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目的:观察在常规抗结核治疗基础上加用运脾法方剂的临床疗效。方法:选取100例初治继发性肺结核患者,随机分为实验组和对照组各50例。对照组以2HREZ/4HR抗结核治疗,实验组在对照组治疗基础上加用运脾法方剂健胃运脾汤治疗。对比2组的临床疗效,观察治疗前和治疗6月后的中医证候积分、外周血T淋巴细胞水平的变化等。结果:治疗后,2组盗汗、干咳、午后手足心热、胸痛和痰中带血丝的积分均低于治疗前(P<0.05),CD3、CD4和CD4/CD8均较治疗前上升(P<0.05),CD8均较治疗前下降(P<0.05);实验组中医证候各项积分均低于对照组(P<0.05),CD3、CD4和CD4/CD8均高于对照组(P<0.05),CD8低于对照组(P<0.05),病灶吸收率、空洞改善率均高于对照组(P<0.05,P<0.01)。实验组治疗3月、6月、9月和12月后的痰菌阴转率均高于对照组(P<0.05,P<0.01)。结论:在常规抗结核治疗的基础上加用运脾法方剂治疗,可有效改善肺结核患者的临床症状,提高痰菌转阴率,促进病灶吸收与空洞闭合,改善生活质量。
Objective: To observe the clinical curative effect of adding the method of applying the method of tonifying the spleen to the routine anti-tuberculosis treatment. Methods: 100 cases of newly diagnosed secondary pulmonary tuberculosis patients were randomly divided into experimental group and control group of 50 cases. The control group with 2HREZ / 4HR anti-TB treatment, the experimental group in the control group based on the treatment plus the spleen Fang Jianwei Yunpi Decoction treatment. Compare the clinical curative effect of the two groups, observe the TCM syndrome score before treatment and after 6 months of treatment, the change of peripheral blood T lymphocyte level and so on. Results: After treatment, the scores of night sweats, dry coughs, afternoon hand, foot and heart heat, chest pain and bloody sputum in sputum were lower than those before treatment (P <0.05) and CD3, CD4 and CD4 / CD8 increased 0.05), while CD8 decreased compared with those before treatment (P <0.05). The scores of TCM syndromes in experimental group were lower than those in control group (P <0.05), but CD3, CD4 and CD4 / ), CD8 lower than the control group (P <0.05), and the rate of lesion absorption and cavity improvement were higher than that of the control group (P <0.05, P <0.01). The negative conversion rate of sputum in the experimental group after 3 months, 6 months, 9 months and 12 months was higher than that of the control group (P <0.05, P <0.01). Conclusion: In the conventional anti-TB therapy plus the method of the prescription of the spleen, can effectively improve the clinical symptoms of patients with pulmonary tuberculosis, increased sputum negative rate, promote the absorption of the lesion and cavity closure, and improve the quality of life.