采用母牛分支杆菌菌苗预防糖尿病患者并发肺结核的临床观察

目的探讨母牛分支杆菌菌苗[Mycobacterium vaccae vaccine(M.vacae vaccine)]对糖尿病患者预防并发肺结核的临床疗效及安全性.方法随机配对分组法将76例糖尿病患者分为M.vaccae vaccine治疗组(M组,38例)和对照组(C组,38例).两组常规使用降糖药及饮食控制血糖.M组加用M.vaccae vaccine治疗3个月,C组不用M.vaccaevaccine.结果治疗结束3个月后,M组未见M.vaccaevaccine对血糖控制等产生不良影响,细胞免疫功能显著改善,M组T细胞亚群各项指标与C组比较:CD3、CD4显著升高(P＜0.01),CD8显著下降(P＜0.05);PPD皮试阳转率M组较C组显著提高(P＜0.05);随访2年观察M组无1例发生肺结核,C组有2例发生.结论 M.vaccaevaccine临床使用安全,有显著改善糖尿病患者的细胞免疫功能,对并发肺结核有较好的预防作用.

Clinical observation on prevention of diabetes complicated with pulmonary tuberculosis by Mycobacterium vaccae vaccine

Objective To investigate the effect and safety of Mycobacterium vaccae vaccine ( M. vaccae vaccine) on diabetes patients complicated with pulmonary tuberculosis. Methods A total of 76 diabetes patients complicated with pulmonary tuberculosis were randomized into immunotherapy group (M, n =38) and control group (C, n =38). Administration of routine anti diabetic drugs and diet treatment were conducted in both groups. In addition, patients in group M were treat with additional M. vaccae vaccine for 3 months, but those in group C were not. Results At the end of the treatment, no side effects of M. vaccae vaccine were found in group M, but immunological function of T cells was significantly improved. Compared with those in group C, CD3 and CD4 in group M were significantly higher ( P <0.01), but CD8 in group M was significantly lower ( P <0.05), and PPD positive conversion rate in group M was significantly higher ( P <0.05). A follow up for 2 years showed no occurrence of pulmonary tuberculosis in group M, but 2 cases in group C. Conclusion Immunotherapy with M. vaccae vaccine is clinically safe and can improve the T cell function of diabetes patients, suggesting that immunotherapy with M. vaccae vaccine. may play an important role in the prevention of complicated pulmonary tuberculosis.