雾化吸入布地奈德联合异烟肼治疗溃疡坏死型支气管结核临床评价

目的探讨雾化吸入布地奈德联合异烟肼治疗溃疡坏死型支气管结核的临床疗效及安全性。方法选取重庆市公共卫生医疗救治中心2018年9月至2019年11月收治的溃疡坏死型支气管结核患者110例,按双色球法随机分为对照组和治疗组,各55例。两组患者均予全身抗结核治疗和雾化吸入异烟肼注射液;治疗组患者增加雾化吸入布地奈德混悬液。两组患者均治疗1个月。结果治疗组总有效率为98.18%,显著高于对照组的83.64%(P<0.05);治疗组患者治疗1,2,3个月后的影像学评分均显著低于对照组,痰菌阴转率、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC水平均显著高于对照组(P<0.05);治疗组患者的并发症发生率为3.64%,显著低于对照组的21.82%(P<0.05);治疗组和对照组的不良反应发生率相当(7.27%比3.64%,P>0.05)。结论雾化吸入布地奈德联合异烟肼治疗溃疡坏死型支气管结核临床疗效良好,可明显降低患者的影像学评分和并发症发生率,改善肺功能,提高痰菌阴转率,且安全性较高。

Efficacy Evaluation of Atomized Inhalation of Budesonide Combined with Isoniazid in the Treatment of Bronchial Tuberculosis of Necrotizing Ulcerative Type

Objective To investigate the clinical efficacy and safety of atomized inhalation of budesonide combined with isoniazid in the treatment of bronchial tuberculosis of necrotizing ulcerative type.Methods A total of 110 patients with bronchial tuberculosis of necrotizing ulcerative type admitted to the Chongqing Public Health Medical Treatment Center from September 2018 to November 2019 were selected and randomly divided into the control group and the treatment group according to the two-color ball method,55 cases in each group.The patients in the two groups were given systemic anti-tuberculosis treatment and atomized inhalation of Isoniazid Injection,on this basis,the patients in the treatment group were given Budesonide Suspension for Inhalation.Both groups were treated for one month.Results The total effective rate of the treatment group was 98.18%,which was significantly higher than 83.64%of the control group(P<0.05).After one,two and three months of treatment,the imaging scores in the treatment group were significantly lower than those in the control group,and the sputum negative conversion rate,the levels of forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and FEV1/FVC in the treatment group were significantly higher than those in the control group(P<0.05).The incidence of complications in the treatment group was 3.64%,which was significantly lower than 21.82%in the control group(P<0.05).The incidence of adverse reactions in the treatment group was similar to that in the control group(7.27%vs.3.64%,P>0.05).Conclusion Atomized inhalation of budesonide combined with isoniazid is effective and safe in the treatment of bronchial tuberculosis of necrotizing ulcerative type,which can significantly reduce the imaging scores and the incidence of complications,improve lung function and the sputum negative conversion rate.