活血化瘀法治疗结核性胸膜炎对患者胸膜厚度及胸水TNF-α、TGF-β1水平的影响  

Effects of Method of Promoting Blood Circulation and Removing Blood Stasis on Pleural Thickness and Levels of TNF-α and TGF-β1 in Pleural Effusion of Patients with Tuberculous Pleurisy

作　　者：王荣华 廖泽飞[1] 张乐 王耿杰[1] 马良赟[1] Wang Ronghua;Liao Zefei;Zhang Le;Wang Gengjie;Ma Liangyun(Department of Thoracic Surgery,the 180th Hospital of the Chinese People′s Liberation Army,Quanzhou 362000,China)

机构地区：[1]中国人民解放军第180医院胸外科,泉州362000

出　　处：《世界中医药》2018年第12期3081-3084,共4页World Chinese Medicine

基　　金：泉州市科技计划项目(2012z66)

摘　　要：目的:探讨活血化瘀法治疗结核性胸膜炎对患者胸膜厚度及胸水肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)水平的影响。方法:选取2015年10月至2016年10月中国人民解放军第180医院收治的结核性胸膜炎患者88例,随机分为观察组和对照组,每组44例。对照组给予常规抗结核治疗及胸腔穿刺抽液术,观察组在对照组的基础上给予血府逐瘀汤,2组均连续治疗8周。观察2组患者治疗前后中医证候、临床疗效、胸膜厚度及胸水中TNF-α、TGF-β1变化。结果:治疗后2组胸痛、发热、气促、咳嗽、咯血、咯痰均显著低于治疗前(P <0. 05或P <0. 01),且2组间比较差异有统计学意义(P <0. 05或P <0. 01);治疗后观察组总有效率显著高于对照组(P <0. 01);治疗8周观察组胸膜厚度明显小于对照组,差异有统计学意义(P <0. 05或P <0. 01);治疗8周2组TNF-α、TGF-β1水平均显著低于治疗前,且2组间比较差异有统计学意义(P <0. 05或P <0. 01)。结论:活血化瘀法治疗结核性胸膜炎能显著改善中医证候,提高临床疗效,减小患者胸膜厚度,降低胸水TNF-α、TGF-β1水平。Objective:To investigate the effects of the method of promoting blood circulation and removing blood stasis for pleural thickness and levels of tumor necrosis factor-α(TNF-α)and transforming growth factor-β1(TGF-β1)in pleural effusion of patients with tuberculous pleurisy.Methods:A total of 88 patients with tuberculous pleurisy in the 180th Hospital of the Chinese People′s Liberation Army from October 2015 to October 2016 were randomly divided into control group and observation group with 44 cases in each group.The control group was given conventional anti-tuberculosis treatment and pleural paracentesis.The observation group was given Xuefu Zhuyu Decoction on the basis of the control group.Both groups were continuously treated for 8 weeks.The changes of traditional Chinese medicine syndrome,clinical efficacy,pleural thickness,and TNF-αand TGF-β1 in pleural effusion were observed before and after treatment.Results:After the treatment,the chest pain,fever,shortness of breath,cough,hemoptysis and expectoration in 2 groups were significantly lower than those before treatment(P<0.05 or P<0.01),and there were significant difference between the two groups(P<0.05 or P<0.01).The total effective rate in the observation group was significantly higher than that in the control group(P<0.05 or P<0.01).The pleural thickness of treatment of 2 or 8 weeks in the observation group was significantly lower than that in the control group(P<0.01).The difference was statistically significant(P<0.05 or P<0.01).The levels of TNF-αand TGF-β1 in the two groups were significantly lower than those before treatment(P<0.05 or P<0.01).Conclusion:Method of promoting blood circulation and removing blood stasis can significantly improve the symptoms of tuberculous pleurisy,improve the clinical efficacy,and reduce the pleural thickness and the levels of TNF-αand TGF-β1 in pleural effusion.

关 键 词：结核性胸膜炎 活血化瘀法 胸膜厚度 TNF-Α TGF-Β1 

分 类 号：R259[医药卫生—中西医结合]