清肺祛痨丸辅助治疗复治肺结核患者的临床疗效分析

doi:10.3969/j.issn.2095-3755.2018.02.008

摘要/Abstract

摘要：

目的分析清肺祛痨丸辅助治疗复治肺结核患者的临床疗效。方法选择2017年1—6月吉林省结核病医院收治的复治菌阳肺结核患者,根据治疗方法不同,分别通过随机数字表法抽取采用西药抗结核药物(2H-R-E-Z-S/6H-R-E)联合清肺祛痨丸治疗的60例患者和单纯采用西药抗结核药物治疗(2H-R-E-Z-S/6H-R-E)的60例患者,分别作为观察组和对照组。观察两组患者的临床症状改善情况、临床治疗效果、痰菌阴转率、胸部X线摄影检查结果等指标。结果两组患者均完成8个月的疗程;治疗后观察组患者的乏力、盗汗等临床症状改善情况[症状发生率分别为10.0%(6/60)、8.3%(5/60)]均优于对照组[分别为75.0%(45/60)、61.7%(37/60)],差异均有统计学意义(χ ²值分别为51.87、37.51,P值均<0.001);观察组患者的痰菌阴转率(88.3%,53/60)高于对照组(76.7%,46/60),但差异无统计学意义(χ ²=2.83,P=0.093);观察组的治疗有效率(88.3%,53/60)也高于对照组(76.7%,46/60),差异亦无统计学意义(Z=-1.71,P=0.088)。胸部X线摄影检查结果显示,观察组患者病灶及空洞显著吸收43例,吸收12例,吸收率为91.7%(55/60),明显高于对照组[显著吸收26例,吸收21例,吸收率为78.3%(47/60)],差异有统计学意义(Z=-3.20,P=0.001)。结论清肺祛痨丸可以辅助治疗肺结核,对于改善患者的临床症状和促进病灶及空洞的吸收具有较好的效果。

关键词: 结核, 肺, 再治疗, 抗生素类, 抗结核, 中草药, 药物疗法, 联合, 治疗结果

Abstract:

Objective To analyze the clinical efficacy of Qingfei Qulao Pill in treating relapsed pulmonary tuberculosis (PTB).Methods From January to June 2017, relapsed bacterial positive PTB patients in the Tuberculosis Hospital of Jilin Province were randomly selected according to their different treatment methods: 60 cases who received chemical drugs (2H-R-E-Z-S/6H-R-E) combined with Qingfei Qulao Pill were selected as the observation group, while 60 cases who received chemical drugs were selected as the control group. The improvement of clinical symptoms, clinical efficacy, bacterial negative conversion rate, and chest X-ray findings in the two groups were compared.Results All patients in both group completed 8 months of treatment. After treatment, the improvement of clinical symptoms such as fatigue and night sweat in the observation group (the incidences were 10.0% (6/60) and 8.3% (5/60), respectively) were better than that in the control group (75.0% (45/60) and 61.7% (37/60), respectively); the differences were statistically significant (χ ² values were 51.87 and 37.51; P values were <0.001 and <0.001, respectively). The rate of sputum negative conversion was higher in the observation group (88.3%, 53/60) compared with the control group (76.7%, 46/60), but the difference was not statistically significant (χ ²=2.83, P=0.093). The observation group showed higher treatment efficacy than the control group (88.3% (53/60) vs 76.7% (46/60)), the difference was not statistically significant (Z=-1.71, P=0.088). The findings of Chest X-ray examination showed that the lesions and cavities were significantly absorbed in 43 cases and absorbed in 12 cases in the observation group, yielding an absorbing rate of 91.7% (55/60). The rate was obviously higher than that of the control group (78.3% (47/60); lesions and cavities were significantly absorbed in 26 cases and absorbed in 21 cases); the difference was statistically significant (Z=-3.20, P=0.001). Conclusion Qingfei Qulao Pill can be used as the adjuvant treatment for relapsed PTB, having a good effect on the improvement of clinical symptoms and induction of lesions and cavities absorption.

Key words: Tuberculosis, pulmonary, Retreatment, Antibiotics, antitubercular, Drugs, Chinese herbal, Drug therapy, combination, Treatment outcome

郑丽华,于景来,孙鹏,李洪庆,陈东,于英杰,倪莎,徐明,程燕,马春光,赵春雨,杨娜,李桂娇,李娟. 清肺祛痨丸辅助治疗复治肺结核患者的临床疗效分析[J]. 结核病与肺部健康杂志, 2018, 7(2): 114-119. doi: 10.3969/j.issn.2095-3755.2018.02.008

Li-hua ZHENG,Jing-lai YU,Peng SUN,Hong-qing LI,Dong CHEN,Ying-jie YU,Sha NI,Ming XU,Yan CHENG,Chun-guang MA,Chun-yu ZHAO,Na YANG,Gui-jiao LI,Juan. LI. Clinical efficacy analysis of Qingfei Qulao Pill in the treatment of patients with relapsed pulmonary tuberculosis[J]. Journal of Tuberculosis and Lung Health, 2018, 7(2): 114-119. doi: 10.3969/j.issn.2095-3755.2018.02.008

图/表 6

表1

两组患者年龄、性别的基本情况

组别	例数	年龄 (岁, $x ˉ$ ±s)		性别[例(构成比,%)]
组别	例数	年龄 (岁, $x ˉ$ ±s)		男	女
观察组	60	46.47±10.91		39(65.0)	21(35.0)
对照组	60	46.03±11.30		37(61.7)	23(38.3)
检验值		Z=0.14^a	χ²=0.14
P值		0.891	0.705

表1

表2

表3

表4

表5

表6

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临床症状	观察组(60例)		χ²值^a	P值^a	对照组(60例)		χ²值^a	P值^a	χ²值^b	P值^b
临床症状	治疗前	治疗后	χ²值^a	P值^a	治疗前	治疗后	χ²值^a	P值^a	χ²值^b	P值^b
咳嗽	55(91.7)	5(8.3)	83.33	<0.001	58(96.7)	6(10.0)	90.54	<0.001	0.10	0.752
咳痰	54(90.0)	3(5.0)	86.92	<0.001	57(95.0)	4(6.7)	93.66	<0.001	0.00^c	1.000^c
咯血	33(55.0)	1(1.7)	42.02	<0.001	32(53.3)	2(3.3)	92.53	<0.001	0.00^c	1.000^c
发热	57(95.0)	5(8.3)	90.23	<0.001	59(98.3)	8(13.3)	87.90	<0.001	0.78	0.378
乏力	60(100.0)	6(10.0)	98.18	<0.001	59(98.3)	45(75.0)	14.14	<0.001	51.87	<0.001
盗汗	50(83.3)	5(8.3)	67.97	<0.001	52(86.7)	37(61.7)	9.79	0.002	37.51	<0.001

组别	例数	显效	有效	无效	Z值^a	P值^a
观察组	60	27(45.0)	26(43.3)	7(11.7)	-1.71	0.088
对照组	60	20(33.4)	26(43.3)	14(23.3)
合计	120	47(39.2)	52(43.3)	21(17.5)

组别	例数	治疗前		治疗后	χ²值	P值
组别	例数	涂阳培阳	涂阴培阳	痰菌阴转	χ²值	P值
观察组	60	51(85.0)	9(15.0)	53(88.3)	2.83	0.093
对照组	60	50(83.3)	10(16.7)	46(76.7)
合计	120	101(84.2)	19(15.8)	99(82.5)

组别	例数	显著吸收	吸收	不变	恶化	Z值^a	P值^a
观察组	60	43(71.6)	12(20.0)	4(6.7)	1(1.7)	-3.20	0.001
对照组	60	26(43.4)	21(35.0)	8(13.3)	5(8.3)
合计	120	69(57.5)	33(27.5)	12(10.0)	6(5.0)

不良反应	观察组		对照组		χ²值	P值
不良反应	例数	发生率(%)	例数	发生率(%)	χ²值	P值
胃肠道症状	7	11.7	10	16.7	0.62	0.432
转氨酶增高≤2倍	7	11.7	9	15.0	0.29	0.591
转氨酶增高>2倍^a	2	3.3	3	5.0	0.00	1.000
尿酸增高	10	16.7	12	20.0	0.22	0.637
白细胞减少^a	3	5.0	5	8.3	0.13	0.714
血小板减少^a	1	1.7	3	5.0	0.26	0.611
皮疹	4	6.7	7	11.7	0.90	0.343
发热^a	2	3.3	4	6.7	0.18	0.675