摘要
【目的】探讨益气润肺汤辅助治疗对肺结核合并肺部真菌感染气阴两虚型老年患者的临床疗效。【方法】将106例肺结核合并肺部真菌感染气阴两虚型老年患者随机分为观察组和对照组,每组各53例。对照组给予常规抗结核、抗真菌西药治疗,观察组在对照组的基础上加用益气润肺汤治疗,疗程为6个月。观察2组患者治疗前后中医证候评分及血清降钙素原(PCT)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平的变化情况,比较2组患者的影像学吸收情况、痰菌转阴率、临床疗效及不良反应发生率。【结果】(1)治疗6个月后,观察组的总有效率为96.23%(51/53),对照组为81.13%(43/53),组间比较,观察组的临床疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的主证评分和次证评分均较治疗前明显降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者血清PCT、IL-6、TNF-α水平均较治疗前明显降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.01)。(4)治疗后,观察组的胸部病灶吸收率为96.23%(51/53),明显高于对照组的84.91%(45/53),差异有统计学意义(P<0.05)。(5)治疗3个月后,观察组和对照组的痰菌转阴率分别为49.06%(26/53)、30.19%(16/53),观察组的痰菌转阴率高于对照组(P<0.05);治疗6个月后,2组患者的痰菌转阴率分别为84.91%(45/53)、60.38%(32/53),观察组的痰菌转阴率也高于对照组(P<0.01),且2组患者治疗6个月后的痰菌转阴率均明显高于治疗3个月后(P<0.01)。(6)观察组的不良反应发生率为13.21%(7/53),对照组为20.75%(11/53),组间比较,差异无统计学意义(P>0.05)。【结论】在常规抗结核、抗真菌西药治疗基础上联合益气润肺汤治疗肺结核合并肺部真菌感染气阴两虚型老年患者,临床疗效确切,可有效改善临床症状,调节炎症因子水平,同时有助于清除病原菌,提高病灶吸收率。
Objective To investigate the clinical efficacy of adjuvant therapy with Yiqi Runfei Decoction in treating elderly patients with pulmonary tuberculosis complicated with pulmonary fungal infection of qi and yin deficiency syndrome type.Methods A total of 106 elderly patients with pulmonary tuberculosis complicated with pulmonary fungal infection of qi and yin deficiency syndrome type were randomly divided into the observation group and the control group,with 53 cases in each group.The control group was given conventional anti-tuberculosis and antifungal western medicine treatment,while the observation group was treated with Yiqi Runfei Decoction based on the conventional anti-tuberculosis and anti-fungal western medicine treatment.The course of treatment lasted for 6 months.Changes in the traditional Chinese medicine(TCM)syndrome scores and the levels of serum calcitonin(PCT),interleukin 6(IL-6)and tumor necrosis factor alpha(TNF-α)of patients in the two groups were observed before and after treatment,and the absorption and dissipation of inflammation showed by X-ray imaging,negative conversion rate of sputum bacterium(sputum conversion rate),clinical efficacy and incidence of adverse reactions were compared between the two groups.Results(1)After 6 months of treatment,the overall effective rate of the observation group was 96.23%(51/53)and that of the control group was 81.13%(43/53),and the intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the primary and secondary syndrome scores of patients in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on decreasing the syndrome scores in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the serum PCT,IL-6 and TNF-αlevels in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on decreasing the levels in the
作者
宋旭东
任玉茹
李静
雷娟
SONG Xu-Dong;REN Yu-Ru;LI Jing;LEI Juan(Dept.of Traditional Chinese Medicine,Ningxia Fifth People’s Hospital,Shizuishan 753000 Ningxia;Dept.of Prevention and Treatment,the Fourth People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750021 Ningxia,China)
出处
《广州中医药大学学报》
CAS
2023年第6期1355-1361,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
宁夏回族自治区自然科学基金项目(编号:2022AAC03714)。
关键词
益气润肺汤
肺结核
肺部真菌感染
炎症因子
气阴两虚
Yiqi Runfei Decoction
pulmonary tuberculosis
pulmonary fungal infection
inflammatory factors
qi-yin deficiency
