百合固金汤合秦艽鳖甲散治疗阴虚火旺型肺结核患者的效果

Effects of Baihe Gujin decoction and Qinjiao Biejia san in treatment of pulmonary tuberculosis of yin deficiency and fire hyperactivity type

目的:观察百合固金汤合秦艽鳖甲散治疗阴虚火旺型肺结核患者的效果。方法:选取98例阴虚火旺型肺结核患者为研究对象,按照随机数字表法分为对照组和观察组各49例。对照组采用西医常规抗结核治疗,观察组在对照组基础上联合百合固金汤合秦艽鳖甲散治疗,比较两组临床疗效、痰菌转阴率、治疗前后中医证候积分、炎性指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)]水平及不良反应发生率。结果:观察组治疗总有效率为87.76%,高于对照组的61.22%,差异有统计学意义(P<0.05);观察组治疗3、6个月痰菌转阴率均高于对照组,差异有统计学意义(P<0.05);观察组咳嗽气短、反复咯血、潮热盗汗、神疲乏力等中医证候积分均低于对照组,差异有统计学意义(P<0.05);观察组CRP、TNF-α、WBC水平均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为6.12%,低于对照组的22.45%,差异有统计学意义(P<0.05)。结论:百合固金汤合秦艽鳖甲散联合西医常规抗结核治疗阴虚火旺型肺结核患者,可提高临床疗效和痰菌转阴率,降低中医证候积分和炎性指标水平,且安全性高,其效果优于单纯西医常规抗结核治疗。

Objective:To observe effects of Baihe Gujin decoction and Qinjiao Biejia san in treatment of pulmonary tuberculosis of yin deficiency and fire hyperactivity type.Methods:98 patients with pulmonary tuberculosis of yin deficiency and fire hyperactivity type were selected as the research objects,and were divided into control group and observation group according to the random number table method,49 cases in each group.The control group was treated with conventional anti-tuberculosis treatment with western medicine,while the observation group was treated with Baihe Gujin decoction and Qinjiao Biejia san on the basis of that of the control group.The clinical effect,the sputum negative conversion rate,the TCM syndrome score,the inflammatory index levels[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),white blood cell count(WBC)]and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 87.76%,which was higher than 61.22% of the control group,and the difference was statistically significant(P<0.05).The sputum negative conversion rates in the observation group 3 months and 6 months after the treatment were higher than those in the control group,and the differences were statistically significant(P<0.05).The scores of TCM syndromes such as cough,shortness of breath,repeated hemoptysis,hot flashes and night sweating,tiredness in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CRP,TNF-αand WBC in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the observation group was 6.12%,which was lower than 22.45% in the control group,and the difference was statistically significant(P<0.05).Conclusions:Baihe Gujin decoction and Qinjiao Biejia san combined with conventional anti-tuberculosis western medicine in the treatment of pulmonary tuberculosis patients of yin deficiency and fire hyperactivity type can improve the clinical effects and the sputum negative conversion rate,reduce,the TCM syndrome score and the inflammatory index levels,and has high safety.Moreover,it is superior to single conventional anti-tuberculosis treatment with western medicine.