耐多药结核病治疗的反思——整体观的必要性  

Reflection on Medical Treatment of Multi-drug Resistance Tuberculosis: The Necessity of Chinese Medicine Holistic View

作　　者：张蕾蕾[1] 金华[2] 

机构地区：[1]兰州市疾病预防控制中心结核病防治所,兰州730000 [2]甘肃中医药大学中医临床学院,兰州730020

出　　处：《中国中西医结合杂志》2015年第12期1517-1521,共5页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：本文从医源性、患者自身、社会因素等角度分析耐多药结核病(multidrug-resistant tuberculosis,MDR-TB)的发生因素,回顾MDR-TB治疗策略从标准短程化疗方案到整体干预策略基础上个体化治疗的演变过程,分析中医抗结核的历史与现阶段研究特点,指出中医学不但重视病原体,肯定"杀虫"之必要,更需关注病原体作用于人体后产生的级联反应,将其与患者自身状况、气候、地理、心理、社会等因素结合起来"整体"地看待MDR-TB的发生、发展。笔者认为中医整体观指导下的治则对MDR-TB治疗有着积极意义和启发,治疗应重视患病个体的整体特征和治疗方案的个体化,并强调"整体观"是提高MDR-TB疗效的基本策略,避免采用单一的"对抗"方式。Causative factors of multi-drug resistance tuberculosis（ MDR-TB） were analyzed from iatrogenic angles,patients themselves,and society. Reviewed was the development of treatment strategies for MDR-TB from directly observed treatment short-course（ DOTS） to DOTS-Plus. The history of Chinese medicine（ CM） fighting TB and characteristics at the present stage were also analyzed. Authors pointed out that CM pays attention not only to killing pathogens and confirms the necessity of getting rid of pathogens,but also to cascade response caused by pathogens. It also regards the occurrence and development of MDR-TB as a whole by combining patients＇ conditions,climatic,geographic,psychological,and social factors.Authors believed that therapeutic principles under guidance of CM holistic view are of positive significance and inspiration in treating MDR-TB,and emphasized holistic view as basic strategies for treating MDR-TB,but not a single countermeasure.

关 键 词：结核 耐多药 中医 整体观 

分 类 号：R52[医药卫生—内科学]