不同全间歇短化方案治疗初治涂阳肺结核疗效的研究

Study on the effect for initial smear positive pulmon ary tuberculosis cases treated with three short course(6 months)intermittent ch emotherapy regimens

目的 用 2H2 R2 Z2 S2 (E2 ) / 4H2 R2 和 2H3 R3 Z3 S3 (E3 ) / 4H2 R2 方案治疗初治涂阳肺结核 ,并与世行项目方案作对照 ,以探索最佳化疗方案。方法 随机抽取 2 0个县 (市 )作为研究现场。将初治涂阳病人随机分为Ⅰ、Ⅱ、Ⅲ组且分别用不同的化疗方案 ,全程督导管理 ,观察痰菌阴转率和细菌学复发率。结果 3组 6月末痰菌阴转率分别为 95.96 %、97.98%、97.37% ,无统计学差异 (P >0 .0 5)。Ⅰ组副反应发生率与Ⅱ、Ⅲ组之间有统计学差异 (P <0 .0 5) ,但Ⅱ、Ⅲ组之间无统计学差异 (P >0 .0 5) ;复发率分别为 4 .86 %、3.70 %、2 .76 % ,无统计学差异 (P >0 .0 5)。总疗程服药情况为Ⅰ、Ⅱ组病人较Ⅲ组服药次数明显减少。结论 研究方案与世行项目方案具有相似的化疗效果 ,Ⅰ组副反应发生率相对较低 ,其他 2组之间无差异。

Objective In order to find a good regimen to tre at tuberculosis patient,the study was carried out to treat initial smear positive TB cases with 2H 2R 2Z 2S 2(E 2)/4H 2R 2,2H 3R 3Z 3S 3(E 3)/4H 2R 2,compairedwith the result that TB cases treated with the regimen in TB contro l program in our country. Methods Twenty TB dispansaries were randomly selected as the st udy fields. Initial smear positive TB cases were chosen as study subjects and were divided into three groups(groupⅠ, groupⅡand group Ⅲ) randomly and were treated with different kinds of short course intermittent regimens of chemothera py.Results The smear negative conversion rates of the three g roups at the end of the sixth month during the treatment courses were 95.96%, 97 .98%, 97.37% respectively. There were not significant differences among them ( P>0.05). Side effect rates of three groups after treatment were 22.73%, 33.88% and 40.00% respectively. The re were significant defferents between groupⅠand other two groups(P<0.01).B ut there was no significant difference between groupⅡ and group Ⅲ(P>0.05). The relapse rates of the three groups were 4.86%, 3.70% and 2.76% respectively and there were no significant differences among them(P>0.05). Average times of each cases of three groups ta king drugs in full treatment courses were 60, 70.48 and 90 times respectively. Conclusion The two experimental chemotherapy regimens have got almost the same results with control group. The side effect rate of cases in group Ⅰ was less than th at in other two groups. The costs of the TB patients were reduced in the experim ent groups.