利福喷汀在结核性胸膜炎巩固治疗期应用的效果观察

目的:比较结核性胸膜炎巩固治疗期每周1次使用利福喷汀化疗方案与每天1次利福平用药方案的疗效、毒性及不良反应,增加患者的耐受性。方法:将2005年1月~2006年6月收治的单纯性结核性渗出性胸膜炎234例,随机分为对照组116例和治疗组118例,对照组采用标准化疗方案(2HRZ/4HR):异烟肼、利福平、吡嗪酰胺强化治疗2个月,后用异烟肼、利福平每日1次巩固治疗,共4个月;治疗组采用改进的治疗方案(2HL3Z/4H3L7):异烟肼、利福喷汀、吡嗪酰胺强化治疗2个月,后采用异烟肼、利福喷汀每周1次巩固治疗,共4个月。结果:两组均治疗6个月,治疗结束时胸水吸收、胸膜肥厚及粘连情况比较,差异无统计学意义(P>0.05);两组不良反应发生率比较差异具有非常显著统计学意义(P<0.01)。结论:改进的巩固治疗方案对结核性胸膜炎的治疗效果良好,药物的毒性作用小、不良反应少,增加了患者的耐受性。

The Effect of Weekly Chemotherapy in Consolidated Stage of Tuberculosis Pleurisy

Objective:To compare the efficacy,side effect of weekly Rifapentine to daily Rifapentine in order to change chemotherapy regiment and improve patient's tolerance.Methods:During 01/2005 and 06/2005,234 patients with tuberculosis pleurisy were randomly divided into the control group(n=116) and treatment group(n=118).Patients in control group received standard chemotherapy(2HRZ/4HR):Isoniazid Rifampin Pyrazinamide for 2 months(Intensified Treatment),then Isoniazid Rifampin daily orally for 4 months.Patients in treatment group received Intensified Treatment(2HL3Z/4H3L7):Isoniazid Rifapentine Pyrazinamide for 2 months,then Isoniazid Rifapentine weekly orally for 4 months.Results:After 6 months,there were no difference of the chest water absorption,extent of pleural thickening and adhesion between two groups(P>0.05).Conclusion:The modified therapy regiment has a good curative effect,less side effects,it also can improve patient tolerance to medication.