中西医结合治疗肺结核的临床研究

Clinical observation of integrated traditional Chinese and western medicine in the treatment of pulmonary tuberculosis

目的 研究中西医结合治疗肺结核 ,应用抗痨汤 (KLT)替代乙胺丁醇 (EB)对比性临床研究。方法 随机分组为治疗组 46例和观察组 30例 ,年龄 18～ 60岁 ,初治菌阳肺结核患者。治疗组为KLT +异烟肼 (INH) +利福平 (RFP) ;对照组为EB +INH +RFP。疗程 3个月。观察两组患者治疗前后中医证候群 (症状 )的变化 ,痰菌阴转率和胸片病变范围吸收情况。根据评分标准总结积分 ,并评定其疗效。结果 在改善中医证候群方面治疗组显效率 88.18% ,总有效率 10 0 % ;对照组显效率 73.33% ,总有效率 98.33% ,治疗后两组比较 ,治疗组显著下降 (P <0 .0 1) ;痰菌阴转情况治疗组第 2个月显效 ;对照组第 3个月显效。胸片病变吸收情况治疗组第 3个月显效 ;对照组第 3个月有效。结论 治疗组在缓解中医证候 ,抗杀结核菌 ,促进病变吸收均优于对照组。

Objective To observe the therapeutic effect of Kanglaotang (KLT) instead of EB in the treatment of pulmonary tuberculosis (TB).Methods 76 patients with new smear positive pulmonary TB (age range,18～60 yr) were randomly divided into treatment group (n=46) and control group (n=30).The therapy was consisted of KLT+isonicotini acid hydraxide (INH)+rifampicin (RFP) in treatment group and ethambutol (EB)+INH+RFP in control group.At the end of third month,clinical symptoms,change of TCM syndrome,sputum negative conversion rate and foci absorption were observed and evaluated for two groups.Results On the improvement of TCM syndrome,the total effective rate in treament group was 100% and the markedly effective rate was 88.18%,which were obviously superior to those of control group respectively (P<0.01).Sputum negative conversion in treatment group was found at the end of second month, while that in control group was at the end of third month.Obviously foci absorption in the treatment group occurred at the end of third month.Conclusions The treatment group is superior to the control group in relieving the TCM syndrome inhibiting mycobacterium tuberculosis and promoting foci absorption.It has vast prospects to investigate a new therapy of integrated traditional Chinese and western medicine in the treatment of pulmonary TB.