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目的观察用抗结核药物组成的两种化疗方案在老年肺结核病例治疗中的疗效及毒副反应。方法随机抽取老年肺结核初治涂阳,复治涂阳,难治及耐药病例共76例,随机分为两组(A,B组)。A组(治疗组)用含力克肺疾和利福喷丁药物组成的化疗方案:(1)2DL2ZS3(E)/4DL2或2DL2ZE/6DL2E。(2)3DL2ZE/6DL2E/2DL1。B组(对照组)用含异烟肼和利福平药物组成化疗方案:(1)2HRZS3(E)/4HR或2HRZE/6HRE。(2)3HRZE/6HRE/2HR。结果经化疗,大多数患者在3个月内症状基本改善,治疗6个月症状明显改善,食欲及体重增加;疗程结束时A组痰菌阴转率为91.9%,B组为75.0%,A组显著高于B组(P<0.05);满疗程时肺部病灶吸收情况,A组显效率为75.7%,B组为44.5%,空洞闭合率A组为86.5%,B组为50%,治疗组病灶吸收,空洞关闭,缩小均与对照组有显著性差异,不良反应发生率A组显著低于B组;A组总有效率为94.6%、B组为83.3%,2组间有显著性差异(P<0.05);说明治疗组化疗方案疗效优于对照组,且毒副反应轻微。结论用含力克肺疾和利福喷丁药物组成的化疗方案治疗老年肺结核患者有较好疗效,毒副反应轻微,耐受性好,使用安全等优点,建议临床上推广应用,尤其适合用于老年患者易接受治疗的药物。
Objective To observe the efficacy and side effects of two chemotherapy regimens composed of anti-tuberculosis drugs in the treatment of elderly pulmonary tuberculosis. Methods A total of 76 elderly patients with early-stage pulmonary tuberculosis smear-positive, retreatment-smear-positive, refractory and drug-resistant cases were randomly divided into two groups (A and B). Group A (treatment group) with Lectacrin disease and rifapentine chemotherapy consisting of chemotherapy: (1) 2DL2ZS3 (E) / 4DL2 or 2DL2ZE / 6DL2E. (2) 3DL2ZE / 6DL2E / 2DL1. Group B (control group) with chemotherapy containing isoniazid and rifampicin chemotherapy: (1) 2HRZS3 (E) / 4HR or 2HRZE / 6HRE. (2) 3HRZE / 6HRE / 2HR. Results After chemotherapy, the symptoms of most patients were basically improved within 3 months. Symptoms were significantly improved and appetite and body weight were improved 6 months after treatment. At the end of treatment, sputum negative conversion rate was 91.9% in group A and 75.0% in group B, A (P <0.05). The uptake of lung lesions during the full course of treatment was significantly higher in group A than in group A (75.7% vs 44.5% in group B), in group A (86.5%) and group B (50% There was a significant difference between the two groups in the number of lesions absorbed, the cavity closed, and the reduction in the treatment group. The incidence of adverse reactions in group A was significantly lower than that in group B; the total effective rate was 94.6% in group A and 83.3% in group B, (P <0.05). It showed that the curative effect of chemotherapy in the treatment group was better than that in the control group, and the side effects were mild. Conclusions The chemotherapy regimen containing Lectra Pulmonary Disease and Rifapentin is effective in elderly patients with pulmonary tuberculosis and has mild toxicities, good tolerability, safe use and so on. It is recommended for clinical use and is especially suitable for the treatment of elderly patients with pulmonary tuberculosis. Elderly patients easy to accept the treatment of drugs.