隔蒜灸配合中药治疗气阴两虚型耐多药肺结核的疗效观察

Therapeutic observation of garlic-insulated moxibustion plus Chinese medication for multidrug-resistant pulmonary tuberculosis due to dual deficiency of Qi and Yin

目的 观察隔蒜灸配合抗痨汤治疗气阴两虚型耐多药肺结核的临床疗效及其对患者胸CT病灶吸收率及肺功能的影响。方法 将130例气阴两虚型耐多药肺结核患者随机分为观察组和对照组,每组65例。对照组给予抗痨汤治疗,观察组给予隔蒜灸配合抗痨汤治疗。观察两组治疗前后各项中医症候积分、免疫功能各项指标(CD4^(+)、CD4^(+)/CD8^(+))、肺功能各项指标[用力肺活量(forced vital capacity, FVC)、第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、FEV1/FVC]及各项炎性因子[基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase-1, TIMP-1)、C反应蛋白(C-reactive protein, CRP)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)]水平的变化情况,比较两组临床疗效、病灶吸收率及不良反应发生率。结果 观察组总有效率及病灶总吸收率分别为90.8%和93.9%,明显高于对照组的72.3%和75.4%,差异具有统计学意义(P<0.05)。两组治疗后各项中医症候积分、CD8^(+)及各项炎性因子水平均较同组治疗前显著下降,CD4^(+)、CD4^(+)/CD8^(+)及肺功能各项指标均显著升高,差异均具有统计学意义(P<0.05)。观察组治疗后各项中医症候积分、CD8^(+)及各项炎性因子水平均明显低于对照组,CD4^(+)、CD4^(+)/CD8^(+)及肺功能各项指标均明显高于对照组,差异均具有统计学意义(P<0.05)。观察组不良反应发生率为3.1%,对照组为7.7%,差异无统计学意义(P>0.05)。结论 隔蒜灸配合抗痨汤治疗气阴两虚型耐多药肺结核可有效改善患者中医症候及肺功能,能促进病灶吸收,提高免疫功能,抑制炎症因子水平。

Objective To observe the clinical efficacy of garlic-insulated moxibustion plus Kang Lao decoction in treating multidrug-resistant pulmonary tuberculosis due to dual deficiency of Qi and Yin and the effects on lesion absorption rate on chest CT and pulmonary function.Method A total of 130 patients with multidrug-resistant pulmonary tuberculosis due to dual deficiency of Qi and Yin were randomized into an observation group and a control group,with 65 cases in each group.The control group was treated with Kan Lao decoction,and the observation group was treated with garlic-insulated moxibustion plus Kang Lao decoction.Before and after the treatment,the following items were observed in both groups:traditional Chinese medicine(TCM)symptom score,﹢immune function indicators[CD4^(+) and CD4^(﹢)/CD8^(﹢)],pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and FEV1/FVC],and inflammatory factor levels[tissue inhibitor of metalloproteinase-1(TIMP-1),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)].The clinical efficacy,lesion absorption rate,and adverse reaction rate were compared between the two groups.Result In the observation group,the total effective rate was 90.8%,and the lesion absorption rate was 93.9%,significantly higher﹢than 72.3%and 75.4%in the control group(P<0.05).In both groups,the TCM symptom scores and the levels of CD8 and inflammatory factors dropped significantly,and the levels of CD4^(﹢),CD4^(﹢)/CD8^(﹢),and pulmonary function indicators increased notably after the treatment(P<0.05).After the intervention,the TCM symptom scores and the﹢levels of CD8 and inflammatory factors were lower,and the levels of CD4^(﹢),CD4^(﹢)/CD8^(﹢),and pulmonary function indicators were higher in the observation group than in the control group,all showing statistical significance(P<0.05).The adverse reaction rate was 3.1%in the observation group versus 7.7%in the control group,and the between-group difference was statistically insignificant(P>0.05).Conclusion Garlic-insulated moxibustion plus Kang Lao decoction can improve the patient’s TCM symptoms and pulmonary function in treating multidrug-resistant pulmonary tuberculosis due to dual deficiency of Qi and Yin,promoting lesion absorption,enhancing immune function,and inhibiting inflammatory factor levels.