百合固金汤加减联合免疫肠内营养辅助治疗重症肺结核的疗效分析

目的探讨百合固金汤加减联合免疫肠内营养辅助治疗重症肺结核的临床疗效。方法60例阴虚火旺型重症肺结核患者随机分为观察组和对照组,每组各30例。对照组给予规范抗痨治疗,观察组在抗痨治疗基础上给予百合固金汤加减联合免疫肠内营养。比较两组患者治疗前后的中医症候积分、淋巴细胞亚群、细胞因子、炎症因子等指标水平,观察治疗2个月末的痰菌阴转率和病灶的吸收情况。结果治疗后,两组的中医证候积分和TNF-α、IL-6、ESR、CRP水平均较治疗前明显降低(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)均较治疗前明显增高(P<0.05),且观察组的变化较对照组更显著(P<0.05);CD8^(+)较治疗前有所上升,但组内及组间比较差异均无统计学意义(P>0.05);IL-10较治疗前均有下降,观察组治疗前后比较差异有统计学意义(P<0.05)。观察组治疗后的痰菌阴转率及病灶吸收情况均优于对照组。结论百合固金汤加减联合免疫肠内营养辅助治疗阴虚火旺型重症肺结核,能够改善患者症状,调节患者免疫功能,增强临床疗效。

Objective To explore the clinical efficacy of Baihe Gujin Decoction combined with immune enteral nutrition in the treatment of severe pulmonary tuberculosis.Methods Sixty patients with severe pulmonary tuberculosis of yin deficiency and fire-strength type were randomly divided into observation group and control group,with 30 cases in each group.The control group was given standard anti-tuberculosis treatment,and the observation group was given Baihe Gujin Decoction combined with immune enteral nutrition on the basis of anti-tuberculosis treatment.The levels of TCM syndrome scores,lymphocyte subsets,cytokines,inflammatory factors and other indicators before and after treatment were compared between the two groups of patients,and the negative conversion rate of sputum bacteria and the absorption of the lesions at the end of the treatment two months were observed.Results After treatment,the scores of TCM syndromes and the levels of TNF-α,IL-6,ESR,and CRP in the two groups were significantly lower than before treatment(P<0.05),and CD4^(+),CD4^(+)/CD8^(+) were significantly higher than before treatment(P<0.05),and the changes in the observation group were more significant than those in the control group(P<0.05),CD8^(+)was increased compared to before treatment,but there was no statistically significant difference within and between groups(P>0.05),IL-10 was compared with treatment.There was a decrease before and after treatment,and the difierence between the observation group before and after treatment was statistically significant(P<0.05).The negative conversion rate of sputum bacteria and the absorption of lesions in the observation group after treatment were better than those m the control group.Conclusion On the basis of anti tuberculosis treatment,Baihe Gujin decoction combined with immune enteral nutrition can improve the symptoms,regulate the immune function and enhance the anti tuberculosis effect of severe pulmonary tuberculosis.