四联抗结核方案联合药物莫西沙星对结核性胸膜炎的治疗作用研究

Study on the therapeutic effect of four antituberculous regimens combined with the drug Moxifloxacin on tuberculous pleurisy

目的探讨四联抗结核方案联合药物莫西沙星对结核性胸膜炎的治疗作用研究。方法选取2017年4月—2018年4月朝阳市第四医院收治的48例结核性胸膜炎患者作为研究对象,按照随机数字表法分为对照组(24例)与实验组(24例)。对照组采用四联抗结核方案联合常规治疗方法,实验组采用四联抗结核方案联合药物莫西沙星治疗方法。比较两组的免疫功能指标包括T淋巴细胞亚群水平CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、血清炎症因子水平包括干扰素-α(INF-α)、干扰素-γ(INF-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、临床疗效。结果实验组治疗后的CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、INF-γ、INF-α高于对照组,差异有统计学意义(P<0.05),实验组治疗后的IL-2、IL-4、IL-10低于对照组,差异具有统计学意义(P<0.05);两组治疗前的CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、INF-γ、INF-α、IL-2、IL-4、IL-10比较,差异无统计学意义(P>0.05);两组治疗后的CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、INF-γ、INF-α均高于治疗前,差异有统计学意义(P<0.05),两组治疗后的IL-2、IL-4、IL-10均低于治疗前,差异有统计学意义(P<0.05);实验组的临床总有效率(87.50%)高于对照组(54.16%),差异有统计学意义(P<0.05)。结论结核性胸膜炎患者应用四联抗结核方案联合药物莫西沙星治疗效果显著,能够有效抑制病情的发展,降低不良反应,值得推广应用。

Objective To explore the therapeutic effect of the quadruple anti-tuberculosis program combined with the drug Moxifloxacin on tuberculous pleurisy.Methods A total of 48 cases of tuberculous pleurisy patients admitted to the Fourth Hospital of Chaoyang City from April 2017 to April 2018 were selected as the research objects,and were divided into the control group(24 cases)and the experimental group(24 cases)according to the random number table method.The control group was treated with a quadruple anti-tuberculosis regimen combined with conventional treatment,and the experimental group was treated with a quadruple anti-tuberculosis regimen combined with the drug Moxifloxacin.The immune function indicators of the two groups were compared,including the levels of T lymphocyte subsets CD8^(+),CD4^(+),CD4^(+)/CD8^(+),and the levels of serum inflammatory factors including interferon-α(INF-α),interferon-γ(INF-γ),and interleukin 2(IL-2),interleukin 4(IL-4),interleukin 10(IL-10),clinical efficacy.Results The CD8^(+),CD4^(+),CD4^(+)/CD8^(+),INF-γ,INF-αof the experimental group after treatment were higher than those of the control group,and the differences were statistically significant(P<0.05).The IL-2,IL-4,IL-10 of the experimental group after treatment were lower than the control group,the differences were statistically significant(P<0.05).There were no significant difference in CD8^(+),CD4^(+),CD4^(+)/CD8^(+),INF-γ,INF-α,IL-2,IL-4 and IL-10 between two groups before treatment(P>0.05).CD8^(+),CD4^(+),CD4^(+)/CD8^(+),INF-γ,INF-αafter treatment in the two groups were all higher than before treatment,and the differences were statistically significant(P<0.05).The IL-2,IL-4,and IL-10 levels of the two groups after treatment were lower than before treatment,and the differences were statistically significant(P<0.05).The total clinical effective rate(87.50%)of the experimental group was higher than that of the control group(54.16%),the difference was statistically significant(P<0.05).Conclusion The quadruple anti-tuberculosis regimen combined with the drug Moxifloxacin has a significant therapeutic effect in patients with tuberculous pleurisy,which can effectively inhibit the development of the disease and reduce adverse reactions.It is worthy of promotion and application.