[关键词]
[摘要]
目的 探讨芪贝胶囊联合2HRZE/4HR方案治疗肺结核(气阴两虚型)的临床疗效。方法 纳入2020年1月-2020年9月就诊于新乡医学院第一附属医院的160例肺结核(气阴两虚型)患者,随机分为对照组和治疗组,每组各80例。对照组给予2HRZE/4HR治疗方案,口服异烟肼片, 1次/d, 0.3 g/次;利福平胶囊1次/d, 0.45 g/次;盐酸乙胺丁醇片3次/d,0.5 g/次;吡嗪酰胺片1次/d, 0.75 g/次,治疗2个月, 2个月后患者停用盐酸乙胺丁醇片和吡嗪酰胺片,继续按照上述剂量口服异烟肼片和利福平胶囊4个月。治疗组在对照组的基础上口服芪贝胶囊, 3次/d, 10粒/次。两组治疗6个月。观察两组患者临床疗效,比较治疗前后两组患者痰菌转阴率和肺部病灶吸收情况,肺功能和炎症因子水平。结果 治疗后,对照组和治疗组总有效率分别为82.50%、93.75%,两组比较差异有统计学意义(P<0.05)。治疗后,对照组痰菌转阴率和肺部病灶吸收率分别为83.75%、85.37%,治疗组痰菌转阴率和肺部病灶吸收率分别为95.00%、96.25%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者第一秒用力呼气容积(FEV1)、用力肺活量(FVC)和γ干扰素(IFN-γ)显著升高,而白细胞介素-4(IL-4)和IL-10显著降低(P<0.05),且治疗组这些指标显著好于对照组(P<0.05)。结论 芪贝胶囊联合2HRZE/4HR方案治疗肺结核(气阴两虚型)的临床疗效显著且安全性较高,能促进病灶吸收和痰菌转阴,且显著改善患者的肺功能。
[Key word]
[Abstract]
Objective To explore the clinical efficacy of Qibei Capsules combined with 2HRZE/4HR regimen in treatment of pulmonary tuberculosis (qi-yin deficiency type).Methods Patients (160 cases) with pulmonary tuberculosis (qi-yin deficiency type) in the First Affiliated Hospital of Xinxiang Medical University from January 2020 to September 2020 were randomly divided into control and treatment group, and each group had 80 cases. Patients in the control group were administered with 2HRZE/4HR regimen. They were po administered with Isoniazid Tablets, 0.3g/time, once daily, with Rifampicin Capsules 0.45g/time, once daily, Ethambutol Hydrochloride Tablets, 0.5g/time, three times daily, Pyrazinamide Tablets, 0.75g/time, once daily. After 2 months of treatment, patient stopped taking Ethambutol Hydrochloride Tablets and Pyrazinamide Tablets, and continued taking Isoniazid Tablets and Rifampicin Capsules at the above doses for 4 months. Patients in the treatment group were po administered with Qibei Capsules on the basis of the control group, 10 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical evaluation was evaluated, the rate of sputum smear negative and lung focus absorption, the lung function, the levels of serum inflammation factors in two groups before and after treatment were compared.Results After treatment, the clinical effective rates of the control group and treatment group were 82.50%, and 93.75% respectively (P < 0.05). After treatment, the sputum negative conversion rate and lung focus absorption rate in the control group were 83.75% and 85.37%, which were significantly lower than 95.00% and 96.25% in the treatment group, respectively, and there were differences between two groups (P < 0.05). After treatment, FEV1, FVC and IFN-γ were significantly increased, while IL-4 and IL-10 were significantly decreased in two groups (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group (P < 0.05).Conclusion Qibei Capsules combined with 2HRZE/4HR regimen in treatment of pulmonary tuberculosis (qi-yin deficiency type) has significant clinical efficacy and high safety, can promote focus absorption and sputum negative conversion, and significantly improve the lung function of patients.
[中图分类号]
R974
[基金项目]
河南省医学科技攻关计划联合共建项目(2018020344)