中西医结合治疗初治继发性肺结核临床疗效观察

目的观察中西医结合治疗初治继发性肺结核临床疗效。方法将89例初治继发性肺结核患者,随机分为两组。对照组41例,采用2HREZ/4HR方案抗结核治疗;治疗组48例,辩证分为肺阴虚、气阴两虚、阴虚火旺三个亚组,在2HRZE/4HR方案治疗基础上分别辅以滋阴润肺免煎颗粒、双百口服液、肺泰胶囊。两组每月复查血常规、肝肾功、尿常规、痰涂片、胸片,隔月复查T细胞亚群,治疗组进行中医证候评分,共治疗6个月。观察临床症状、肺部X线影像、空洞变化、痰液细菌学阴转及药物不良反应。结果治疗6个月后治疗组在改善临床症状、肺部阴影吸收、空洞闭合及降低抗痨药物不良方面优于对照组(P<0.05);在痰菌阴转方面差异无统计学意义(P>0.05)。结论中医辩证施治配合化疗药物治疗肺结核对临床症状消除、促进病灶吸收、空洞闭合等方面具有良好的促进作用并可降低抗痨药物不良反应。

The clinical observation on the curative effect of initial treatment secondary pulmonary tuberculosis treated with integrated chinese and western medicine

Objective To observe the curative effect of integrated traditional with Chinese and western medicine treatment of initial treatment secondary pulmonary tuberculosis.Methods 89 cases of initial treatment secondary pulmonary tuberculosis were randomized into two groups.41 cases in control group,the daily medication program of 2HRZE/4HR was adopted.48 cases in treatment group,on the basis of 2HRZE/4HR program,with corresponding Chinese medicine according to traditional Chinese medicine syndrome differentiation:lung yin deficiency syndrome with ziyin run fei mian jian granules were supplemented;yin deficiency and fire excess syndrome with Feitai capsule;qi and yin deficiency syndrome with Shuangbai oral liquid.The blood routine examination,hepatorenal function,sputum smear,and chest radiograph,were reexamined monthly,and T lymphocyte subsets,and syndromes score were observed every other month.The treatment lasted 6 months.The clinical symptom,changes in lung X-ray image,empty change,sputum bacteriology conversion and drug side effects were observed.Results After the treatment for 6 months,the improvements in clinical symptom,absorption of the shadows in the lung,empty closed,and toxicity resistance of anti-tuberculosis drug in treatment group were all superior to control group(P<0.05).In terms of negative reversion of sputum bacteria,the statistical management did not present significant difference.Conclusion The therapy of traditional Chinese medicine syndrome differentiation and chemotherapeutic drugs has the good promoter action in eliminating tuberculosis symptoms,improving absorption of the focus in the lung,empty closed,and reduce the toxicity of anti-tuberculosis drugs.