复方芩部丹颗粒治疗阴虚火旺型耐多药肺结核

薛鸿浩，张惠勇，秦朝辉，鹿振辉，耿佩华，郭晓燕

(上海中医药大学附属龙华医院肺病科，上海 200032)

摘要：目的观察复方芩部丹颗粒辅助化疗药物治疗阴虚火旺型耐多药肺结核(MDR-PTB)强化期的临床疗效。方法采用多中心、随机、平行对照临床研究，纳入符合标准MDR-PTB患者72例，治疗组、对照组各36例。对照组采用基础化疗方案(6 Amk，Pa，Lfx+15 Pa,Lfx)+X(X药物由各中心专家根据患者个体病况选择，原则不超过3种)治疗，治疗组在给予基础化疗方案的同时服用复方芩部丹颗粒。观察比较2组治疗前、强化期治疗结束时(治疗第6个月)痰结核菌培养、痰抗酸杆菌涂片、胸片、中医证候积分。结果强化期治疗结束时，治疗组、对照组痰菌转阴率无统计学意义(P>0.05)；痰涂片阳性分级计数2组分别与治疗前比较均有显著性下降(P<0.05)，2组间比较有统计学意义(P<0.05)；在胸片病灶吸收、空洞闭合缩小、中医证候积分方面，治疗组优于对照组，2组间比较有统计学意义(P<0.05)。结论复方芩部丹颗粒能降低阴虚火旺型MDR-PTB患者痰液结核菌含量，降低传染性，能促进阴虚火旺型MDR-PTB患者肺部病灶吸收、空洞缩小及闭合，减轻患者症状。

关键词：耐多药肺结核；复方芩部丹颗粒；阴虚火旺；基础化疗

DOI:10.13463/j.cnki.jlzyy.2015.03.014

中图分类号：R521.5文献标志码： A

文章编号：1003-5699(2015)03-0258-04

基金项目：国家“十一五”重大科技专项(2008ZX10005-011)。

作者简介：薛鸿浩(1982-)，男，硕士，主治医师,从事中医药防治呼吸系统疾病研究。

收稿日期:(责任编辑：张晔2014-08-28)

Compound Qinbudan Particle for fire hyperactivity due to Yin deficiency type of

multi-drug resistant pulmonary tuberculosis

XUE Honghao,ZHANG Huiyong,QIN Zhaohui,LU Zhenhui,GENG Peihua,GUO Xiaoyan

(Department of Pulmonary Disease,Longhua Hospital Affiliated to Shanghai University of TCM,Shanghai 200032,China)

Abstract：ObjectiveTo observe the effect of Compound Qinbudan Particle combined with chemical medicine on fire hyperactivity due to yin deficiency type of multi-drug resistant pulmonary tuberculosis.MethodsThe 72 MDR-PTB cases were randomized into two groups (36 cases in each group).The control group cases were treated with chemical medicine (6 Amk,Pa,Lfx+15 Pa,Lfx)+X(X was chosen by experts of each centre according to patients’ individual conditions.But it could not be more than three kinds on principle).The treatment group cases were treated with Compound Qinbudan Particle on the basis of chemical medicine.The sputum specimen tubercle bacillus cultivation,sputum specimen acid-fast bacillus smear examinations,chest X-ray and clinical symptoms of the two groups were observed and compared before and at the end of 6 months after treatment to evaluate the clinical efficiency.ResultsAfter treatment,there was no statistical significance between two groups in terms of sputums pecimen tubercle bacillus cultivation(P>0.05).But in terms of sputum specimens acid-fast bacillus smear examination compared with before treatment 2 groups were significantly decreased(P<0.05),there was statistical significance(P<0.05).There was statistical significance in lesions absorption,lung cavity and Clinical symptoms between two groups(P<0.05).ConclusionCompound Qinbudan Particle for fire hyperactivity due to yin deficiency type of MDR-PTB can reduce the amount of tuberculosis in sputum specimens and then reduce infection.It can also promote lesions absorption and lung cavity closed or decreased on chest X-ray to improve clinical symptoms of patients.

Keywords:Multi-drug Resistant Pulmonary Tuberculosis (MDR-PTB);Compound Qinbudan Particle;fire hyperactivity due to yin deficiency;chemotherapy

耐多药肺结核(MDR-PTB)指肺结核患者痰结核菌培养至少同时对异烟肼和利福平耐药[1]。由于用药不规则、患者依从性差、免疫力下降等原因,导致耐药结核病发病增加[2]。我国是全球22个结核病高负担国家之一,2007—2008年全国的结核病耐药基线调查[3]显示，我国肺结核患者中耐多药率为8.32%。初治涂阳病例中,耐多药率为5.71%，复治涂阳病例中，耐多药率为25.64%。 龙……