化痰解凝汤剂联合抗结核药物治疗气滞痰凝型淋巴结核的效果  

Therapeutic effects of Huatan Jiening decoction combined with antituberculosis drugs in the treatment of lymph tuberculosis of Qizhi Tanning type

作　　者：薛伊晴 李倩 周洁 张湘 张莉[1] XUE Yiqing;LI Qian;ZHOU Jie;ZHANG Xiang;ZHANG Li(Department of Scrofula,Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210014;Department of Gastroenterology,Yixing Fourth People’s Hospital,Yixing Jiangsu 214200;Department of Internal Medicine,Nantong First People’s Hospital,Nantong Jiangsu 226001;Department of Gynecology,Traditional Chinese Medicine of Wuxi Hospital of Traditional Chinese Medicine,Wuxi Jiangsu 214100,China)

机构地区：[1]南京市中西医结合医院瘰疬科,南京210014 [2]宜兴市第四人民医院消化科,江苏宜兴214200 [3]南通市第一人民医院中医内科,江苏南通226001 [4]无锡市中医院中医妇科,江苏无锡214100

出　　处：《临床与病理杂志》2023年第7期1348-1355,共8页Journal of Clinical and Pathological Research

摘　　要：目的:分析化痰解凝汤剂联合抗结核药物治疗气滞痰凝型淋巴结核的疗效和安全性。方法:选取2020年2月至2022年2月在南京市中西医结合医院瘰疬科就诊的120例气滞痰凝型淋巴结核患者作为研究对象。采用随机数字表法将患者分为研究组与对照组,每组60例。对照组患者给予四联抗结核药物治疗,研究组患者在此基础上口服化痰解凝汤,2组均连续治疗2个月,治疗结束后开展6个月随访。对2组临床疗效,临床症状缓解率,治疗前、后的免疫炎症指标,不良反应发生率及随访期复发率进行比较。结果:研究组患者的疗效优于对照组,临床有效率及临床症状缓解率均高于对照组,2组比较差异均有统计学意义(均P<0.05)。治疗后,2组患者的外周血CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值均较治疗前升高,血清肿瘤坏死因子(tumor necrosis factor,TNF)-α、干扰素(interferon,INF)-γ水平均较治疗前下降,血清白细胞介素(interleukin,IL)-10水平较治疗前上升,差异均有统计学意义(均P<0.05)。研究组患者治疗后的外周血CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值均高于对照组,血清TNF-α、IFN-γ水平均低于对照组,血清IL-10水平高于对照组,2组比较差异均有统计学意义(均P<0.05)。2组患者治疗期间各项不良反应的发生率及不良反应的总发生率比较,差异均无统计学意义(均P>0.05)。研究组患者无复发病例,对照组患者有5例复发,复发率为8.77%(5/57),2组比较差异有统计学意义(P<0.05)。结论:在抗结核药物的基础上联合应用化痰解凝汤剂治疗气滞痰凝型淋巴结核,可提升临床疗效、降低复发率,通过调节机体T淋巴细胞亚群比例改善免疫功能,降低TNF-α、IFN-γ等促炎因子水平并提升IL-10等抑炎因子水平缓解炎症损害,且治疗安全性较好。Objective:To analyze the therapeutic effects and safety of Huatan Jiening decoction combined with antituberculosis drugs in the treatment of lymph tuberculosis of Qizhi Tanning type.Methods:A total of 120 patients with lymph tuberculosis of Qizhi Tanning type treated at the Department of Scrofula of Nanjing Integrated Hospital of Traditional Chinese and Western Medicine from February 2020 to February 2022 were selected as study subjects.The patients were randomly divided into a study group and a control group(60 patients in each group).The patients in the control group were treated with 4 combination of antituberculous drugs.On this basis,the patients in the study group were additionally treated with Huatan Jiening decoction orally.Both groups were treated for 2 consecutive months and followed-up for 6 months after the treatment.The therapeutic effects,remission rates of clinical symptoms,immunoinflammatory indexes before and after the treatment,the incidences of adverse events and the recurrence rate in the follow-up period were compared between the 2 groups.Results:The therapeutic effect of the patients in the study group was better than that in the control group,the clinical effective rate and the remission rates of clinical symptoms were higher than those in the control group.The differences between the 2 groups were statistically significant(both P<0.05).After the treatment,the percentage of CD4^(+)T lymphocytes and the ratio of CD4^(+)/CD8^(+)T lymphocytes in peripheral blood in both groups were higher than those before the treatment,and the serum tumor necrosis factor(TNF)-α,interferon(INF)-γlevels in both groups were lower than those before the treatment,the serum interleukin(IL)-10 level was significantly higher than that before the treatment,the differences were statistically significant(all P<0.05).The percentage of CD4^(+)T lymphocytes and the ratio of CD4^(+)/CD8^(+)T lymphocytes in peripheral blood in the study group after the treatment was higher than those in the control group,the serum TNF-αan

关 键 词：化痰解凝汤剂 气滞痰凝型 淋巴结核 疗效 安全性评价 

分 类 号：R52[医药卫生—内科学]