摘要
目的:观察百合固金汤联合常规抗结核方案(2HRZE/4HR)治疗老年肺结核的临床疗效,并观察其对患者免疫功能、外周血自然杀伤细胞2族成员D(natural killer cell group 2 D,NKG2D)的影响。方法:80例老年肺结核患者按照随机数字表法分为治疗组和对照组各40例。对照组给予2HRZE/4HR治疗,治疗组在对照组治疗基础上给予百合固金汤。比较两组患者治疗前后中医症状评分和免疫功能指标、外周血NKG2D和NKG2A表达、临床疗效、不良反应。结果:治疗后,治疗组有效率为(97.50%),对照组有效率为(80.00%),两组有效率比较,差异有统计学意义(χ^(2)=6.135,P=0.013)。治疗后,两组患者中医症状评分均显著降低,且治疗组咳嗽、乏力、消瘦、盗汗评分低于同期对照组(P<0.05)。治疗后,两组患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)显著升高,CD8^(+)显著降低(P<0.05);治疗组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)高于同期对照组,CD8^(+)低于同期对照组(P<0.05)。治疗后,两组患者NKG2D表达均升高、NKG2A表达均降低,且治疗组NKG2D表达高于同期对照组,NKG2A表达低于同期对照组(P<0.05)。治疗组不良反应发生率为5.00%,对照组不良反应发生率为20.00%,两组比较,差异有统计学意义(χ^(2)=4.114,P=0.043)。结论:百合固金汤联合2HRZE/4HR治疗老年肺结核患者临床疗效显著,可显著改善患者症状,提高患者免疫功能,调节外周血NKG2D水平,且不良反应少、安全性高。
Objective: To observe the clinical efficacy of Baihe Gujin Decoction combined with conventional anti-tuberculosis regimen(2HRZE/4HR) in the treatment of senile pulmonary tuberculosis, and to observe its impact on patients′ immune function and natural killer cell group 2D(NKG2D) in peripheral blood.Methods: 80 elderly patients with pulmonary tuberculosis were randomly divided into treatment group and control group with 40 cases each.The control group was treated with 2HRZE/4HR regimen, and the treatment group was treated with Baihe Gujin Decoction on the basis of the treatment in the control group.The TCM symptom score, immune function index, peripheral blood NKG2D and NKG2A expression, clinical efficacy and adverse reactions were compared between the two groups before and after treatment.Results: After treatment, the effective rate of the treatment group was(97.50%) and that of the control group was(80.00%).The difference between the two groups was statistically significant(χ^(2)=6.135,P=0.013).After treatment, the TCM symptom scores of the two groups were significantly reduced, and the scores of cough, fatigue, emaciation and night sweats in the treatment group were lower than those in the control group at the same time(P<0.05).After treatment, CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were significantly increased, while CD8^(+)was significantly decreased(P<0.05);CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the treatment group were higher than those in the control group at the same time, and CD8^(+)was lower than those in the control group at the same time(P<0.05).After treatment, the expression of NKG2D increased and the expression of NKG2A decreased in both groups, and the expression of NKG2D in the treatment group was higher than that in the control group at the same time, while the expression of NKG2A was lower than that in the control group at the same time(P<0.05).The incidence of adverse reactions in the treatment group was 5.00%,and that in the control group was 20.00%.The difference between the two groups was statistically significant(χ^(2)=4.114,P=0.043).Conclusion: Baihe Gujin Decoction combined with 2HRZE/4HR has a significant clinical effect in the treatment of elderly patients with pulmonary tuberculosis.It can significantly improve the symptoms of patients, improve the immune function of patients, and regulate the level of NKG2D in peripheral blood, with less adverse reactions and high safety.
作者
张金良
ZHANG Jinliang(Central Hospital of Zhumadian City,Zhumadian Henan China 463000)
出处
《中医学报》
CAS
2023年第3期638-643,共6页
Acta Chinese Medicine
基金
河南省自然科学基金项目(20-21ZY1018)。
