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目的观察小柴胡汤合葶苈大枣汤加减联合西药治疗结核性胸膜炎的疗效。方法选择2011年1月~2014年1月结核性胸膜炎的患者90例,随机分为观察组和对照组,每组45例。对照组予以2HREZ/4HR方案治疗,观察组在对照组的基础上予以小柴胡汤合葶苈大枣汤加减治疗。观察治疗后两组的疗效,胸膜增厚,白介素-2(IL-2),IL-6和干扰素-γ(INF-γ)水平的变化。结果观察组的总有效率为97.78%,对照组的82.22%,观察组总有效率明显优于对照组(χ2=4.444,P<0.05)。治疗后两组均较治疗前明显增厚(P<0.01),而观察组的增厚明显低于对照组(P<0.05或<0.01)治疗后两组的IL-2,IL-6和INF-γ水平较前明显降低(P<0.01),而观察组的降低水平较对照组更为明显(P<0.01)。结论小柴胡汤合葶苈大枣汤加减联合西药治疗结核性胸膜炎的疗效显著,具有提高抗结核的疗效,抑制炎症介质的释放,改善症状和预后的作用。
Objective To observe the curative effect of Xiao Chai Hu decoction combined with Jujube decoction combined with western medicine in the treatment of tuberculous pleurisy. Methods From January 2011 to January 2014, 90 patients with tuberculous pleurisy were randomly divided into observation group and control group, with 45 cases in each group. The control group was treated with 2HREZ / 4HR regimen. The observation group was treated with Xiaochaihu decoction combined with Decoction of Jujube Decoction on the basis of the control group. The curative effect, pleural thickening, interleukin-2 (IL-2), interleukin-6 and interferon-gamma (INF-γ) levels in the two groups were observed. Results The total effective rate was 97.78% in the observation group and 82.22% in the control group. The total effective rate in the observation group was significantly better than that in the control group (χ2 = 4.444, P <0.05). After treatment, both groups were significantly thicker than those before treatment (P <0.01), while the thickening of the observation group was significantly lower than that of the control group (P <0.05 or <0.01). After treatment, IL-2, IL-6 and INF (P <0.01), while the decrease in the observation group was more significant than that in the control group (P <0.01). Conclusion Xiaochaihu decoction combined with western medicine Decoction combined with Western medicine treatment of tuberculous pleurisy has a significant effect, with the effect of improving anti-TB, inhibit the release of inflammatory mediators and improve the symptoms and prognosis.