补肺养阴汤辅助治疗耐多药肺结核的疗效观察

2020-05-06于菁菁胡雪

中国现代医生 2020年6期

于菁菁胡雪

[摘要] 目的探討补肺养阴汤辅助治疗耐多药肺结核的临床疗效及对患者免疫功能的影响。方法选择2017年1～12月在医院诊断治疗的耐多药肺结核患者60例为研究对象，随机分为两组，观察组30例，对照组30例。两组均给予常规西药治疗，观察组在此基础上加用补肺养阴汤治疗。比较两组临床疗效、痰结核菌培养转阴率、CT影像结果好转率、外周血T细胞水平及中医证候积分。结果观察组总有效率显著高于对照组，差异有统计学意义（P<0.05）。治疗后，两组中医证候积分显著下降，差异有统计学意义（P<0.05）;治疗后观察组中医证候积分得分显著低于对照组，差异有统计学意义（P<0.05）。观察组治疗3个月与6个月，痰结合菌培养转阴率均显著高于对照组，差异有统计学意义（P<0.05）。治疗后3个月、6个月，观察组影像好转率均显著高于对照组，差异有统计学意义（P<0.05）。治疗后，观察组CD3+、CD4+、CD4+/CD8+水平显著高于治疗前及对照组治疗后，差异有统计学意义（P<0.05）;CD8+水平显著低于治疗前及对照组，差异有统计学意义（P<0.05）。结论中西医结合治疗耐多药肺结核能显著改善患者免疫功能，提高临床疗效，提高痰结核菌转阴率。

[关键词] 中西医结合;耐多药;肺结核;免疫功能;咳嗽;咯血

[Abstract] Objective To investigate the clinical efficacy of Bufei Yangyin Decoction in the treatment of multidrug-resistant tuberculosis and its effect on immune function. Methods 60 patients with multidrug-resistant pulmonary tuberculosis diagnosed and treated in the hospital from January to December 2017 were randomly divided into two groups including the observation group （n=30） and the control group（n=30）. Both groups were treated with conventional western medicine， and the observation group was treated with Bufei Yangyin decoction based on the above treatment. The clinical efficacy， the negative conversion ratio of sputum tuberculosis culture， the CT image improvement rate， the peripheral blood T cell level and the TCM syndrome scores of the two groups were compared. Results The total effective rate of the observation group was significantly higher than that of the control group， and the difference was statistically significant（P<0.05）. After treatment， the scores of TCM syndromes in the two groups decreased significantly， and the difference was statistically significant（P<0.05）. After treatment， the scores of TCM syndromes in the observation group were significantly lower than those in the control group， and the difference was statistically significant（P<0.05）. The negative conversion ratio of sputum tuberculosis culture in the observation group was significantly higher than that of the control group after 3 months and 6 months of treatment， and the difference was statistically significant（P<0.05）. At 3 months and 6 months after treatment， the image improvement rate of the observation group was significantly higher than that of the control group， and the difference was statistically significant（P<0.05）. After treatment， the levels of CD3+， CD4+， CD4+/CD8+ in the observation group were significantly higher than those before treatment and those in the control group after treatment（P<0.05）. The level of CD8+ in the observation group after treatment was significantly lower than that before treatment and that in the control group， and the difference was statistically significant（P<0.05）. Conclusion Integrated Chinese and Western medicine treatment of multidrug-resistant tuberculosis can significantly improve the immune function of patients， improve clinical efficacy， and improve the negative conversion ratio of sputum tuberculosis.

综上所述，中西医结合治疗耐多药肺结核能显著改善患者免疫功能，提高临床疗效，提高痰结核菌转阴率。

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