目的 探讨白百抗痨颗粒联合四联抗结核方案治疗结核性渗出性胸膜炎的临床疗效。方法 纳入2023年6月—2024年6月于新乡医学院第一附属医院治疗的结核性渗出性胸膜炎患者110例，随机分为对照组和治疗组，每组各55例。对照组患者口服异烟肼片、利福平片、吡嗪酰胺片以及盐酸乙胺丁醇片，其中异烟肼片3片/次，1次/d；利福平片3片/次，1次/d；吡嗪酰胺片2片/次；盐酸乙胺丁醇片3片/次，1次/d。治疗组患者在对照组的基础上口服白百抗痨颗粒，1袋/次，3次/d。两组患者连续治疗3月。观察两组患者临床疗效，比较治疗前后两组患者发热、咳嗽、胸痛消退时间，外周血血沉、腺苷脱氨酶（ADA）和乳酸脱氢酶（LDH）表达水平，及血清白细胞介素-33（IL-33）、IL-6和γ-干扰素诱导蛋白10（IP-10）表达水平。结果 治疗后，治疗组总有效率为94.55%，对照组总有效率为80.00%，两组比较差异具有统计学意义（P＜0.05）。治疗后，治疗组发热消退时间、咳嗽消退时间以及胸痛消退时间均显著低于对照组（P＜0.05）。治疗后，两组血沉、ADA、LDH表达水平均显著降低（P＜0.05），且治疗组血沉、ADA、LDH表达水平显著低于对照组（P＜0.05）。治疗后，两组血清IL-33、IL-6和IP-10表达水平显著降低（P＜0.05），且治疗组血清因子表达水平显著低于对照组（P＜0.05）。结论 白百抗痨颗粒联合四联抗结核方案治疗结核性渗出性胸膜炎的临床疗效显著，能快速缓解患者临床症状。

Objective To investigate the clinical efficacy of Baibai Kanglao Granules combined with quadruple anti-tuberculosis regimen in treatment of tuberculous exudative pleurisy. Methods Patients (110 cases) with tuberculous exudative pleurisy in the First Affiliated Hospital of Xinxiang Medical University from June 2023 to June 2024 were randomly divided into control and treatment groups, and each group had 55 cases. Patient in the control group were po administered with Isoniazid Tablets, Rifampicin Tablets, Pyrazinamide Tablets and Ethambutol Hydrochloride Tablets, 3 tablets/time of Isoniazid Tablets, once daily; 3 tablets/time of Rifampicin Tablets, once daily; 2 tablets/time of Pyrazinamide Tablets; 3 tablets/time of Ethambutol Hydrochloride Tablets, once/day. Patient in the treatment group were po administered with Baibai Kanglao Granules on the basis of the control group, 1 bag/time, three times daily. Patient in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, and the resolution time of fever, cough and chest pain, erythrocyte sedimentation rate, ADA and LDH expression levels, and the levels of inflammatory factors IL-33, IL-6 and IP-10 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 94.55%, and the total effective rate in the control group was 80.00%, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the resolution time of fever, cough and chest pain in the treatment group were significantly lower than that in the control group (P < 0.05). After treatment, the expression levels of ESR, ADA, and LDH were significantly reduced in two groups (P < 0.05), and the expression levels in the treatment group were significantly lower than those in the control group (P< 0.05). After treatment, the serum expression levels of IL-33, IL-6 and IP-10 in two groups were significantly reduced (P < 0.05), and the serum factor expression levels in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion Baibai Kanglao Granules combined with anti-tuberculosis drugs could significantly improve clinical efficacy in tuberculous exudative pleurisy, rapidly alleviating symptoms.

R978.3

河南省医学科技攻关计划项目（LHGJ20200520）；新乡医学院结核病研究所开放课题（XYJHB202107）