摘要
目的探究三子牵牛汤结合胸腔微创置管辅助尿激酶治疗结核性胸膜炎临床疗效及安全性。方法研究纳入79例结核性胸膜炎患者,均由医院2018年2月—2020年2月收治,采取随机数字表法将其分为两组,予以对照组患者(39例)胸腔微创置管辅助尿激酶治疗,予以观察组患者(40例)三子牵牛汤结合胸腔微创置管辅助尿激酶治疗,比较两组患者临床疗效、治疗前后患者中医症状(发热、咳嗽、胸胁痛、气促、纳差、舌淡苔白、脉沉弦等)积分、胸膜厚度变化及胸膜粘连比例、胸水完全吸收时间及引流液量、治疗前后患者白介素-6(IL-6)、C反应蛋白水平(CRP)、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)水平变化、腺苷脱氨酶(ADA)水平变化、并发症及治疗不良反应。结果观察组治疗有效率(95.00%,38/40)高于对照组(76.92%,30/39)(P<0.05);治疗前,两组患者发热咳嗽、胸胁痛、气促、纳差、舌淡苔白、脉沉弦等中医症状积分、胸膜厚度、IL-6、CRP、TNF-α、IFN-γ、ADA等指标比较,P>0.05,治疗后各组患者发热咳嗽、胸胁痛、气促、纳差、舌淡苔白、脉沉弦等中医症状积分、胸膜厚度、IL-6、CRP、TNF-α、IFN-γ、ADA等指标均改善,观察组患者治疗后发热咳嗽、胸胁痛、气促、纳差、舌淡苔白、脉沉弦等中医症状积分、胸膜厚度、IL-6、CRP、TNF-α、IFN-γ、ADA等指标优于对照组(P<0.05);治疗前,两组患者胸膜粘连例数相当(P>0.05),治疗后各组患者胸膜粘连例数均降低,对照组治疗前后胸膜粘连例数比较,P>0.05,观察组治疗前后胸膜粘连例数比较,P<0.05,,观察组治疗后胸膜粘连例数少于对照组,P<0.05;观察组患者胸水完全吸收时间短于对照组,引流液量少于对照组(P<0.05);观察组患者并发症率(5.00%,2/40)低于对照组(23.08%,9/39)(P<0.05);观察组未见不良反应(0.00%),对照组患者出现2例胃肠道反应(5.00%,2/40)(P>0.05)。结论三子牵牛汤�
Objective To explore the clinical efficacy and safety of Sanzi Qianniu Decoction(三子牵牛汤)combined with minimally invasive catheter assisted urokinase in the treatment of tuberculous pleurisy.Methods Seventy-nine patients with tuberculous pleuritis were admitted to our hospital in February 2018 to February 2020.They were divided into two groups by random number table method.Patients in the control group(39 cases)were given minimally invasive thoracic catheterization assisted urokinase,while those in the observation group(40 cases)were given Sanzi Qianniu Decoction combined with minimally invasive thoracic catheterization assisted urokinase.The clinical efficacy,the score of traditional Chinese medicine symptoms(fever,cough,chest and flank pain,shortness of breath,anorexia,pale tongue coating,deep and string-like pulse,etc.)before and after treatment,the change of pleural thickness and the proportion of pleural adhesion,the complete absorption time of pleural fluid and the amount of drainage fluid,the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interferonγ(IFN-γ)changes and adenosine deaminase(ADA),complications and adverse reactions before and after treatment were compared between the two groups.Results The effective rate(95.00%,38/40)in the observation group was higher than that in the control group(76.92%,30/39)(P<0.05).Before treatment,two groups’Chinese medicine symptoms(fever,cough,chest and flank pain,shortness of breath,anorexia,pale tongue coating,deep and string-like pulse),pleural thickness,levels of IL-6,CRP,TNF-α,IFN-γand ADA had no difference(P>0.05).After treatment group,traditional Chinese medicine symptoms integral(fever,cough,chest and flank pain,shortness of breath,anorexia,pale tongue coating,deep and string-like pulse),pleural thickness,levels of IL-6,CRP,TNF-α,IFN-γand ADA were improved.The scores of traditional Chinese medicine symptoms,pleural thickness and levels of IL-6,CRP,TNF-α,IFN-γand ADA in the observation group were better
作者
李振云
崔俊伟
高远
郗玉玲
张边防
高景利
LI Zhenyun;GUI Junwei;GAO Yuan;XI Yuling;ZHANG Bianfang;GAO Jingli(The First Affiliated Hospital of Xinxiang Medical College,Henan Tuberculosis Hospital,Xinxiang 453100,Henan,China)
出处
《中华中医药学刊》
CAS
北大核心
2021年第12期201-205,共5页
Chinese Archives of Traditional Chinese Medicine
基金
河南省医学科技攻关计划(2018020344)。
关键词
结核性胸膜炎
三子牵牛汤
胸腔微创置管辅助尿激酶
疗效
并发症
不良反应
tuberculous pleurisy
Sanzi Qianniu Decoction(三子牵牛汤)
thoracic minimally invasive catheterization assisted urokinase
curative effect
complications
adverse reactions
