芪甲利肺胶囊辅助治疗复治肺结核合并2型糖尿病的疗效及T淋巴细胞亚群的变化  

Auxiliary curative effect of Qijialifei capsule for the treatment of recurrent pulmonary tuberculosis with type 2 diabetes and the changes of T lymphocyte subsets

作　　者：王和林[1] 李明瑛[2] 韩伟[1] 肖志坚[1] 

机构地区：[1]新乡医学院第一附属医院结核内科二病区,河南卫辉453100 [2]新乡医学院第一附属医院结核内科四病区,河南卫辉453100

出　　处：《新乡医学院学报》2016年第10期922-926,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨芪甲利肺胶囊辅助治疗复治肺结核合并2型糖尿病患者的疗效及T淋巴细胞亚群的变化。方法将280例经细菌学确诊的复治肺结核合并2型糖尿病患者按入院先后顺序随机分为观察组和对照组,每组140例。2组患者均应用3HRZES/9HRE(H:异烟肼,R:利福平,Z:吡嗪酰胺,E:乙胺丁醇,S:链霉素)方案抗结核治疗,观察组患者在此基础上加用芪甲利肺胶囊辅助治疗,每次3粒,口服,每日3次,疗程8个月。比较2组患者痰菌转阴情况、病灶及空洞变化情况、中医证候疗效及细胞免疫功能的差异。结果观察组患者强化期治疗结束时和疗程结束时痰菌阴转率分别为73.72%(101/137)、91.24%(125/137),对照组患者分别为57.97%(80/138)、80.43%(111/138),观察组患者强化期治疗结束时和疗程结束时痰菌阴转率均高于对照组(P<0.05)。观察组患者强化期结束时和疗程结束时病灶吸收的显效率分别为68.62%(94/137)、87.59%(120/137),对照组患者分别为45.65%(63/138)、69.57%(96/138),观察组患者强化期结束时和疗程结束时病灶吸收的显效率均高于对照组(P<0.05)。观察组患者强化期结束时和疗程结束时空洞闭合率分别为21.9%(30/137)、54.01%(74/137),对照组患者分别为10.87%(15/138)、28.26%(39/138),观察组患者强化期结束时和疗程结束时空洞闭合率均高于对照组(P<0.05)。疗程结束时观察组和对照组患者中医证候疗效总有效率分别为89.78%(123/137)、79.71%(110/138),观察组患者中医证候疗效总有效率高于对照组(P<0.05)。与对照组比较,观察组患者强化期结束时和疗程结束时CD3^+、CD4^+水平及CD4^+/CD8^+升高(P<0.05);2组患者强化期结束时和疗程结束时CD8^+水平比较差异无统计学意义(P>0.05)。结论芪甲利肺胶囊辅助治疗复治肺结核合并2型糖尿病能提高痰菌转阴率、病灶显效率和空洞闭合率,并能提高中医证候疗效和细胞免疫功能。Objective To discuss the auxiliary curative effect of Qijialifei capsule for the treatment of recurrent pulmonary tuberculosis with type 2 diabetes and the changes of T lymphocyte subsets.Methods Two hundred and eighty recurrent pulmonary tuberculosis with type 2 diabetes patients who were diagnosed definitely by bacteriology were divided into observation group and control group according to admission order,with 140 cases in each group.The two groups were given antituberculosis therapy with 3HRZES /9HRE（ H： isoniazid,R： rifampicin,Z： pyrazinamide,E： ethambutol,S： streptomycin）.Based on this,the patients in the observation group were added Qijialifei capsule orally for auxiliary treatment,three times a day,three pills each time,the course of treatment was eight months.Sputum negative conversion,lesions and cavity changes,effect of traditional Chinese Medicine syndrome（ TCM） and cellular immune function between the two groups were compared.Results The rate of sputum negative conversion at the end of the intensive phase and the end of the treatment in the observation group was 73.72%（ 101 /137） and 91.24%（ 125 /137）,respectively,while in the control group it was 57.97%（ 80 /138） and80.43%（ 111 /138）,the rate of sputum negative conversion at the end of the intensive phase and the end of the treatment in the observation group was higher than that in the control group（ P〈0. 05）.The excellence rate of lesions resorption at the end of the intensive phase and the end of the treatment in the observation group was 68.62%（ 94 /137） and 87.59%（ 120 /137）,respectively,while in the control group it was 5.65%（ 63 /138） and 69.57%（ 96 /138）,the excellence rate of lesions resorption at the end of the intensive phase and the end of the treatment in the observation group was higher than that in the control group（ P〈0. 05）.The synizesis rate of cavity at the end of the intensive phase and the end of the treatment in the observation group was 21.9%（ 30 /137） and 54.01%�

关 键 词：肺结核 复治 糖尿病 中成药 抗结核药 T淋巴细胞亚群 

分 类 号：R521[医药卫生—内科学] R587.1[医药卫生—临床医学]