目的 探讨复方柳菊胶囊联合四联抗结核药物治疗结核性渗出性胸膜炎的临床疗效及安全性。方法 选取2020年6月—2020年12月在新乡医学院第一附属医院就诊的120例结核性渗出性胸膜炎患者，按照随机数字表法分为对照组和治疗组，每组各60例。对照组给予标准四联抗结核药物治疗，口服异烟肼片，3片/次，1次/d；利福平片，3片/次，1次/d；盐酸乙胺丁醇片，3片/次，1次/d；吡嗪酰胺片，2片/次，3次/d。治疗组在对照组的基础上口服复方柳菊胶囊，5粒/次，3次/d。两组均治疗4个月。观察两组患者临床疗效，比较治疗前后两组患者症状和体征改善情况，白细胞介素-4（IL-4）、肿瘤坏死因子-α（TNF-α）和γ干扰素（IFN-γ）水平，及Th1细胞比例和Th1/Th2。结果 治疗后，对照组和治疗组总有效率分别为85.00%和96.66%，两组比较差异有统计学意义（P<0.05）。治疗后，与对照组相比，治疗组胸水排出量、胸腔积液消退时间均显著降低（P<0.05）。治疗后，两组胸膜厚度、TNF-α和IFN-γ水平均显著降低（P<0.05），且治疗组降低更显著（P<0.05）。治疗后，两组Th1和Th1/Th2均显著降低（P<0.05），且治疗组患者降低更明显（P<0.05）。结论 复方柳菊胶囊联合四联抗结核药物治疗方案能显著改善结核性渗出性胸膜炎患者的临床症状和体征，可能与纠正Th1/Th2细胞比例失衡有关。

Objective To investigate the clinical efficacy and safety of Compound Liuju Capsules combined with quadruple anti-tuberculosis regimen in treatment of tuberculous exudative pleurisy. Methods Patients (120 cases) with tuberculous exudative pleurisy in the First Affiliated Hospital of Xinxiang Medical University from June 2020 to December 2020 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were administered with standard quadruple antituberculous drugs, 3 Isoniazid Tablets orally each time, once daily, 3 Rifampicin Tablets orally each time, once daily, 3 Ethambutol Hydrochloride Tablets orally each time, once daily, 2 Pyrazinamide Tablets orally each time, three times daily. Patients in the treatment group were po administered with Compound Liuju Capsules, 5 grains/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical evaluation was evaluated, the improvement of symptoms and signs, the serum level of IL-4, TNF-α, and IFN-γ, the percentage of Th1 and Th2, Th1/Th2 cells in two groups before and after treatment were compared. Results After treatment, the clinical effective rates of the control group and the treatment group were 85.00% and 96.66% respectively (P < 0.05). After treatment, the pleural effusion output, and pleural effusion regression time were significantly lower than those in the control group (P< 0.05). After treatment, the pleural thickness, levels of TNF-α and IFN-γ were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the proportion of Th1 cells and Th1/Th2 cells were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Compound Liuju Capsules combined with quadruple anti-TB regimen can significantly improve the clinical symptoms and signs of patients with tuberculous exudative pleurisy, which may be related to correcting the imbalance of Th1/Th2 cells.

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