摘要
目的:观察活血化瘀汤联合西药治疗结核性胸膜炎增厚的临床疗效。方法:将120例结核性胸膜炎增厚患者采用随机数字表分为对照组与观察组,每组60例。对照组予以常规西药治疗(抗结核2HREZ/10HR方案+胸腔穿刺术),观察组在对照组治疗基础上联合中药活血化瘀汤治疗,方药组成:瓜蒌仁、葶苈子、茯苓、桔梗各15 g,桃仁、红花、赤芍、当归、白术、紫苏子、枳壳各10 g,炙甘草5 g,大枣5枚,两组均治疗2个月,观察两组治疗前后胸水肿瘤坏死因子(tumor necrosis factor alpha,TNF-α)及纤维蛋白原(fibrinogen,FIB)水平、转化生长因子(transforming growth factor-β1,TGF-β1)、胸膜厚度、临床疗效,并检测治疗前后肝、肾功能,包括天门冬氨酸氨基转移酶(aspartateaminotransferase,AST)、谷丙转氨酶(alanine aminotransferase,ALT),肾功能指标血尿素氮(blood urea nitrogen,BUN)及血肌酐(serum creatinine,Scr)水平。结果:两组临床疗效比较,对照组有效率为83.33%,明显低于观察组95.0%,差异有统计学意义(P<0.05);两组TNF-α、FIB及TGF-β1含量较治疗前均显著下降,且观察组下降幅度明显高于对照组,差异有统计学意义(P<0.05);随着病情的进展,两组胸膜厚度逐渐增加,但观察组增加幅度明显低于对照组,差异有统计学意义(P<0.05);对照组AST、ALT、BUN、Scr较治疗前无明显改善,观察组较治疗前显著下降,且明显低于对照组,差异均有统计学意义(P<0.05)。结论:活血化瘀汤联合西药对结核性胸膜炎胸膜增厚患者较单独使用西药治疗临床疗效显著,可有效抑制机体炎性反应,减少纤维蛋白产生,降低肝、肾功能损伤,有效抑制胸膜肥厚改变。
Objective：To observe the clinical curative effect of Huoxue Huayu decoction combined with Western medicine in treat- ment of tuberculous pleural thickening. Methods ：120 cases of tuberculous pleurisy thickening patients were randomly divided into the control group and the observation group,60 cases in each group. The control group was given routine treatment of Western med- icine （anti tuberculosis scheme 2HREZ/10HR and thoraeenteses） , and the observation group was treated with Huoxue Huayu de- coction based on the control group, composition ： Gualouren （ Trichosanthes Kirilowii） 15 g, Tinglizi （ Semen Lepidii） 15 g, Fuling （Poria） 15 g, Jiegeng （Platyeodon） 15 g, Taoren （ Peach Kernel） 10 g, Honghua （Safflower） 10 g, Chishao （ Red Peony Root） 10 g, Danggui （Angelica） 10 g, Baizhu （Aractylodes） 10 g, Zisuzi （ Perilla Seed） 10 g, Zhike （ Fruetus Aurantii） 10 g, Zhigancao （ Dried Licorice） 5 g, Dazao （Jujube） 5 pieces. 2 months of treatment, observed before and after treatment of tumor necrosis faetor alpha （TNF-alpha） and fibrinogen （FIB） level, transforming growth factor-131 （ TGF-131 ）, pleural thickness, clinical efficacy of the two groups, detected liver and kidney function, including aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, blood urea nitrogen ereatinine （BUN） , and serum creatinine （Scr） levels before and after treatment. Results：The effective rate of controlgroup was 83.33% , significantly lower than the observation group 95.0%, the difference was statistically significant （P 〈 0.05 ） ; the levels of TNF-ot, FIB and TGF-[31 in the two groups were significantly lower than those before treatment, and the decrease rate of the observation group was higher than that of the control group （ P 〈 0.05 ）. As the disease progresses, pleural thickness in- creased gradually increased, but the increasing extent in the observation group was significantly lower than the eontrol group （P 〈 0.
出处
《中医学报》
CAS
2017年第8期1547-1550,共4页
Acta Chinese Medicine
基金
河南省医学科技攻关计划项目(201602341)
关键词
结核性胸膜炎
活血化瘀汤
胸膜增厚
中医药疗法
中西医结合
Key words： tuberculous pleurisy
Huoxue Huayu decoction
pleural thickening
TCM therapy
combination of Chinese and Westernmedicine
