短程化疗方案在初次复发涂阳肺结核中的效果评价

目的 评价短程化疗方案治疗初次复发涂阳肺结核的临床疗效。 方法 选取2012年1月—2015年1月于温州市中心医院住院治疗的213例初次复发涂阳肺结核患者，采用随机数字表法将其随机分为短疗程组(105例)和标准疗程组(108例)，短疗程组患者予5MRftPZ方案治疗,标准疗程组患者予2HREZS/6HRE方案治疗。比较2组患者治疗第2个月末及治疗9个月时痰涂片的阴转率，比较2组患者治疗9个月时的总有效率、病灶直径及病灶好转率，并记录治疗过程中出现的不良反应。 结果 2组患者治疗2个月(χ2=3.367,P=0.066)及治疗9个月时(χ2=3.045,P=0.080)的痰涂片阴转率比较差异均无统计学意义；治疗9个月时短疗程组的病灶直径明显小于标准治疗组(t=7.442，P＜0.001)，短疗程组的总有效率(χ2=4.478，P=0.034)及病灶好转率(χ2=6.115，P=0.013)均明显高于标准疗程组；且2组患者治疗过程中的不良反应在予以对症处理后均好转，且均无严重不良反应发生。 结论 5MRftPZ短程化疗方案可有效改善患者临床症状，缩小肺结核患者病灶直径，提高临床治疗效率，无明显不良反应，安全有效。 

Evaluation of short-term chemotherapy regimen in the first recurrence pulmonary tuberculosis

Objective To evaluate the clinical efficacy of short-course chemotherapy in the treatment of primary recurrence of smear-positive pulmonary tuberculosis. Methods A total of 213 patients with primary recurrent smear-positive pulmonary tuberculosis who were hospitalized in Wenzhou Central Hospital from January 2012 to January 2015 were randomly assigned to a short course (105 patients) and a standard course (108 cases), patients in the short course of treatment were treated with 5MRftPZ regimen, and patients in the standard course of treatment were treated with 2HREZS/6HRE regimen. The negative conversion rate of sputum smear was compared between the two groups at the end of the second month and 9 months after treatment. The total effective rate, lesion diameter and lesion improvement rate were compared between the two groups receiving 9 months of treatment, and the course of treatment was recorded together with adverse reactions. Results There was no significant difference in the sputum smear conversion rate between the two groups (χ2=3.367, P=0.066) and 9 months (χ2=3.045, P=0.080); 9 treatments were treated. The lesion diameter of the short-term treatment group was significantly smaller than that of the standard treatment group (t=7.442, P<0.001). The total effective rate of the short-course group (χ2=4.478, P=0.034) and the improvement rate of the lesion (χ2=6.115, P=0.013) were significantly higher than the standard course of treatment; and the adverse reactions during the treatment of both groups improved after symptomatic treatment, and no serious adverse reactions occurred. Conclusion 5MRftPZ short-course chemotherapy can effectively improve the clinical symptoms, reduce the diameter of tuberculosis patients, improve the clinical treatment efficiency, without obvious adverse reactions, which is safe and effective.