母牛分枝杆菌菌苗辅助治疗单纯结核性胸膜炎的临床效果

目的评价母牛分枝杆菌菌苗（微卡）在治疗结核性胸膜炎（tuberculous pleurisy TP）中的效果。方法随机将80例TP患者分为治疗组（40例）和对照组（40例）。2组均采用统一抗结核化疗方案2HALZ/6HL₂及胸穿抽液,治疗组肌肉注射微卡,每周1次,共3个月,对照组口服强的松68周。观察2组病例胸膜肥厚情况及胸液吸收情况,随访11.5年;观察微卡不良反应。结果治疗组胸膜肥厚率5%,对照组22.5%,有显著性差异（P<0.05）;治疗组平均胸液吸收时间19.3 d,对照组28.3 d,有显著性差异（P<0.01）;治疗组及对照组随访至1.5年各35例,复发率分别为0和8.6%,2组间无显著性差异（P>0.05）。微卡不良反应:局部硬结1例,低热1例。结论微卡用于治疗TP,能减少胸膜肥厚和黏连,是一种安全有效的药物。

The clinical effect of chemotherapy combined with Mycobacterium vaccae vaccine on tuberculous pleurisy

Objective To evaluate the therapeutic effect of Mycobacterium vaccae（M.vaccae）vaccine on tuberculosis pleurisy.Methods Eighty cases of tuberculosis pleurisy were divided randomly into study group（40 cases） and control group（40 cases）.All of the two groups were treated by chemotherapy with a regimen of 2HALZ/6HL₂ and aspirating pleural effusion.And the study group was given intramuscular injections of M.vaccae vaccine once weekly for three months,the control group took prednisone for 6～8 weeks.Results The rates of pleural thickening were 5% in the study group and 22.5% in the control group.There was significant difference（P＜0.05）.The average times of absorption of pleural effusion were 19.3 days in the study group and 28.3 days in the control group.There was significant difference（P＜0.01）.The relapse rates following 1.5 years follow-up were 0 in the study group and 8.6% in the control group（P＞0.05）.The side effects of M.vaccae vaccine were local in duration（1 case） and slight fever（1 case）,Conclusion M.vaccae vaccine is an effective and safe drug to reduce pleural thickening in treating patients with tuberculous pleurisy.