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目的观察胸腺肽与抗结核药物联合治疗耐多药肺结核的治疗效果。方法 100例耐多药肺结核患者,随机分为对照组(46例)及治疗组(54例)。对照组给予3HR2ES/15HRE方案治疗,治疗组在对照组的基础上加用胸腺肽治疗。比较两组治疗效果。结果 (1)治疗组治疗6、12、18个月末的痰菌阴转率(37%、61%、89%)高于对照组(17%、39%、65%),差异均具有统计学意义(P<0.05)。(2)治疗组肺部改变情况优于对照组,差异具有统计学意义(U=3.107,P<0.05)。治疗组明显吸收率高于对照组,差异具有统计学意义(χ~2=8.484,P<0.05)。(3)治疗组空洞闭合情况优于对照组,差异具有统计学意义(U=2.105,P<0.05)。治疗组闭合率高于对照组,差异具有统计学意义(χ~2=4.314,P<0.05)。(4)治疗组痰培养阳性率11%低于对照组35%,差异具有统计学意义(P<0.05)。(5)两组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论胸腺肽与抗结核药物联合应用不仅能提高痰菌阴转率,也有助于肺部病灶吸收及空洞闭合,为治疗耐多药肺结核提供了一个新方法 ,值得临床上推广应用。同时也说明一线抗结核药物在治疗耐多药肺结核方面仍有一定的空间,可以大大减轻患者的经济负担。
Objective To observe the therapeutic effect of thymosin combined with anti-TB drugs in the treatment of multi-drug resistant pulmonary tuberculosis. Methods 100 cases of MDR-TB patients were randomly divided into control group (46 cases) and treatment group (54 cases). Control group given 3HR2ES / 15HRE program treatment, the treatment group in the control group based on the addition of thymosin treatment. Compare the treatment effect of two groups. Results (1) The sputum negative conversion rate (37%, 61%, 89%) in the treatment group at the end of 6, 12 and 18 months was higher than that in the control group (17%, 39%, 65% Significance (P <0.05). (2) The pulmonary changes in the treatment group were better than those in the control group, with significant difference (U = 3.107, P <0.05). Significantly higher absorption rate of the treatment group than the control group, the difference was statistically significant (χ ~ 2 = 8.484, P <0.05). (3) The cavity closure in the treatment group was better than that in the control group, the difference was statistically significant (U = 2.105, P <0.05). The closure rate of the treatment group was higher than that of the control group, with statistical significance (χ ~ 2 = 4.314, P <0.05). (4) The positive rate of sputum culture in the treatment group was 11% lower than that in the control group (35%), the difference was statistically significant (P <0.05). (5) There was no significant difference between the two groups in the incidence of adverse drug reactions (P> 0.05). Conclusion The combination of thymosin and antituberculous drugs can not only improve the sputum negative conversion rate, but also help the absorption of lung lesions and hollow closure. It provides a new method for the treatment of multidrug-resistant pulmonary tuberculosis and is worthy of clinical application. It also shows that first-line anti-tuberculosis drugs still have some space to treat multi-drug resistant tuberculosis and can greatly reduce the financial burden on patients.