自拟健脾益气汤干预复治涂阳肺结核患者细胞免疫失衡的效果

Self-Prepared Jianpi Yiqi Decoction in Treating Cellular Immune Imbalance of Patients with Smear-Positive Pulmonary Tuberculosis

目的探讨自拟健脾益气汤对复治涂阳肺结核患者细胞免疫失衡的干预作用,并总结其护理要点。方法选择医院收治的复治涂阳肺结核患者200例,随机分为对照组和观察组,各100例。对照组患者采用3SHRZE/6HRE方案抗结核治疗,观察组患者在此基础上加用自拟健脾益气汤,均给予相应的个体化护理。结果治疗后,观察组的痰转阴率、病灶吸收率、空洞闭合率均明显高于对照组(P<0.05),观察组的CD_3^+,CD_4^+,CD_4^+/CD_8^+明显高于对照组(P<0.05),观察组各项临床症状缓解时间及平均住院时间均明显短于对照组(P<0.05);随访1年,观察组再咳血例数、再咳血量、及复发率等均明显低于对照组(P<0.05);两组患者不良反应发生率比较,无统计学差异(P>0.05)。结论自拟健脾益气汤能治疗复治涂阳肺结核疗效明显且能增强患者细胞免疫功能,减少复发率;联合个体化护理可提高依从性,保障治疗顺利进行,值得临床推广。

Objective To investigate the intervention effect of Jianpi Yiqi Decoction on cellular immunity imbalance of pulmonary tuberculosis patients,and to summarize the nursing points.Methods 200 patients with pulmonary tuberculosis were randomly divided into the control group and the observation group,100 cases in each group.The control group used 3SHRZE / 6HRE scheme of anti- tuberculosis treatment,the observation group were given self- prepared Jianpi Yiqi Decoction additionally,and both groups were given individualized nursing.Results After treatment,the sputum negative conversion rate,focus absorption and cavity closure rate of the observation group were significantly higher than the control group( P < 0.05); the levels of CD_3^+,CD_4^+,CD_4^+/ CD_8^+of the observation group were significantly higher than those in the control group( P < 0.05); the clinical symptoms and average hospitalization time of the observation group was significantly shorter than those of the control group( P < 0.05); after 1 year of follow- up,the cases of hemoptysis,hemoptysis volume,and the rate of recurrence of the observation group were significantly lower than control group( P < 0.05).The occurrence rate of adverse reactions of the two groups had no significant difference( P > 0.05).Conclusion Self- prepared Jianpi Yiqi Decoction can improve the clinical efficacy of pulmonary tuberculosis and enhance cellular immune function,reduce the recurrence rate; with joint clinical quality nursing of pulmonary tuberculosis,it can significantly improve the treatment compliance,which is worthy of clinical promotion.