益气养阴活血方联合常规化疗干预复治肺结核临床观察

Clinical Observation of Yiqi Yangyin Huoxue Recipe Combined with Routine Chemotherapy in the Intervenetion of Recurrent Pulmonary Tuberculosis

目的:观察中医益气养阴活血方联合西医常规化疗干预复治肺结核的临床观察。方法:将70例复治肺结核患者随机分为治疗组36例和对照组34例,对照组采用西医常规化疗方案为3EHRZ/5HRE或3EHL2Z/5HL2E8个月方案(异烟肼、利福平、盐酸乙胺丁醇、吡嗪酰胺、利福喷丁)强化期3个月,巩固期5个月。治疗组在强化期联合益气养阴活血方,每日1剂,分2次口服,疗程均为8个月。观察中医证候积分、痰涂片抗酸杆菌计数、X线影像学检查病灶吸收情况和空洞变化。结果:临床疗效:治疗组总有效率94.4%;对照组总有效率79.4%,两组临床疗效比较有统计学意义(P<0.05)。X线影像学检查病灶吸收及空洞闭合情况比较:治疗组、对照组病灶吸收率分别是91.2%和76.5%;空洞闭合率分别为81.2%和51.7%,两组比较,P<0.05差异具有统计学意义。两组治疗过程中均未发现不良反应。结论:中医益气养阴活血方联合西医常规化疗干预复治肺结核可提高患者X线影像学检查病灶吸收率和空洞闭合率,明显改善患者临床症状,提高患者免疫水平,减少药物的不良反应。

Objective:To observe Yiqi Yangyin Huoxue Recipe combined with conventional chemotherapy for the patients with recurrent pulmonary tuberculosis(TB).Methods:70 cases of pulmonary TB were randomly divided into treatment group(36 cases)and controlled group(34 cases).The controlled group received conventional chemotherapy 3 HREZ/5 HRE or 3 HL2 EZ/5 HL2 E for 8 months(isoniazid,rifampin,ethambutol,pyrazinamide,rifapentine),including intensive period of 3 months and consolidation period of 5 months.The treatment group was given conventional chemotherapy and Yiqi Yangyin Huoxue Recipe in the intensive period one dose per day,orally twice.The course of treatment was 8 months.Observed and recorded the scores of TCM syndrome,sputum smear acid fast bacilli counts,X-ray imaging about lesion absorption and cavity changing.Results:The clinical efficacy:94.4%of the patients in the treatment group were improved and 79.4%in the controlled were improved,which indicated there was a significant difference between the two groups(P<0.05).Comparison of X-ray imaging examination about lesion and cavity:the focus absorption rate in the treatment group and the controlled group were 91.2%and 76.5%,respectively.The cavities closed in 81.2%and 51.7%patients of the treatment group and the controlled group,respectively,which showed significant difference(P<0.05)between the two groups.No adverse reactions were found in the two groups during the treatment.Conclusion:TCM Yiqi Yangyin Huoxue Recipe combined with conventional chemotherapy can improve lesions absorption and cavity closing,and significantly alleviate the clinical symptoms,improving the immunity of patients and reducing drug side effects.