利福布汀胶囊联合莫西沙星治疗耐多药肺结核的疗效分析

Efficacy Analysis of Rifambutin capsule Combined with Moxifloxacin in the Treatment of Multidrug-resistant Pulmonary Tuberculosis

目的:探讨利福布汀联合莫西沙星治疗耐多药肺结核的价值。方法:选择2019年6月至2020年9月沈阳市第十人民医院收治的耐多药肺结核患者96例,按随机数字表法分成两组各48例,M组服用利福布汀^(+)莫西沙星,Z组服用利福布汀^(+)左氧氟沙星。服药前及服药后6个月测定两组的C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、辅助性T细胞(CD4^(+))、细胞毒性T细胞(CD8^(+))及CD4^(+)/CD8^(+)指标。观察两组痰菌转阴及病灶吸收状况,统计两组不良反应发生率,比较两组用药结果。结果:服药前两组炎性因子差异无统计学意义(P>0.05)。服药后M组CRP、IL-6、TNF-α低于Z组,服药后1、3、6个月M组的痰菌转阴率均高于Z组,差异均有统计学意义(P<0.05)。服药前两组T细胞亚群差异无统计学意义(P>0.05)。服药后M组CD4^(+)、CD4^(+)/CD8^(+)高于Z组,但CD8^(+)低于Z组,差异均有统计学意义(P<0.05)。M组病灶吸收有效率高于Z组(79.17%vs 60.42%,P<0.05)。M组不良反应发生率低于Z组(6.25%vs 20.83%,P<0.05)。结论:利福布汀^(+)莫西沙星治疗耐多药肺结核疗效更好,可消除炎性反应,促进病灶吸收,改善T细胞亚群,提升痰菌转阴率,同时避免严重不良反应发生。

Objective:To study the application value of rifabutin and moxifloxacin in multi drug resistant pulmonary tuberculosis.Methods:A total of 96 patients with MDR-TB admitted to Shenyang 10th People’s Hospital from June2019 to September 2020 were selected and divided into two groups according to random number table:group M received rifambutin^(+)moxifloxacin,group Z received rifambutin^(+)levofloxacin,48 patients in each group.The C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),helper T cells(CD4^(+)),cytotoxic T cells(CD8^(+)) and CD4^(+)/CD8^(+)indexes in both groups were measured before and 6 months after medication.The turn of sputum into negative and the absorption of lesions were observed in the two groups.The incidence of adverse reactions in the two groups was counted and the results of medication in the two groups were compared.Results:There was no significant difference in inflammatory factors between the two groups before administration(P>0.05).After medication,CRP,IL-6 and TNF-αin group M were lower than those in group Z,and the sputum bacteria negative conversion rate in group M was higher than that in group Z at 1,3 and 6months after medication,with statistical significance(P<0.05).There was no significant difference in T cell subsets between the two groups before administration(P>0.05).After medication,CD4^(+)and CD4^(+)/CD8^(+)in group M were higher than that in group Z,but CD8^(+)was lower than that in group Z,with statistical significance(P<0.05).The absorption efficiency in M group was higher than that in Z group(79.17%vs.60.42%,P<0.05).The incidence of adverse reactions in group M was lower than that in group Z(6.25%vs.20.83%,P<0.05).Conclusion:Rifampin combined with moxifloxacin can better relieve the inflammatory reaction,promote the focal absorption,improve T cell subsets and sputum negative rates,and avoid serious adverse reactions.