摘要
目的:观察养阴补肺汤联合含卷曲霉素化疗方案治疗耐多药肺结核疗效及对炎症因子、免疫功能的影响。方法:选择沧州市传染病医院2016年2月~2018年2月收治的耐多药肺结核86例,按照随机数字表法分为2组,每组43例,对照组予以含卷曲霉素化疗方案治疗,治疗组予以中药养阴补肺汤联合含卷曲霉素化疗方案治疗。比较两组治疗前及治疗6个月后中医证候评分、外周血CD3^+、CD4^+、CD8^+含量、CD4^+/CD8^+值及血清基质金属蛋白酶-9(MMP-9)、骨桥蛋白(OPN)和白细胞介素-18(IL-18)水平;比较治疗6个月、12个月和24个月两组痰菌转阴率、病灶吸收率、空洞缩小率。结果:治疗6个月后治疗组中医证候咳痰咯血、发热盗汗、神疲乏力、咽燥口干评分均低于对照组(P<0.01),外周血CD3^+、CD4^+、CD4^+/CD8^+高于对照组(P<0.01),CD8^+含量低于对照组(P<0.05);血清MMP-9、OPN、IL-18水平均低于对照组(P<0.01);治疗12个月、24个月后治疗组痰菌转阴率、病灶吸收率、空洞缩小率均高于对照组(P<0.05),差异均有统计学意义。结论:养阴补肺汤联合含卷曲霉素化疗方案可调节机体免疫功能,减少炎症因子分泌,改善中医证候,痰菌转阴率、病灶吸收率、空洞缩小率,治疗耐多药肺结核效果显著。
Objective:To explore the therapeutic effect of Yangyin Bufei Decoction combined with Capreomycin containing chemotherapy on multiple drug resistant tuberculosis(MDR-TB)and its influence on inflammatory factors and immune function.Methods:86 patients with MDR-TB admitted to Cangzhou Infectious Diseases Hospital from February 2016 to February 2018 were divided into two groups according to the random number table method,with 43 cases in each group.The controlled group were treated with Capreomycin containing chemotherapy,and the treatment group were treated with Chinese medicine Yangyin Bufei Decoction combined with Capreomycin containing chemotherapy.TCM syndrome score,peripheral blood CD3^+,CD4^+,CD8^+,CD4^+/CD8^+value,serum matrix metalloproteinase-9(MMP-9),osteopontin(OPN)and interleukin-18(IL-18)levels were compared between the two groups before treatment and in 6 months after treatment.Sputum negative conversion rate,focus absorption rate and cavity shrinkage rate were compared between the two groups in 6,12,24 months after treatment.Results:The scores of expectoration and hemoptysis,fever and night sweat,fatigue and dryness of throat of the treatment group were lower than those of the controlled group in 6 months after treatment(P<0.01),the CD3^+,CD4^+,CD4^+/CD8^+in the peripheral blood were higher than those of the control group(P<0.01),the CD8^+content was lower than that of the controlled group(P<0.05),the levels of MMP-9,OPN and IL-18 in the serum were lower than those of the controlled group(P<0.01),and the sputum bacteria turned negative of the treatment group in 12 and 24 months after treatment.The absorption rate and cavity reduction rate were higher than those of the controlled group(P<0.05),and the difference was statistically significant.Conclusion:Yangyin Bufei Decoction combined with Capreomycin containing chemotherapy can regulate the immune function of the body,reduce the secretion of inflammatory factors,improve the syndrome of traditional Chinese medicine,the negative rate of sputum bacteria,the absorption rate of focus,the rate of cavity reduction,and it has a significant effect in the treatment of MDR-TB.
作者
张风艳
李志强
陆烨凯
ZHANG Fengyan;LI Zhiqiang;LU Yekai(Department of Infection,Cangzhou Hospital of Infectious Diseases,Cangzhou Hebei 061000,China;Tuberculosis Section Ⅲ of Infectious Diseases Department,Cangzhou Hospital of Infectious Diseases,Cangzhou Hebei 061000,China)
出处
《四川中医》
2020年第10期70-73,共4页
Journal of Sichuan of Traditional Chinese Medicine
基金
沧州市科技计划项目(编号:162302097)。
