目的 探究疗肺宁片联合2HRZE/4HR方案治疗活动性肺结核的疗效及其对降钙素原（PCT）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）水平的影响。方法 选取2018年2月-2020年6月在郑州市第六人民医院治疗的80例活动性肺结核患者作为研究对象，按照随机数字表法分为对照组（40例）和观察组（40例）。对照组患者口服吡嗪酰胺片，0.25 g/次，1次/d，盐酸乙胺丁醇片，0.15 g/次，1次/d，利福平胶囊空腹口服，0.45~0.60 g/次，1次/d，异烟肼片，0.1 g/次，1次/d，联合化疗的常规抗结核治疗方案。观察组在对照组的基础上口服疗肺宁片，10片/次，3次/d。两组均治疗4个月。观察两组患者的临床疗效，同时比较两组患者的血清PCT、IL-10、TNF-α水平，X线病灶吸收情况及痰菌转阴率。结果 治疗后，与对照组总有效率67.50%相比，观察组87.50%明显升高（P<0.05）。治疗后，两组血清PCT、IL-10、TNF-α水平均明显降低（P<0.05）；且观察组PCT、IL-10、TNF-α水平明显低于对照组（P<0.05）。治疗后，观察组总吸收率95.00%，与对照组75.00%比较明显升高（P<0.05）。治疗3个月、6个月，观察组痰菌转阴率分别为52.50%、87.50%，显著高于对照组的30.00%、67.50%（P<0.05）。治疗期间，两组患者不良反应发生率比较差异无统计学意义。结论 疗肺宁片联合2HRZE/4HR方案治疗活动性肺结核可有效降低炎性因子水平，提高病灶吸收及痰菌转阴率，且不会增加不良反应发生率，安全有效。

Objective To investigate the therapeutic effect of Liaofeining Tablets combined with 2HRZE/4HR regimen in treatment of active pulmonary tuberculosis, and its effect on the levels of PCT, IL-10 and TNF-α. Methods A total of 80 patients with active pulmonary tuberculosis treated in The Sixth Peoples Hospital of Zhengzhou from February 2018 to June 2020 were selected as the research subjects, and divided into control group (40 cases) and observation group (40 cases) according to random number table method. After admission, all patients were po administered with Pyrazinamide Tablets, 0.25 g/time, once daily; Ethambutol Hydrochloride Tablets, 0.15 g/time, once daily; Rifampicin Capsules, 0.45-0.60 g/time, once daily; Isoniazid Tablets, 0.1 g/time, once daily. The conventional anti-tuberculosis treatment regimen was combined with chemotherapy. Patients in the observation group were po administered with Liaofeining Tablets on the basis of control group, 10 tablets/time, three times daily. Both groups were treated for 4 months. The clinical efficacy of two groups was observed, and the levels of serum PCT, IL-10, TNF-α, X-ray lesions absorption, and sputum bacteria negative rate of two groups were compared. Results After treatment, the total effective rate of observation group was 87.50%, which was significantly higher than 67.50% of control group (P < 0.05). After treatment, the levels of serum PCT, IL-10 and TNF-α in two groups were significantly decreased (P < 0.05), the levels of PCT, IL-10 and TNF-α in observation group were significantly lower than those in control group (P < 0.05). After treatment, the total absorption rate of observation group was 95.00%, which was significantly higher than 75.00% of control group (P < 0.05). After 3 months and 6 months of treatment, the sputum negative conversion rate of the observation group was 52.50% and 87.50%, respectively, which were significantly higher than 30.00% and 67.50% of the control group (P < 0.05). During treatment, there was no significant difference in the incidence of adverse reactions between two groups. Conclusion Liaofeining Tablets combined with 2HRZE/4HR regimen in treatment of active pulmonary tuberculosis can effectively reduce the level of inflammatory factors, improve the absorption of lesions and the rate of sputum bacteria turning negative, and do not increase the incidence of adverse reactions, which is safe and effective.

R974

河南省高等学校重点科研项目（21B310003）