摘要
目的:探讨单耐药肺结核应用黄芪注射液联合西药治疗的临床效果。方法:选取2015年6月—2017年10月我院收治的94例单耐药肺结核患者,采取随机数字表法将这94例患者随机分成观察组(n=47)与对照组(n=47)。对照组采用9R-Lfx-Z-E化疗方案治疗,观察组在此基础上联合黄芪注射液治疗,所有患者均治疗9个月后观察疗效。比较两组临床疗效,治疗前后抗/促炎因子[白介素(IL)-10、干扰素(IFN)-γ、IL-17]水平、免疫功能指标[T淋巴细胞亚群(CD4^+/CD8^+比值)、CD4^+CD25^+调节性T细胞(CD4^+CD25^+Treg)]变化,不良反应发生情况。结果:观察组总有效率为89.4%(42/47),明显高于对照组[72.3%(34/47),P<0.05]。观察组治疗3、6、9个月时的痰涂片转阴率分别为55.3%、70.2%、80.9%,均依次显著高于对照组(36.2%、48.9%、61.7%,P<0.05);且观察组痰培养阴转时间较对照组显著缩短(P<0.05)。与治疗前相比,两组治疗后血清IL-10浓度和外周血CD4^+CD25^+Treg水平均显著减少(P<0.05),血清IFN-γ、IL-17水平及外周血CD4+/CD8+比值均显著增加(P<0.05);且观察组改善更显著(P<0.05)。观察组不良反应率[19.1%(9/47)]较对照组[38.3%(18/47)]显著降低(P<0.05)。结论:单耐药肺结核应用黄芪注射液联合西药治疗可有效解除患者症状,下调血中抗炎因子表达,诱导促炎因子分泌,正向调节体内细胞免疫功能,有助于结核分枝杆菌的迅速清除,减毒增效作用显著。
Objective:To explore clinical effect of Astragalus Injection combined with Western medicine in the treatment of mono-resistant pulmonary tuberculosis.Methods:Selected 94 cases with mono-resistant pulmonary tuberculosis in our hospital from June 2015 to October 2017 as research objectives,and divided those 94 cases into observation group(n=47)and control group(n=47)randomly.Provided 9R-Lfx-Z-E chemotherapy to both group,and provided Astragalus Injection to observation group additionally,observed clinical effects after 9 month treatments.Compared two groups'clinical effects,anti/pro inflammatory factors[interleukin(IL)-10,interferon(IFN)-γ,IL-17],immune function indicators[T lymphocyte subsets(CD4^+/CD8^+ratio),CD4^+CD25^+regulatory T cells(CD4^+CD25^+Treg)]before and after treatment,as well as adverse reaction rate.Results:Observation group's overall effective rate was 89.4%(42/47)which was significant higher than that in the control group[72.3%(34/47),P<0.05].Observation group's sputum smear conversion rates at 3,6,and 9 months were 55.3%,70.2%,and 80.9%,respectively,they were significant higher than that in the control group(36.2%,48.9%,61.7%,P<0.05),and observation group's sputum conversion time was significant shorter than that in the control group(P<0.05).Compared with those before treatment,two groups'serum IL-10 concentration and peripheral blood CD4^+CD25^+Treg levels were significant lower after treatment(P<0.05),serum IFN-γ,IL-17 levels and peripheral CD4+/CD8+ratio were significant higher(P<0.05),and observation group improved more significantly(P<0.05).Observation group's adverse reaction rate[19.1%(9/47)]which was significant lower than that in the control group[38.3%(18/47),P<0.05].Conclusion:Astragalus Injection combined with Western machine helps patients with mono-resistant pulmonary tuberculosis to relieve symptoms,down-regulate the expression of anti-inflammatory factors in blood,induce secretion of pro-inflammatory factors,and positively regulate cellular immune function in the body,which hel
作者
李毅
席素雅
石庆芳
郑浩
王建梅
侯宏伟
冯秀莉
LI Yi;XI Suya;SHI Qingfang;ZHENG Hao;WANG Jianmei;HOU Hongwei;FENG Xiuli(Chest Hospital of Hebei Province,Shijiazhuang 050041,Hebei,China;Harrison Internationnal Peace Hospital,Hengshui 053000,Hebei,China)
出处
《辽宁中医药大学学报》
CAS
2019年第8期149-152,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
河北省中医药管理局科研计划项目(2018087)
关键词
单耐药肺结
黄芪注射液
西药
抗/促炎因子
免疫功能
mono-resistant tuberculosis
Astragalus Injection
Western medicine
anti/pro inflammatory factor
immune function
