.765、4.613、13.859,P<0.05);泵入组的病灶吸收有效率显著高于注射组,差异有统计学意义(χ^(2)=4.941,P=0.026),泵入组发热、咳嗽、咯血、寝汗时间分别为(6.03±0.97)d、(4.73±0.78)d、(2.78±0.43)d、(7.34±1.56)d;注射组发热、咳嗽、咯血、寝汗明显好转时间分别为(8.44±1.98)d、(9.24±1.24)d、(4.24±1.01)d、(9.41±2.01)d;泵入组发热、咳嗽、咯血、寝汗明显好转时间均显著短于注射组,差异有统计学意义(t=16.102、37.472、22.004、8.599,P<0.05)。结论肺结核合并糖尿病治疗中,多次皮下注射给药方式与泵持续皮下注射给药方式相比,后者应用效果更佳,可明显提高痰菌转阴率与病灶吸收有效率,促进症状改善。

Objective To analyze the effect of different administration methods of tuberculosis complicated with diabetes on the clinical efficacy of tuberculosis treatment.Methods In this study,84 patients with pulmonary tuberculosis and diabetes who were diagnosed and treated in the hospital from June 2018 to January 2019 were randomly divided into pumping group(n=42)and injection group(n=42).All were administered 3HRZS(E)/6-12HREB tuberculosis treatment plan,in which the pumping group was given continuous subcutaneous injection of insulin by pump,and the injection group was given insulin by multiple subcutaneous injections.The sputum bacteria and lung lesions absorption and time to improve symptoms of the two groups were compared.Results The negative rates of sputum bacteria in the pumping group at 4,6 and 8 weeks were 64.29%,80.95%,and 95.24%,respectively,which were higher than 38.10%,59.52%and 61.90%in the injection group.The pumping group negative rate was significantly higher than that of the injection group,the difference was statistically significant(χ^(2)=5.765,4.613,13.859,P<0.05);the effective rate of lesion absorption in the pumped group was significantly higher than the injection group,the difference was statistically significant(χ^(2)=4.941,P=0.026),the pumping group had fever,cough,hemoptysis,and bed sweating time were(6.03±0.97)d,(4.73±0.78)d,(2.78±0.43)d,(7.34±1.56)d;the injection group had fever,cough,the time for hemoptysis and bed sweating to improve significantly were(8.44±1.98)d,(9.24±1.24)d,(4.24±1.01)d,(9.41±2.01)d,respectively;the time for the pumping group to get better for fever,cough,hemoptysis,and sleeping sweat was significantly shorter than that of the injection group,the difference was statistically significant(t=16.102,37.472,22.004,8.599,P<0.05).Conclusion In the treatment of pulmonary tuberculosis complicated with diabetes,multiple subcutaneous injections are more effective than pump continuous subcutaneous injections.The latter has a better application effect,which can significantly increase the rate of sputum bacteria conversion and the effective rate of lesion absorption,and promote symptom improvement.