中医整体观辨治耐多药肺结核化疗过程胃肠道反应的观察  

Observation of the Therapeutic Effect With Differentiation and Treatment of Traditional Chinese Medicine's Holism in the Treatment of Gastrointestinal Reactions During MDR-TB Chemotherapy

作　　者：黄志余[1] 李卫林[1] 林宪和[1] 

机构地区：[1]福建省疾病预防控制中心门诊部,福州350001

出　　处：《光明中医》2014年第5期964-967,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

摘　　要：目的比较中医整体观辨治和对症治疗耐多药肺结核(MDR-TB)化疗过程胃肠道反应的近期疗效和复发率以及对MDR-TB疗效的影响。方法将2000年1月—2009年12月在门诊化疗过程出现胃肠道反应的MDR-TB患者96例,分为中医辨治组(观察组)和对症治疗组(对照组)。中医辨治组经辨证分为2型,分别用参苓白术散加减和补天大造丸合理中汤加减治疗,对症治疗组用奥美拉唑、盐酸甲氧氯普胺治疗;观察比较两组治疗前后胃肠道反应症状积分、全疗程胃肠道反应复发率、全疗程因胃肠道反应干预失败而中断口服化疗率、24个月内达治愈标准率。结果中医辨治组治疗后胃肠道反应症状与治疗前相比,有非常显著改善(P<0.01);与对照组治疗后相比,症状明显轻微(P<0.05);对症治疗组治疗后除了便秘或腹泻症状较治疗前无明显改善(P>0.05);其余症状也显著改善(P>0.05);中医辨治组全疗程胃肠道反应复发率、全疗程因胃肠道反应干预失败而中断口服化疗率均明显低于对症治疗组,差异有非常显著性意义(P<0.01);中医辨治组24个月内达治愈标准率高于对症治疗组,但差异无显著性意义(P>0.05)。结论中医整体观辨治MDR-TB化疗过程胃肠道反应的近期疗效好,复发率低,因胃肠道反应干预失败而中断口服化疗率低。Objective To study and compare syndrome differentiation and treatment of Traditional Chinese Medicine＆#39;s holism and symptomatic treatment of gastrointestinal reaction for multidrug-resistant tuberculosis （ MDR-TB） patients during chemotherapy .Short-term effect and recurrence rate as well as the impact of MDR-TB chemotherapy were also studied .Methods From January 2000 to December 2009, cases of MDR-TB patients with gastrointestinal reactions during chemotherapy were studied , 96 cases were divided into Traditional Chinese Medicine （TCM） syndrome differentiation and treatment group （observationgroup） and the symptomatic group（control group）.The observationgroup also divided into two sub-groups, treated with shenlingbaishusan and butiandazaowan with lizhongtang respectively , the symptomatic group was treated with omeprazole , metoclopramide .Observed and compared before and after treatment of gastrointestinal tract symptom score ,the rate of the gastrointestinal tract recurrence during the whole course , the rate of peroral chemotherapy discontinuation due to gastrointestinal intervention failure during the whole course , the rate of up to the cure standard rate within 24 months of the two group . Results After Treatment,gastrointestinal symptom of the observationgroup were very significantly improved （P〈0.01）;compared with the control group , symptoms were mild （ P〈0.05 ）; the control group after treatment , except constipation or diarrhea symptoms was no significantly improved （P〉0.05）;other symptoms were significantly improvement （P〈0.05）; for the observationgroup, the rate of the gastrointestinal tract recurrence during whole course , the rate of peroral chemotherapy discontinuation due to gastrointestinal Intervention failure during whole course was significantly lower than the control group , the difference was very statistically significant （ P〈0.01）;up to the cure standard rate within 24 months of the observationgroup is higher than the control group , bu

关 键 词：中医整体观 辨证论治 肺结核 药物治疗 胃肠道反应 

分 类 号：R259[医药卫生—中西医结合]