首次复治涂阳肺结核治疗方案研究

目的 对首次复治涂阳肺结核临床疗效观察,为制定合理的化学治疗方案提供科学依据。方法 采用随机、对照、开放、前瞻性队列研究方法将48例首次复治涂阳肺结核患者,随机分为A组（标准方案组）2HREZS/6HRE方案,B组（氧氟沙星组）2OfxPaREZ/6OfxPaR方案,C组（左氧氟沙星组）2LfxPaREZ/6LfxPaR方案,D组（超短程化疗组）5MfxPaRfbZE方案抗痨治疗。观察临床症状、肺部X线影像、空洞变化、痰细菌学阴转及药物不良反应。结果 ABCD四组疗程结束痰菌阴转率依次为66.67%、55.56%、80.00%、88.89%;病灶吸收50%、55.56%、70%、88.89%;空洞缩小50%、55.56%、66.67%、85.71%;治愈率66.67%、55.56%、80.00%、88.89%;血小板降低16.67%、22.22%、10.00%、11.11%;肝功能损害16.67%、33.33%、30.00%、11.11%;尿酸升高66.67%、55.56%、50.00%、66.67%;2月末病灶吸收标准方案组与超短程化疗组之间比较差异有统计学意义（P〈0.05）。余差异无统计学意义（P〉0.05）。D组药物成本明显高于A、B、C组。结论 首次复治涂阳肺结核患者采用超短程化疗方案治疗疗效与其他各组差异无统计学意义（P〉0.05）,疗程较标准方案缩短3个月,不良反应发生率较低,但治疗成本相对较高。

For the First Time the Retreatment Smear-positive Tuberculosis Treatment Research

Objective For the first time the retreatment smear-positive tuberculosis clinical curative effect observation,To provide scientific evidence for reasonable chemical treatments. Methods Using open,randomized,controlled,prospective cohort study method to 48 cases of recurrent smear-positive pulmonary tuberculosis patients for the first time,Were randomly divided into group A（Standard solutions group）shall be 2HREZS/6HRE plan, group B（ ofloxacin group）shall be 2OfxPaREZ/6OfxPaR plan, group C（levofloxacin group）shall be 2LfxPaREZ/6LfxPaR plan,Group D（Super the short-range chemotherapy group ）using 5MfxPaRfbZE plan the chemotherapy treatment. To observe the clinical symptoms, chest x-rays, empty change, sputum bacteriology Yin turn and adverse drug reactions. Results The ABCD four groups of treatment rate of end phlegm germ feminine changed in the order 66. 67%, 55. 56%, 80. 00%, 88. 89%;Lesions absorption were 50%, 55. 56%, 50%, 55. 56%;Empty decreased 50%, 55. 56%, 66. 67%, 85. 71%;The cure rate were 66. 67%, 55. 56%, 66. 67% and 55. 56%;Platelet reduced by 16. 67%、22. 22%、10. 00%、11. 11%;Liver damage by 16. 67%、33. 33%、30. 00%、11. 11%;Uric acid increased by 66. 67%, 55. 56%, 50. 00% and 66. 67%, respectively. In late February lesions absorption comparison between standard solution and ultra dots group difference was statistically significant （ P 〈0. 05 ） , There was no statistically significant difference more （ P 〉0. 05 ）.Drug costs D group was obviously higher than that of group A, B, C groups. Conclusion For the first time the retreatment smear-positive pulmonary tuberculosis were treated by super compact chemotherapy regimen for curative effect is excellent （ P〉0. 05）,Course of a standard solution to shorten for 3 months,Low incidence of adverse reactions,But the treatment cost is relatively high.