结核丸联合常规西药治疗阴虚火旺型耐药结核病临床研究  

Clinical Study on Jiehe Pills Combined with Routine Western Medicine for Drug-Resistant Tuberculosis of Yin Deficiency Resulting in Vigorous Fire Type

作　　者：曹培谦[1] 王志刚[1] 唐苗苗[1] CAO Peiqian;WANG Zhigang;TANG Miaomiao(Department of Adolescent Tuberculosis,The Sixth People's Hospital of Zhengzhou,Zhengzhou Henan 450000,China)

机构地区：[1]郑州市第六人民医院青少年结核病科,河南郑州450000

出　　处：《新中医》2024年第9期61-65,共5页New Chinese Medicine

摘　　要：目的:观察结核丸联合常规西药治疗耐阴虚火旺型耐药结核病的临床疗效及对微小核糖核酸-30a-5p (miR-30a-5p)、微小核糖核酸-431 (miR-431)表达的影响。方法:采用随机数字表法将98例阴虚火旺型耐药结核病患者分为治疗组、对照组各49例。对照组予以常规西药治疗,治疗组予以结核丸联合常规西药治疗,2组均治疗6个月。比较2组治疗前后中医证候积分、T细胞亚群、炎症因子[白细胞介素-4 (IL-4)、C-反应蛋白(CRP)、干扰素-γ (INF-γ)]、miR-30a-5p、miR-431水平,评估2组临床疗效及不良反应发生情况。结果:治疗后,治疗组总有效率97.96%,对照组总有效率85.71%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组miR-30a-5p、CD3^(+)、CD4^(+)、INF-γ水平及CD4^(+)/CD8^(+)较治疗前升高(P<0.05),中医证候积分及CD8^(+)、miR-431、IL-4、CRP水平降低(P<0.05);治疗组治疗后miR-30a-5p、CD3^(+)、CD4^(+)、INF-γ水平及CD4^(+)/CD8^(+)高于对照组(P<0.05),中医证候积分及CD8^(+)、miR-431、IL-4、CRP水平低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:结核丸联合常规西药治疗阴虚火旺型耐药结核病疗效显著,能调节患者miR-30a-5p、miR-431水平,提高免疫功能,减轻炎症反应,安全性较高。Objective:To observe the clinical effect of Jiehe Pills combined with routine western medicine on drug-resistant tuberculosis of yin deficiency resulting in vigorous fire and its effect on the expressions of micro ribonucleic acid-30a-5p(miR-30a-5p)and micro ribonucleic acid-431(miR-431).Methods:A total of 98 cases of patients with drug-resistant tuberculosis of yin deficiency resulting in vigorous fire were divided into the treatment group and the control group according to the random number table method,with 49 cases in each group.The control group was treated with routine western medicine,and the treatment group was treated with Jiehe Pills combined with routine western medicine.Both groups were treated for 6 months.Traditional Chinese medicine(TCM)syndrome scores and the levels of T cell subsets,inflammatory factors[interleukin-4(IL-4),C-reactive protein(CRP),interferon-γ(INF-γ)],miR-30a-5p,and miR-431 were compared before and after treatment between the two groups;the clinical effects and the incidence of adverse reactions in the two groups were evaluated.Results:After treatment,the total effective rate was 97.96%in the treatment group and 85.71%in the control group,the difference being significant (P<0.05). After treatment,the levels of miR-30a-5p,CD3^(+),CD4^(+),INF-γand CD4^(+)/CD8^(+) in the two groups were increased when compared with those before treatment, and theTCM syndrome scores and the levels of CD8^(+),miR-431,IL-4 and CRP were decreased (P<0.05). Aftertreatment,the levels of miR-30a-5p,CD3^(+),CD4^(+) and INF- γ in serum and CD4^(+)/CD8^(+) in the treatmentgroup were higher than those in the control group (P<0.05),and the TCM syndrome scores and the levelsof CD8^(+),miR-431,IL-4 and CRP in the treatment group were lower than those in the control group (P<0.05). There was no significant difference being found in the comparison of the incidence of adversereactions between the two groups (P>0.05). Conclusion: Jiehe Pills combined with routine westernmedicine has a significant curative effect i

关 键 词：耐药结核病 阴虚火旺 结核丸 T细胞亚群 炎症因子 

分 类 号：R521[医药卫生—内科学]