柴枳半夏汤加减对结核性胸膜炎治疗前后胸膜厚度及炎症因子的影响  

Effect of Chaizhi Banxia decoction on pleural thickness and inflammatory factors before and after treatment of tuberculous pleurisy

作　　者：潘静洁[1] 黄晋 刘堂营 PAN Jingjie;HUANG Jin;LIU Tangying(Department of Chinese Medicine,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院中医科

出　　处：《实用医学杂志》2019年第13期2180-2184,共5页The Journal of Practical Medicine

摘　　要：目的探讨柴枳半夏汤加减配合胸腔穿刺术加常规抗结核对结核性胸膜炎治疗前后胸膜厚度及炎症因子水平的影响。方法选取2018年3月至2019年2月广州市胸科医院接受诊治的结核性胸膜炎患者80例,随机分为对照组和联合组,每组40例。对照组予常规2HRZE/4HR方案抗结核治疗及胸腔穿刺术,联合组在对照组的基础上给予柴枳半夏汤,2组均连续治疗8周。观察2组患者治疗前后临床疗效、胸膜厚度、胸腔积液消失时间及胸水中TGF β1、TNF α和IFN γ的mRNA水平变化。结果治疗后,联合组的临床有效率(90%)明显高于对照组(67.5%,P<0.05);对照组患者胸腔积液消失时间和胸膜厚度均明显大于联合组(P<0.05);两组患者胸水中TGF β1、TNF α和IFN γ的mRNA水平均明显降低(P<0.05),且与对照组相比,联合组患者下调得更为显著(P<0.05)。结论柴枳半夏汤加减配合胸腔穿刺术加常规抗结核方案能更加有效治疗结核性胸膜炎,降低患者胸膜厚度,缩短胸腔积液消失时间,以及抑制胸水TGF β1、TNF α、IFN γ的mRNA水平。Objective To investigate the effect of Chaizhi Banxia decoction combined with thoracic puncture and routine anti-tuberculosis on pleural thickness and inflammatory factors before and after the treatment of tuberculous pleurisy.Methods From March 2018 to February 2019,80 patients with tuberculous pleurisy were randomLy divided into control group(n=40)and combined group(n=40).During the 8-week treatment,the control group was treated with routine 2HRZE/4HR regimen and thoracic puncture,and the combined group with additional Chaizhi Banxia decoction.Clinical efficacy,pleural thickness,disappearance time of pleural effusion,the mRNA level of TGF-β1,TNF-α and IFN-γ in pleural effusion was observed before and after the treatment.Results After the treatment ,the clinical effective rate in the combined group(90%)was significantly higher than that in the control group(67.5%)(P<0.05).The disappearance time and pleural thickening of pleural effusion in the control group were significantly longer and thicker than those in the combined group(P<0.05).The mRNA level of TGF-β 1,TNF-α and IFN-γ in pleural effusion of the two groups were significantly decreased(P<0.05),but more obviously in the combined group(P<0.05).Conclusion Chaizhi Banxia decoction combined with thoracic puncture and routine anti-tuberculosis regimen would be more effective in the treatment of tuberculous pleurisy,which could reduce the pleural thickness and shorten the disappearance time of pleural effusion.It also inhibits the contents and mRNA level of TGF-β1,TNF-α,IFN-γ in pleural effusion.

关 键 词：柴枳半夏汤 胸膜厚度 胸腔积液 TGF-Β1 TNF-Α IFN-Γ 

分 类 号：R259[医药卫生—中西医结合]