抗痨药物联合免疫调节剂在治疗老年肺结核合并糖尿病中的疗效及对生活能力的影响

Effect of Antituberculosis Drug Combined with Immunomodulator in Treatment of Senile Pulmonary Tuberculosis with Diabetes and Its Influ⁃ence on Living Ability

目的探讨对老年肺结核合并糖尿病患者在抗痨药物基础上联用免疫调节剂治疗的效果及其对痰菌转阴率、病灶吸收、空洞闭合率的影响。方法选择2019年1月—2021年12月扬州市第三人民医院收治的120例老年肺结核合并糖尿病患者,以随机数表法分为对照组(n=60,常规抗痨药物治疗)与观察组(n=60,抗癌药物联合胸腺肽治疗),对比两组临床疗效、血糖控制率、痰菌转阴率、病灶吸收率以及空洞闭合率,并评估两组日常生活能力、营养及衰弱状态。结果观察组总有效率较对照组高(86.67%vs 63.33%),差异有统计学意义(χ^(2)=8.711,P<0.05);两组血糖控制率对比(91.67%vs 86.67%),差异无统计学意义(χ^(2)=0.776,P>0.05)。观察组痰菌转阴、病灶吸收、空洞闭合率(91.67%、86.67%、51.67%)较对照组(70.00%、66.67%、31.67%)高,差异有统计学意义(χ^(2)=9.090、6.708、4.937,P<0.05)。治疗后,观察组ADL评分、MNA评分分别为(87.23±7.29)分、(24.08±1.25)分,均高于对照组,MFS评分为(18.65±5.72)分,低于对照组,差异有统计学意义(t=9.764、9.546、7.689,P<0.05)。结论对老年肺结核合并糖尿病患者采用抗痨药物联合免疫调节剂治疗疗效可靠,能促进患者康复,且可改善机体综合状态。

Objective To explore the effect of antituberculosis drugs combined with immunomodulators in elderly pa⁃tients with pulmonary tuberculosis and diabetes,and its impact on of sputum negative conversion rate,lesion absorp⁃tion rate and cavity closure rate.Methods 120 elderly patients with pulmonary tuberculosis and diabetes admitted to Yangzhou Third People's Hospital from January 2019 to December 2021 were selected,and they were divided into the control group(n=60,treated with conventional antituberculosis drugs)and the observation group(n=60,antituber0culo⁃sis drugs combined with thymosin)by the random numbel-table.The clinical efficacy,blood glucose control rate,spu⁃tum negative conversion rate,focus absorption rate and cavity closure rate of the two groups were compared,and the ability of daily living,nutrition and weakness of the two groups were evaluated.Results The total effective rate of the observation group was higher than that of the control group(86.67%vs 63.33%),and the difference was statistically significant(χ^(2)=8.711,P<0.05).There was no statistically significant difference in blood glucose control rate between the two groups(91.67%vs 86.67%)(χ^(2)=0.776,P>0.05).The sputum bacteria turning negative,focus absorption rate,and cavity closure rate in the observation group(91.67%,86.67%,51.67%)were higher than those in the control group(70.00%,66.67%,31.67%),and the difference was statistically significant(χ^(2)=9.090,6.708,4.937,P<0.05).Af⁃ter treatment,the ADL score and MNA score of the observation group were(87.23±7.29)points and(24.08±1.25)points,respectively,which were higher than those of the control group,the MFS score was(18.65±5.72)points,which was significantly lower than that of the control group,and the difference was statistically significant(t=9.764,9.546,7.689,P<0.05).Conclusion The combination of antituberculosis drugs and immunomodulators is effective for the el⁃derly patients with pulmonary tuberculosis and diabetes.It can promote the recovery of patients and improve the over⁃all state of the body.