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[目的]观察抗痨补肺汤联合化疗治疗耐多药肺结核疗效。[方法]使用随机平行对照方法,将140例住院患者按区组方法简单随机分为两组。对照组60例吡嗪酰胺(Z),阿米卡星(Am)或卡那霉素(Km)、卷曲霉素(Cm),左氧氟沙星(Lfx)或莫西沙星(Mfx),对氨基水杨酸(PAS)或环丝氨酸(Cs)、乙胺丁醇(E),丙硫异烟胺(Pto),强化阶段治疗6个月;MTB阴转后Z、Lfx(Mix)、PAS(Cs,E)、Pto巩固治疗18个月。治疗组80例抗痨补肺汤(猫爪草、黄连、百部、白芨、沙参、麦冬、百合、生地、黄芪、甘草各20g,水煎1000m L,2次/d;咳嗽剧烈加川贝母、桔梗;咯血加地榆、藕节炭、仙鹤草、白茅根等;低热加功劳叶、银柴胡、百贝、阿胶等;胸痛加广郁金、元胡等);西药治疗同对照组。连续治疗2年为1疗程。观测临床症状、痰培养菌落、血常规、肝肾功能、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈69例,显效77例,有效77例,无效3例,总有效率96.25%。对照组痊愈44例,显效50例,有效50例,无效10例,总有效率95.00%。治疗组疗效优于对照组(P<0.05)。肝功能异常发生率、临床症状两组均有改善(P<0.05),治疗组优于对照组(P<0.05)。[结论]抗痨补肺汤联合化疗治疗耐多药肺结核,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Kangbianbufeifei decoction combined with chemotherapy on multidrug-resistant pulmonary tuberculosis. [Methods] Using randomized parallel control method, 140 inpatients were randomly divided into two groups according to block method. In the control group, 60 cases of pyrazinamide (Z), amikacin (Am) or kanamycin (Km), capreomycin (Cm), levofloxacin (Lfx) or moxifloxacin (Mfx) (PAS) or cyclosporine (Cs), ethambutol (E), and prothiocarbamide (Pto) for 6 months. After MTB was negative, Z, Lfx, E), Pto consolidation treatment for 18 months. In the treatment group, 80 cases of Kangbian Bufei Decoction (cat’s claw, Coptis chinensis, Radix alba, Bletilla striata, Radix Aconiti kusnezoffii, Lily, Habitat, Astragalus, licorice each 20g, decoction 1000m L, 2 times / d; Fritillaria, Radix, Agrimony, Rhizoma Imperatae; low fever with ginseng leaves, silver Bupleurum, shellfish, gelatin, etc .; chest pain plus Guangyu gold, Yuanhu, etc.); western medicine treatment with the control group. Continuous treatment of 2 years for a course of treatment. Observation of clinical symptoms, sputum culture colonies, blood, liver and kidney function, adverse reactions. Treatment of a course of treatment to determine the efficacy. [Results] The treatment group cured 69 cases, markedly effective in 77 cases, effective in 77 cases, 3 cases were ineffective, the total effective rate was 96.25%. The control group, 44 cases were cured, markedly effective in 50 cases, effective in 50 cases, ineffective in 10 cases, the total effective rate was 95.00%. The treatment group was better than the control group (P <0.05). The incidence of liver dysfunction and clinical symptoms were improved in both groups (P <0.05), and the treatment group was superior to the control group (P <0.05). [Conclusion] Kangbianbufeifei decoction combined with chemotherapy for multidrug-resistant pulmonary tuberculosis has satisfactory curative effect and no serious adverse reactions, which deserves promotion.