摘要
目的:观察优福宁胶囊联合2HRZE/4HR方案治疗新发活动性肺结核的临床疗效。方法:采用随机数字表法将140例新发活动性肺结核患者分为对照组、治疗组各70例。对照组给予2HRZE/4HR方案治疗,治疗组在对照组基础上加服优福宁胶囊,2组连续治疗6个月。比较2组痰菌转阴率、肺部病灶吸收好转率;比较2组治疗前后用力肺活量(FVC)、最大呼气峰流速(PEF)、第1秒用力呼气容积(FEV1)、干扰素-γ(IFN-γ)、白细胞介素(IL)-4、IL-17、IL-10水平;比较2组调节性T细胞(Treg)、辅助性T细胞1 (Th1)、辅助性T细胞2 (Th2)、辅助性T细胞17 (Th17)水平及Th1/Th2、Th17/Treg,并评估2组临床疗效及不良反应发生情况。结果:治疗后,治疗组总有效率、痰菌转阴率、肺部病灶吸收好转率分别为85.71%、85.71%和81.43%,对照组总有效率、痰菌转阴率、肺部病灶吸收好转率分别为67.14%、67.14%和57.14%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组FEV1、FVC、PEF、IFN-γ、IL-17、Th1、Th17水平及Th1/Th2、Th17/Treg均较治疗前升高(P<0.05),且治疗组治疗后上述指标高于对照组(P<0.05)。2组治疗后IL-10、Treg水平较治疗前降低(P<0.05),且治疗组治疗后IL-10、Treg水平低于对照组(P<0.05)。2组治疗前后IL-4、Th2水平及2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:优福宁胶囊联合2HRZE/4HR方案治疗新发活动性肺结核临床疗效显著,能够改善患者肺功能,促进肺部病灶吸收,减轻炎症反应,调节Th1/Th2及Th17/Treg免疫失衡,安全性较高。
Objective:To observe the clinical effects of Youfuning Capsules combined with 2HRZE/4HR regimen on newly active pulmonary tuberculosis.Methods:A total of 140 cases with newly active pulmonary tuberculosis were divided into the control group and the treatment group according to the random number table method,with 70 cases in each group.The control group was given 2HRZE/4HR regimen,and the treatment group was additionally given Youfuning Capsules orally based on the treatment of the control group,and the two groups were treated continuously for six months.The negative conversion rate of sputum and the absorption improvement rate of lung lesions were compared between the two groups.The levels of forced vital capacity(FVC),maximum peak expiratory flow(PEF),forced expiratory volume in one second (FEV1),interferon-γ (IFN-γ),interleukin (IL)-4,IL-17 and IL-10 beforeand after treatment were compared between the two groups. The levels of regulatory T cells (Treg),helperT cells 1 (Th1),helper T cells 2 (Th2),helper T cells 17 (Th17) and Th1/Th2 and Th17/Treg in the two groupswere compared, and the clinical effects and the incidence of adverse reactions in the two groups wereevaluated. Results: After treatment, the total effective rate, negative conversion rate of sputum andabsorption improvement rate of lung lesions in the treatment group were 85.71%, 85.71% and 81.43%,respectively, while the total effective rate, negative conversion rate of sputum and absorptionimprovement rate of lung lesions in the control group were 67.14%, 67.14% and 57.14%, respectively;the difference was statistically significant (P<0.05). After treatment,the levels of FEV1,FVC,PEF,IFN-γ,IL-17, Th1, Th17 and Th1/Th2 and Th17/Treg in the two groups were enhanced when compared withthose before treatment (P<0.05), and the above levels in the treatment group were higher than those inthe control group (P<0.05). The levels of IL-10 and Treg in both groups were decreased when comparedwith those before treatment (P<0.05),and the levels of IL-10 and Treg
作者
李晓阳
王霞
赵桂增
LI Xiaoyang;WANG Xia;ZHAO Guizeng(Department of Tuberculosis,The First Affiliated Hospital of Xinxiang Medical University/Henan Provincial Tuberculosis Hospital,Weihui Henan 453000,China)
出处
《新中医》
CAS
2024年第15期67-71,共5页
New Chinese Medicine
基金
新乡医学院结核病研究所开放课题(XYJHB202107)。
