芪甲利肺胶囊结合恩替卡韦治疗初治菌阳肺结核合并乙型肝炎临床效果及安全性观察  

Clinical Effect and Safety of Qijia Lifei Capsule(芪甲利肺胶囊)Combined with Entecavir in Treatment of Primary Positive Pulmonary Tuberculosis Complicated with Hepatitis B

作　　者：陈振华 王林 梅湘 邹芳芳 徐胜辉 CHEN Zhenhua;WANG Lin;MEI Xiang;ZOU Fangfang;XU Shenghui(Hunan Chest Hospital,Changsha 410013,Hunan,China)

机构地区：[1]湖南省胸科医院,湖南长沙410013

出　　处：《中华中医药学刊》2025年第1期196-199,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：湖南省卫生健康委员会项目(202103082480)。

摘　　要：目的探究芪甲利肺胶囊结合恩替卡韦治疗初治菌阳肺结核合并乙型肝炎(乙肝)临床效果及安全性。方法研究总计纳入初治菌阳肺结核合并乙肝患者102例(2022年1月—2022年11月收治)进行试验,根据随机数字表法将其分为观察组和对照组,各组51例,对照组患者脱落1例,观察组患者脱落2例,给予对照组患者(50例)恩替卡韦治疗,给予观察组患者(49例)恩替卡韦结合芪甲利肺胶囊治疗,各组数据观察:疗效、中医证候积分变化(午后潮热、气短声低、盗汗与自汗并见、咳痰、咳嗽等)、机体炎症反应指标变化与免疫指标变化、肝功能指标及肝功能损害发生率、生活质量提升率。结果与观察组患者治疗总有效率比较,对照组更低(P<0.05);各组患者治疗前中医证候积分(午后潮热、气短声低、盗汗与自汗并见、咳痰、咳嗽等)、肿瘤坏死因子α(tumour necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、白细胞计数(white blood cell,WBC)等炎症反应指标、免疫球蛋白A/G/M(immunoglobulin A/immunoglobulin G/immunoglobulin M,IgA/IgG/IgM)等免疫指标、血清总胆红素(total bilirubin,TBiL)、谷草转氨酶(aspartate transaminase,AST)、谷氨酰转肽酶(gamma glutamyl transferase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)、谷丙转氨酶(glutamic pyruvic transaminase,ALT)等肝功能指标比较(P>0.05),而观察组患者治疗后中医证候积分(午后潮热、气短声低、盗汗与自汗并见、咳痰、咳嗽等)、TNF-α、CRP、WBC、IgA/IgG/IgM、TBiL、AST、GGT、ALP、ALT等指标均优于对照组患者(P<0.05);较对照组,观察组患者治疗后肝功能损害发生率更低,生活质量提升率更高(P<0.05)。结论芪甲利肺胶囊结合恩替卡韦治疗初治菌阳肺结核合并乙肝临床效果显著,可较好改善患者病情,一定程度提升机体免疫功能及生活质量,减少肝损伤,较为安全可靠。Objective To explore the clinical effect and safety of Qijia Lifei Capsule(芪甲利肺胶囊)combined with entecavir in the treatment of primary positive pulmonary tuberculosis complicated with hepatitis B.Methods A total of 102 patients with newly treated bacteriopositive pulmonary tuberculosis combined with hepatitis B(admitted from January 2022 to November 2022)were included in this study.According to the random number table method,they were divided into observation group and control group,with 51 patients in each group,including 1 patient felling out in the control group and 2 patients felling out in the observation group.The control group(50 cases)were given entecavir treatment.The observation group(49 cases)were treated with entecavir combined with Qijia Lifei Capsule,and the data of each group[efficacy,changes of TCM symptom scores(afternoon tidal fever,shortness of breath and low voice,night sweats and spontaneous sweating,phlegm,cough,etc.),changes of inflammatory response indexes and immune indexes,liver function indexes and incidence of liver function damage and improvement rate of quality of life]was observed.Results Compared with that in the observation group,the total effective rate of the control group was lower(P<0.05).Before treatment,TCM syndrome scores(afternoon tidal fever,shortness of breath and low voice,night sweats and spontaneous sweating,phlegm,cough,etc.),the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),white blood cell count(WBC),immunoglobulin A/G/M(IgA/IgG/IgM),serum total bilirubin(TBiL),aspartate aminotransferase(AST),glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),alanine aminotransferase(ALT)and other liver function indexes were not significant(P>0.05).After treatment,TCM syndrome scores(afternoon tidal fever,shortness of breath and low voice,night sweats and spontaneous sweating,phlegm,cough,etc.),the levels of TNF-α,CRP,WBC,IgA/IgG/IgM,TBiL,AST,GGT,ALP,ALT and other indexes in observation group were better than those in the control group(P<0.05).C

关 键 词：初治菌阳肺结核合并乙肝 芪甲利肺胶囊 恩替卡韦 疗效 安全性 中医证候积分 生活质量 

分 类 号：R259.21[医药卫生—中西医结合] R259.126.2[医药卫生—中医内科学]