芪百汤对老年耐多药肺结核患者免疫功能的影响

Effect of Qibai decoction on the immune function in patients with senile polydrug-tolerant pulmonary tuberculosis

目的 :研究芪百汤对老年耐多药肺结核患者免疫状态的调节作用。方法 :6 0例老年性耐多药肺结核患者随机分为中西医结合治疗组和西药对照组 ,采用相应药物治疗。观察两组治疗前后 T淋巴细胞亚群(TL CFU )以及可溶性白细胞介素 2受体 (s IL 2 R)含量的变化 ,同时以 4 0例健康人为对照。结果 :6 0例耐多药肺结核患者治疗前 CD3、CD4及 CD4 /CD8比值均明显低于健康对照组 (P均 <0 .0 1) ,中西医结合治疗后CD3、CD4、CD4 /CD8显著升高 (P<0 .0 5或 P<0 .0 1) ,CD8明显下降 (P<0 .0 5 ) ,上述改变均较西药对照组为优。 6 0例耐多药肺结核患者 s IL 2 R含量显著高于健康对照组 (P<0 .0 1) ,中西医结合治疗后 s IL 2 R含量显著下降 (P<0 .0 1) ,且较西药对照组明显 (P<0 .0 1)。结论 :老年耐多药肺结核患者存在严重的细胞免疫功能低下和失调 ,TL CFU和 s IL 2 R可评估患者的机体免疫平衡状态。

Objective: To study the regulatory action of Qibai decoction(QBD, ) on the immune state in patients with senile polydrug -tolerant pulmonary tuberculosis. Methods: Sixty patients with senile polydrug-tolerant pulmonary tuberculosis were randomly divided into the control group and the QBD treatment group. The changes of T-lymphocyte subgroup (TL-CFU) and soluble interleukin-2 receptor (sIL-2R) were observed before and after treatment, meantime 40 healthy persons were as the normal control group. Results: CD3, CD4 and the ratio of CD4/CD8 of 60 patients were lower than those of the normal control group (all P <0 01). In the patients of QBD treatment group, the levels of CD3,CD4 and the ratio of CD4/CD8 raised significantly after treatment( P <0 05 or P <0 01),the level of CD8 obviously dropped ( P <0 05) . In comparison with the control group, the changes of the treatment group were superior to those of the control group ( P <0 01). The contents of sIL-2R in 60 patients with polydrug-tolerant pulmonary tuberculosis were obviously higher than that of the normal control group( P <0 01). After treatment the levels of sIL-2R in the control group and the QBD treatment group were obviously decreased respectively than that before treatment( P <0 01), and there was an obvious difference between the control group and the QBD treatment group ( P <0 01). Conclusion: The patients with senile polydrug-tolerant pulmonary tuberculosis exist a serious hypoimmunity and immunologic dysfunction. TL-CFU and sIL-2R could be synthetic immune index and have good clinic applied value in estimating the immune state of the human body. QBD has a good regulatory action on the immune state in patients with senile polydrug-tolerant pulmonary tuberculosis.