摘要
目的:观察养阴祛瘀汤口服联合胸腺素α1皮下注射治疗肺结核并糖尿病患者的疗效,并观察其对血清Th1/Th2细胞因子[γ-干扰素(IFN-γ)、白细胞介素(IL)-2及IL-4、IL-6]水平的影响,进一步探讨治疗机制。方法:选择同期收治的120例肺结核并糖尿病患者作为研究对象,采用随机数字表法分为观察组和对照组各60例。两组均予常规降糖、抗结核治疗及胸腺素α1皮下注射,在此基础上观察组联合服用养阴祛瘀汤,均连续治疗6~8个月。比较两组病灶吸收率、痰菌阴转率、空洞闭合率;观察两组治疗前后中医证候积分及血清糖化血红蛋白(HbA1c)、IFN-γ、IL-2、IL-4、IL-6水平变化;判定临床疗效,记录两组不良反应发生情况。结果:治疗结束后,观察组病灶吸收率、痰菌阴转率、空洞闭合率和临床总有效率均显著高于对照组(P<0.05);两组中医证候积分、血清HbA1c均较治疗前显著改善,且观察组两指标均显著低于对照组(P<0.05);两组血清IFN-γ、IL-2、IL-4、IL-6水平均较治疗前显著改善(P<0.05),且观察组血清Th1细胞因子IFN-γ、IL-2水平显著高于对照组(P<0.05),血清Th2细胞因子IL-4、IL-6水平显著低于对照组(P<0.05);两组血清Th1细胞水平明显升高(P<0.05)、Th2细胞水平明显降低(P<0.05),且观察组血清Th1细胞水平显著高于对照组(P<0.05)、血清Th2细胞水平显著低于对照组(P<0.05);观察组和对照组不良反应发生率分别为16.67%、15.00%,差异无统计学意义(P> 0.05)。结论:养阴祛瘀汤联合胸腺素α1治疗肺结核并糖尿病临床效果显著、安全性高,机制可能与两药联用可以调节外周血Th1/Th2细胞因子失衡有关。
Objective:To investigate the therapeutic effect of oral administration of Yangyin Quyu Decoction ( 养 阴祛 瘀 汤 ) combined with subcutaneous injection of thymosin α1 on patients with pulmonary tuberculosis and diabetes mellitus,and to observe its effect on serum Th1/Th2 cytokine levels(IFN-γ,IL-2,IL-4 and IL-6). Methods:A total of 120 patients with pulmonary tuberculosis and diabetes mellitus were selected as the study subjects,and were divided into the observation group and control group with 60 cases each using the random number table method. The two groups were given routine hypoglycemic treatment,anti-tuberculosis treatment and thymosin α1 subcutaneous injection. On this basis,the observation group was combined with Yangyin Quyu Decoction,both groups received continuous treatment for 6 ~8 months. The focus absorption rate,sputum negative conversion rate and cavity closure rate were compared between the two groups. The changes of traditional Chinese medicine(TCM) syndrome scores and serum levels of HbA1 c,IFN-γ,IL-2,IL-4 and IL-6 were observed before and a fter treatment in the two groups. The therapeutic effects were determined,and the occurrence of adverse reactions in both groups was recorded. Results:After treatment,the focus absorption rate,sputum negative conversion rate,cavity closure rate and total effective rate of clinical treatment in the observation group were significantly higher than those in the control group(P< 0.05). The TCM syndrome score and serum HbA1 c level in the two groups improved significantly compared with those before treatment(P< 0.05),and both indexes in the observation group were significantly lower than those in the control group(P< 0.05). The serum levels of IFN-γ,IL-2,IL-4,IL-6 in the two groups were significantly improved(P< 0.05),and serum levels of Th1 cytokines including IFN-γ,IL-2 in the observation group were significantly higher than those in the control group(P< 0.05),serum levels of Th2 cytokines including IL-4,IL-6 were significantly lower than those in t
作者
王栋
张磊
刘凡平
张素娟
WANG Dong;ZHANG Lei;LIU Fanping;ZHANG Sujuan(Department of Tuberculosis,Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Oncology,Affiliated Hospital of Hebei University,Baoding 071000,China)
出处
《山东中医药大学学报》
2020年第6期668-673,共6页
Journal of Shandong University of Traditional Chinese Medicine
基金
河北省2017年度医学科学研究重点课题计划项目(编号:201707804)。
