摘要
目的探讨柴胡桂枝干姜汤对肺结核患者疗效及痰菌阴转率、不良反应影响性。方法选取2017年5月-2019年12月辨证为肺结核患者114例为研究对象,按入组先后顺序分成两组,每组57例。对照组常规抗结核治疗,研究组柴胡桂枝干姜汤加减治疗,均治疗6个月。观察治疗后在痰菌阴转率、不良反应变化情况,比较治疗前末免疫功能、肝功能指标。结果 (1)两组治疗前各症状积分比较差异无统计学意义(P>0.05),治疗末胸痛、咯血、咳嗽咳痰、乏力低热、消瘦盗汗症状积分较治疗前比较均显著下降(P<0.05),且研究组治疗末以上积分显著优于对照组(P<0.05)。(2)研究组痰菌转阴率64.91%(37/57)、病灶吸收有效率80.7%(46/57)、空洞闭合有效率91.23%(52/57),对照组相对应比率分别为49.12%(28/57)、54.39%(31/57)、66.67%(38/57),研究组显著优于对照组(P<0.05)。(3)两组治疗前CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)含量比较差异无统计学意义(P>0.05),治疗末较治疗前两组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)显著上升,CD_(8)^(+)显著下降,且治疗末研究组显著优于对照组(P<0.05)。(4)两组治疗前谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL),血清学指标有白细胞介素2-受体(IL-2R)、单核细胞趋化蛋白-1(MCP-1)、Foxp3含量比较差异无统计学意义(P>0.05),治疗末较治疗前两组IL-2R、MCP-1、Foxp3显著下降,ALT、AST、TBiL显著上升,且治疗末研究组显著优于对照组(P<0.05)。(5)研究组胃肠反应、肝功能损害、骨髓抑制、过敏性皮炎发生率为26.32%(15/57)、19.3%(11/57)、5.26%(3/57)、7.02%(4/57),对照组分别为54.39%(31/57)、31.58%(18/57)、15.79%(9/57)、33.33%(10/57),研究组显著低于对照组(P<0.05)。结论柴胡桂枝干姜汤能改善肺结核患者痰菌阴转率、降低不良反应,提高免疫功能和生活质量。
Objective To explore the therapeutic effect of Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤,CGGD) on pulmonary tuberculosis, the negative conversion rate of sputum bacteria and the influence of adverse reactions. Methods A total of 114 patients with pulmonary tuberculosis from May 2017 to December 2019 were selected as the research objects, and divided into two groups according to the order of enrollment, 57 cases in each group. The control group was treated with routine antituberculosis therapy, and the study group was treated with CGGD for 6 months. We observed the negative conversion rate of sputum bacteria and the change of adverse reactions after treatment, and compared the immune function and liver function indexes before and after treatment. Results(1)There was no significant difference between the two groups before treatment(P>0.05), and the scores of chest pain, hemoptysis, cough and expectoration, asthenia and low fever, emaciation and night sweat at the end of treatment were significantly lower than those before treatment(P<0.05), and the scores above at the end of treatment in the study group were significantly better than those in the control group(P<0.05).(2)In the study group, the sputum negative rate was 64.91%(37/57), the effective rate of focus absorption was 80.7%(46/57), and the effective rate of cavity closure was 91.23%(52/57). In the control group, the corresponding rates were 49.12%(28/57), 54.39%(31/57) and 66.67%(38/57), respectively. The study group was significantly better than the control group(P<0.05).(3)There was no significant difference in CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+) or CD_(4)^(+)/CD_(8)^(+) between the two groups before treatment(P>0.05). At the end of treatment, CD_(3)^(+)、CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) increased significantly and CD_(8)^(+) decreased significantly in two groups compared with those before treatment. And at the end of treatment, the study group was significantly better than the control group(P<0.05).(4)Before treatment, ALT, AST, TBiL, IL-2 R, MCP-1 and Foxp3 were not significant before treatment. At the end of the treatment, IL-2 R, MCP-1 and Foxp3 were significantly decreased, and ALT, AST and TBiL were significantly increased. The study group was significantly better than the control group(P<0.05).(5)The incidence of gastrointestinal reaction, liver function damage, myelosuppression and allergic dermatitis was 26.32%(15/57), 19.3%(11/57), 5.26%(3/57) and 7.02%(4/57) in the study group. And those were 54.39%(31/57), 31.58%(18/57), 15.79%(9/57) and 33.33%(10/57) in the control group. The incidences were significantly lower in the study group than those in the control group(P<0.05). Conclusion CGGD can improve the sputum negative conversion rate, reduce the adverse reactions and improve the immune function and quality of life.
作者
郎雅珍
孔晓华
甄利波
崔岩飞
魏小娇
LANG Yazhen;KONG Xiaohua;ZHEN Libo;CUI Yanfei;WEI Xiaojiao(Zhejiang Integrated Traditional Chinese and Western Medicine Hospital,Hangzhou Red Cross Hospital,Hangzhou 310003,Zhejiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2021年第5期239-242,共4页
Chinese Archives of Traditional Chinese Medicine
基金
浙江省中医药科技计划(2016ZA157)。
关键词
柴胡桂枝干姜汤
肺结核
疗效
痰菌阴转率
不良反应
症状积分
T淋巴细胞
Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤)
pulmonary tuberculosis
curative effect
sputum negative conversion rate
adverse reaction
symptom score
T lymphocyte
