益补方对肺结核合并糖尿病患者近期疗效及T细胞亚群的影响  

Effects of Yibu Formula on Short-term Efficacy and T-lymphocyte Subsets in Patients with Pulmonary Tuberculosis Complicated with Diabetes

作　　者：沈凌筠 杨永锐 陆霓虹 刘幸 李海雯 赵雁红 王戈 骆鹏举 杜映荣 SHEN Lingjun;YANG Yongrui;LU Nihong;LIU Xing;LI Haiwen;ZHAO Yanhong;WANG Ge;LUO Pengju;DU Yingrong(Yunnan Infectious Disease Clinical Medical Center/Kunming Third People′s Hospital,Kunming 650301,China)

机构地区：[1]云南省传染性疾病临床医学中心/昆明市第三人民医院,昆明650301

出　　处：《世界中医药》2023年第17期2492-2497,共6页World Chinese Medicine

基　　金：国家卫生健康委员会毒品依赖和戒治重点实验室科学研究项目(2020DAMOP-0013);昆明市医药卫生科技计划基金资助项目(2021-03-02-003);昆明市第三人民医院院内课题(2020LX-KMSY-01)。

摘　　要：目的:观察益补方辅助治疗耐药肺结核合并2型糖尿病患者的近期疗效观察及T淋巴细胞亚群分析。方法:选取2018年1月至2020年6月在昆明市第三人民医院住院部诊断为耐多药肺结核合并糖尿病的患者80例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组40例。对照组采用常规抗耐药肺结核的化疗方案,观察组在此基础上,加用自拟中药方益补方治疗,观察2组在不同时间痰菌转阴情况、血糖情况,治疗6个月后的中医疗效,中医证候改善情况,肺部病灶吸收情况,以及细胞免疫指标,同时记录不良反应。结果:2组患者一般资料比较,差异无统计学意义(P>0.05);治疗6个月后,观察组中医疗效为87.50%,高于对照组(P<0.05);观察组在治疗后第6、9、12个月时的痰菌转阴率分别为77.50%、82.50%和87.50%,均高于对照组(均P<0.05)。观察组病灶吸收率为87.50%,高于对照组(P<0.05);治疗第3、6个月后,观察组FBG下降情况优于对照组(P<0.05或0.01);观察组中医证候评分、T淋巴细胞亚群水平下降情况显著优于对照组(P<0.05);Th1、Th2、Th17和Treg水平改善情况显著优于对照组(P<0.01);观察组总的不良反应发生率为25.00%,显著低于对照组(P<0.01)。结论:益补方可以显著提高耐多药合并2型糖尿病患者机体免疫功能,促进化疗药物作用,具有减毒增效的效果。Objective:To observe the effects of Yibu Formula on short-term efficacy and T-lymphocyte subset in patients with drug-resistant pulmonary tuberculosis complicated with diabetes.Methods:Eighty patients diagnosed with drug-resistant pulmonary tuberculosis complicated with diabetes between January 2018 and June 2020 at the Kunming Third People′s Hospital were enrolled and randomly divided into an observation group and a control group,with 40 patients in each group.The control group received conventional chemotherapy for drug-resistant pulmonary tuberculosis,while the observation group received Yibu Formula in addition to the conventional treatment.The two groups were compared for sputum negative conversion,blood sugar levels at different periods,traditional Chinese medicine(TCM)efficacy after 6 months of treatment,improvement in TCM syndrome,absorption of pulmonary lesions,and cellular immune indicators.Adverse reactions were also recorded.Results:There was no statistically significant difference in general information of patients between the two groups(P>0.05).After 6 months of treatment,the TCM efficacy in the observation group was 87.50%,which was higher than that in the control group(P<0.05).The sputum negative conversion rates in the observation group at 6,9,and 12 months after treatment were 77.50%,82.50%,and 87.50%,respectively,all of which were higher than those in the control group(all P<0.05).The absorption rate of pulmonary lesions in the observation group was 87.50%,which was higher than that in the control group(P<0.05).After 3 and 6 months of treatment,the reduction in fasting blood glucose(FBG)in the observation group was superior to that in the control group(P<0.05 or 0.01).The improvement in TCM syndrome scores and T-lymphocyte subset levels in the observation group was significantly better than that in the control group(P<0.05).The improvement in Th1,Th2,Th17,and Treg levels in the observation group was significantly better than that in the control group(P<0.01).The overall incidence of adverse r

关 键 词：耐多药肺结核 2型糖尿病 机体免疫 化疗 中药 益补方 T淋巴细胞亚群 疗效 

分 类 号：R289.5[医药卫生—方剂学] R521[医药卫生—中药学]