康复新液联合抗结核西药治疗结核性腹膜炎的临床疗效观察

Clinical Efficacy of Kangfuxin Solution Combined with Anti-tuberculosis Western Medicine in the Treatment of Tuberculous Peritonitis

目的研究康复新液联合抗结核西药治疗结核性腹膜炎的临床疗效观察。方法选取2017年6月—2019年6月期间河北省胸科医院收治的105例结核性腹膜炎患者作为研究对象,运用随机数字表法将其分为对照组和治疗组,对照组50例患者采用西医常规抗结核治疗,治疗组55例患者采用康复新液联合抗结核西药治疗,两组患者均治疗9个月。治疗完成后,对两组患者的临床总疗效、临床指标(抽水次数、腹水吸收时间及治疗前后的腹膜厚度)、治疗前后中医临床症状(发热、腹痛/腹胀、腹泻、乏力)积分及血清和腹水相关炎症指标[干扰素-γ(Interferon-γ,IFN-γ)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin 6,IL-6)、可溶性白细胞介素2受体(Soluble interleukin-2 receptor,SIL-2R)]进行比较。结果治疗后治疗组总有效率为90.91%(50/55),对照组总有效率为80%(40/50),治疗组临床总有效率明显高于对照组,差异有统计学意义(Z=-1.135,P=0.037,P<0.05)。治疗后两组患者发热、腹痛/腹胀、腹泻、乏力积分与治疗前比较明显降低,差异有统计学意义(P<0.05),且治疗组发热、腹痛/腹胀、腹泻、乏力积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组患者抽水次数、腹水吸收时间、腹膜厚度均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者腹水中IFN-γ、TNF-α、IL-6、SIL-2R水平与治疗前比较明显降低,差异有统计学意义(P<0.05);且治疗组腹水中IFN-γ、TNF-α、IL-6、SIL-2R水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清中IFN-γ、TNF-α、IL-6、SIL-2R水平与治疗前比较明显降低,差异有统计学意义(P<0.05);且治疗组血清中IFN-γ、TNF-α、IL-6、SIL-2R水平均明显低于对照组,差异有统计学意义(P<0.05)。结论康复新液联合常规抗结核药物在结核性腹膜炎患者治疗过程中取得显著疗效。康复新液治疗结核性腹膜炎取得疗效可能涉及多方面机制,需要进一步深入研究,以便更好地将康复新液推广应用于结核性腹膜炎的治疗。

Objective To study the clinical efficacy of Kangfuxin Solution combined with anti-tuberculosis western medicine in the treatment of tuberculous peritonitis.Methods A total of 105 patients(31~52 years old)with tuberculous peritonitiswho were admitted to Hebei Chest Hospital from June 2017 to June 2019 were selected and classified into the control group(n=50)and treatment group(n=55)with the random number table method.The control group received conventional anti-tuberculosis western medicine,andthe treatment group were treated with Kangfuxin Solution and anti-tuberculosis western medicine.The treatment lasted 9 months for both groups.After treatment,the total clinical effective rate,clinical indicators(times of tapping the abdomen,ascites absorption time,and peritoneal thickness before andafter treatment),scores of traditional Chinese medicine(TCM)symptoms(fever,abdominal pain/distention,diarrhea,fatigue)before and after treatment,and serum-and ascites-related inflammatory indicators[interferon-γ(IFN-γ),tumor necrosisfactor-α(TNF-α),interleukin-6(IL-6),soluble interleukin-2 receptor(SIL-2 R)]were compared.Results The total effective rate in the control group was 80%(40/50),as compared with the 90.91%(50/55)in the treatment group(Z=-1.135,P=0.037,P<0.05).After treatment,the scores of fever,abdominal pain/distention,diarrhea,and fatiguewere lower than those before treatment in both groups(P<0.05),and lower in the treatment group than in the control group(P<0.05).After treatment,the times of tapping the abdomen,ascites absorption time,and peritoneal thickness in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of IFN-γ,TNF-α,IL-6,and SIL-2 R in ascites and serum of the two groups of patients werelower than those before treatment(P<0.05),and the levels werelower in the treatment group than in the control group(P<0.05).Conclusion Kangfuxin Solution combined with conventional anti-tuberculosis drugs has achieved significant effects in the treatment of tuberculous peritonitis patients.The therapeutic effect of Kangfuxin Solution in the treatment of tuberculous peritonitis may involve various mechanisms,and further research is needed to better apply Kangfuxin Solution to the treatment of tuberculous peritonitis.