母牛分支杆菌菌苗治疗肺结核的临床研究

观察、评价母牛分支杆菌菌苗对肺结核患免疫功能的影响和疗效。方法将７０例痰涂片阳性初治肺结核患随机分入Ⅰ组和Ⅱ组，分别采用２ＨＲＺＳ／４ＨＲ方案和２ＨＲＺＳ／４ＨＲ加母牛分支杆菌菌苗方案治疗；将３１例耐多药肺结核患归入Ⅲ组，采用４－６种敏感药物加母牛分支杆菌菌苗治疗。

A clinical study on vaccine of Mycobacterium vaccae in treating pulmonary tuberculosis]

OBJECTIVE: To study the effect of vaccine of Mycobacterium vaccae on cell-mediated immunity and on treating patients with pulmonary tuberculosis. METHODS: Seventy cases of pulmonary tuberculosis with smear positive and initial treatment were classified randomly into group I (35 cases) and group II (35 cases), receiving 2HRZS/4HR and 2HRZS/4HR plus vaccine of Mycobacterium vaccae regimens respectively. Thirty-one multi-drug resistant pulmonary tuberculosis cases were classified into group III, receiving 4 - 6 sensitive antituberculous drugs and vaccine of Mycobacterium vaccae. Improvement of clinical symptoms, resolution of pulmonary lesions, negative conversion of sputum and changes of immunological functions were observed. RESULTS: No significant difference in improvement of symptoms was found in group I and group II (P > 0.05), and the improvement rate of clinical symptoms in group III was found more than 50%. X-ray resolution rates in 4th month were 83% and 89%, and cavity reducing rates 40% and 50% respectively in group I and group II, and no significant differences were found (P > 0.05). X-ray resolution rate was 29%, cavity reducing rate 7% and no deteriorated case was found in group III. Sputum negative conversion rates in 1st, 2nd, 3rd and 4th month were 23%, 51%, 83% and 97% respectively in group I, while 31%, 77%, 89% and 100% in group II, and 3%, 16%, 29% and 32% in group III. Significant difference was found between group I and group II in sputum negative conversion rate in 2nd month after treatment (P < 0.05). After treatment, values of lymphocyte transformation test (LTT), CD(3), CD(4) and CD(4)/CD(8) of the above 3 groups were all higher than that before the treatment (P < 0.05), level of tumor necrosis factor decreased in group II and IL-2, IL-6 increased in group III. CONCLUSIONS: Vaccine of Mycobacterium vaccae is a good immunotherapy preparation, which promotes sputum negative conversion and activation of cell-mediated immunity.