中药滋阴降火糊超声电导透入协同西药治疗淋巴结结核阴虚火旺证的临床研究  

Clinical Study on the Treatment of Lymph Node Tuberculosis with Yin Deficiency and Fire Flourishing Syndrome by Ultrasonic Conductivity Penetration of Traditional Chinese Medicine

作　　者：杨春睿[1] 钮晓红[1] YANG Chunrui;NIU Xiaohong(Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing Jiangsu 210014,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院,江苏南京210014

出　　处：《中医药导报》2023年第11期104-108,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：南京市医学科技发展项目(YKK19120);第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号)。

摘　　要：目的:观察中药滋阴降火糊超声电导透入协同化疗药物治疗淋巴结结核阴虚火旺证的疗效。方法:选取240例淋巴结结核阴虚火旺证患者,随机分为治疗组(滋阴降火糊超声透入+西药四联抗结核化疗)、对照1组(滋阴降火糊外敷+西药四联抗结核化疗)、对照2组(利福平超声透入+西药四联抗结核化疗),各80例,治疗2周。比较3组患者临床疗效、中医证候评分、外周血中结核感染特异性T细胞(T-SPOT.TB)水平、淋巴结中局部结核杆菌的含量、免疫指标和安全性指标。结果:治疗组2例、对照1组4例、对照2组2例退出研究。治疗组总有效率[91.03%(71/78)]明显高于对照1组[65.79%(50/76)]、对照2组[71.79%(56/78)],差异均有统计学意义(P<0.05)。3组患者治疗后中医证候评分、淋巴结中局部结核杆菌的含量、CD8^(+)水平、肿瘤坏死因子-α(TNF-α)水平、γ干扰素(IFN-γ)水平均较治疗前降低,且治疗组患者治疗后上述指标明显低于对照1组、对照2组,差异均有统计学意义(P<0.05)。治疗后3组患者外周血中CD4^(+)、CD4^(+)/CD8^(+)、白介素-2(IL-2)水平均较治疗前升高,且治疗组患者治疗后上述指标明显高于对照1组、对照2组,差异均有统计学意义(P<0.05)。治疗后3组患者外周血中T-SPOT.TB比较,差异无统计学意义(P>0.05)。3组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:中药滋阴降火糊超声电导透入协同化疗药物治疗阴虚火旺证淋巴结结核能有效提高临床疗效,增强局部抗结核作用,减轻临床症状,并提高免疫水平,且安全可靠。Objective:To observe the efficacy of ultrasonic conductivity penetration of traditional Chinese medicine Nourishing-Yin Reducing-Fire Paste(滋阴降火糊)in the treatment of lymph node tuberculosis with Yin deficiency and fire flourishing syndrome.Methods:240 patients with lymphatic tuberculosis who met the diagnostic criteria of Yin deficiency and fire flourishing syndrome were selected,and divided into treatment group(ultrasonic penetration of NYRFP+four combinations of Western medicine),control group 1(external application of NYRFP+four combinations of Western medicine),and control group 2(ultrasonic penetration of rifampicin^(+)four combinations of Western medicine).A total of two weeks were observed.The clinical efficacy,traditional Chinese medicine syndrome scores,levels of tuberculosis specific T cells(T-SPOT.TB)in peripheral blood,content of local tuberculosis bacteria in lymph nodes,immune and safety indicators of three groups were compared.Results:2 cases in the treatment group,4 cases in the control group 1,and 2 cases in the control group 2 withdrew from the study.The total effective rate of the treatment group[91.03%(71/78)]was significantly higher than that of the control group 1[65.79%(50/76)]and the control group 2[71.79%(56/78)],with statistical significance(P<0.05).After treatment,the TCM syndrome scores,the content of local tuberculosis bacteria in lymph nodes,CD8^(+),tumor necrosis factor-α(TNF-α)and IFN-γin three groups decreased compared to before treatment,and the above indicators in the treatment group were significantly lower than those in the control group 1 and control group 2,with statistical significance(P<0.05).After treatment,the levels of CD4^(+),CD4^(+)/CD8^(+),and interleukin-2(IL-2)in the peripheral blood of the three groups increased compared to before treatment,and the above indicators in the treatment group were significantly higher than those in the control group 1 and control group 2 after treatment,with statistical significance(P<0.05).After treatment,there was no sta

关 键 词：淋巴结结核 阴虚火旺证 滋阴降火糊 超声电导透入 利福平 临床研究 

分 类 号：R263[医药卫生—中医外科学]