加味百合固金汤辅助西药治疗对复治性肺结核免疫功能及安全性的影响研究  

Effects of Adjuvant Therapy of Modified Baihe Gujin Decoction Combined with Western Medicine on Immune Function of Retreated Pulmonary Tuberculosis Patients and Its Safety

作　　者：刘星 郭遂怀 彭若轩 武彩花 王文慧 LIU Xing;GUO Sui-Huai;PENG Ruo-Xuan;WU Cai-Hua;WANG Wen-Hui(Dept.of Traditional Chinese Medicine,Wuhan Pulmonary Hospital,Wuhan 430030 Hubei,China;Dept.of Acupuncture and Moxibustion,Wuhan First Hospital,Wuhan 430022 Hubei,China)

机构地区：[1]武汉市肺科医院中医科,湖北武汉430030 [2]武汉市第一医院针灸科,湖北武汉430022

出　　处：《广州中医药大学学报》2023年第8期1890-1895,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81804187)。

摘　　要：【目的】探讨加味百合固金汤辅助西药治疗对复治性肺结核免疫功能及安全性的影响。【方法】将2020年5月~2022年5月收治的106例复治肺结核患者随机分为对照组和观察组,每组各53例。对照组给予单纯西药(2HRZE/4HR标准化疗方案)抗结核治疗,观察组在对照组的基础上联合加味百合固金汤治疗,疗程为8周。观察2组患者治疗前后血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)及免疫指标T细胞亚群CD3^(+)、CD4^(+)、CD8^(+)含量的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗8周后,观察组的总有效率为92.45%(49/53),对照组为75.47%(40/53),组间比较,观察组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)炎症因子方面,治疗8周后,2组患者血清TNF-α、IL-6水平均较治疗前明显降低(P<0.05),且观察组对血清TNF-α、IL-6水平的降低幅度均明显优于对照组,差异均有统计学意义(P<0.01)。(3)免疫指标方面,治疗8周后,2组患者血清T细胞CD3^(+)、CD4^(+)水平均较治疗前明显升高(P<0.05),血清T细胞CD8^(+)水平均较治疗前明显降低(P<0.05),且观察组对血清T细胞CD3^(+)、CD4^(+)水平的升高幅度及对血清T细胞CD8^(+)水平的降低幅度均明显优于对照组,差异均有统计学意义(P<0.01)。(4)安全性方面,治疗过程中,2组患者的血常规和肝肾功能等安全性指标均无异常变化。观察组有3例患者存在胃肠道反应,不良反应发生率为5.66%(3/53),对照组有2例患者存在胃肠道反应,不良反应发生率为3.77%(2/53),组间比较,差异无统计学意义(χ^(2)=0.210,P>0.05)。【结论】与单纯西药抗结核治疗比较,加味百合固金汤辅助西药治疗复治性肺结核效果更好,能更有效地降低患者炎症因子水平,提高患者免疫功能,且无明显不良反应。Objective To investigate the effect of adjuvant therapy of modified Baihe Gujin Decoction combined with western medicine on the immune function of retreated pulmonary tuberculosis patients and its safety.Methods From May 2020 to May 2022,106 patients with retreated pulmonary tuberculosis were randomly divided into the control group and the observation group,with 53 cases in each group.The control group was given antituberculosis treatment with western medicine alone(2HRZE/4HR standard chemotherapy regimen),while the observation group was treated with the combination of modified Baihe Gujin Decoction on the basis of treatment for the control group.Both groups were treated for a period of 8 weeks.The patients in the two groups were observed in terms of the changes in serum levels of tumor necrosis factorα(TNF-α),interleukin 6(IL-6)and immune indexes of CD3^(+),CD4^(+)and CD8^(+)subsets before and after treatment.After treatment,the clinical efficacy and safety of the patients in the two groups were evaluated.Results(1)After 8 weeks of treatment,the overall effective rate of the observation group was 92.45%(49/53)and that of the control group was 75.47%(40/53).The intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After 8 weeks of treatment,the serum inflammatory factor levels of TNF-αand IL-6 in both groups were significantly decreased compared with those before treatment(P<0.05),and the decrease of serum TNF-αand IL-6 levels in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.01).(3)After 8 weeks of treatment,the serum immune index T cell evels of CD3^(+)and CD4^(+)in both groups were significantly increased(P<0.05)and the serum CD8^(+)level was significantly decreased(P<0.05)compared with those before treatment,and the increase of serum CD3^(+)and CD4^(+)levels and the decrease of serum

关 键 词：复治性肺结核 加味百合固金汤 抗结核治疗 免疫功能 炎症因子 安全性 

分 类 号：R259.21[医药卫生—中西医结合]