微卡配合治疗复难治结核病疗效观察

目的观察微卡配合抗结核药物治疗复难治菌阳肺结核的临床疗效、不良反应。方法将43例复难治菌阳肺结核患者随机分为治疗组：3微卡＋PaVZTH1321SM／15微卡＋PaVZTH132122例（Z用药9月取消），对照组：3PaVZTH1321SM／15PaVZTH132121例（z用药9月取消）。结果治疗3、6、9、15个月痰菌阴转率治疗组为50％,72．7％、81．8％、86．4％，对照组为38．1％、57．1％、61．9％、66．7％（P〈0．05）；治疗3月末胸片上治疗组与对照组病灶吸收率分别为31．8％、14．3％（P〈0．05）；空洞闭合率为50％、33．3％（P〈0．05）；治疗组在治疗3月末临床咳嗽、低热、乏力、盗汗消失率为94．4％、90％、100％、80％，对照组为81．3％、71．4％、80％、60％（P〈0．05）；无不良反应发生。结论微卡联合抗结核药物治疗复难治结核病较单用抗结核药治疗痰菌阴转、胸片病灶吸收和临床症状改善效果要好，是理想的结核病免疫治疗制剂。

Clinical observation of treatment effect of using mycobacterium vaccae together with chemotherapy on re-treated difficult pulmonary tuberculosis patients

Objective To observe clinical effect,including side effects,of using mycobacterium vaccae together with regular anti-tuberculosis chemotherapy on re-treated difficult pulmonary tuberculosis patients.Methods.A total of 43 cases were randomly divided into three groups: the treatment group(n=22) used 3 mycobacterium vaccae+PaVZTH1321 SMs/15s and mycobacterium vaccae+the PaVZTH1321(the use of Z stopped after 9-month treatment) and the control group(n=21) used mycobacterium vaccae+3PaVZTH1321SM/15 PaVZTH1321ses of the 3 PaZVTH1321(the use of Z stopped after 9-month of treatment).Results For the treatment group,the sputum smear positive-turned-negative rates were 50%,72.7%,81.8%,86.4%,respectively,for the 3rd,5th,9th and 15th after the treatment;In comparison,the respective rates for the controls were 38.1%,57.1%,61.9%,66.7%.The group comparisons were significant at P<0.05.At the end of 3rd month after the treatment,the absorption rate of the focus shown on X-ray for the treatment and for the control groups were respectively 31.8%,14.3%: P<0.05;and in the cavity closure rates,50% and 33.3%(P<0.05).The disappearance rates of clinical symptoms of cough,low fever,tiredness and night sweat were respectively,94.4%,90%,100%,80%,for the treatment group,and for the control group,the rates were respectively 81.3%,71.4%,80%,60%: P <0.01 for the group comparisons.No other side effects were reported.Conclusion Mycobacterium vaccae is an ideal drug as supplument for treatment of difficult re-treated pulmonary tuberculosis patients.