龚惠莉　　张燕玲　　吴国强　　陈　艳　　袁晓峰　　陈振中

上海市浦东新区肺科医院结核科，上海　201209

逐饮活血方剂联合西药治疗结核性胸膜炎的临床研究

龚惠莉张燕玲吴国强陈艳袁晓峰陈振中

上海市浦东新区肺科医院结核科，上海201209

目的探讨逐饮活血方剂联合常规抗结核方案（2HREZ/10HR）治疗结核性胸膜炎的临床效果。方法选取2014年1月～2015年6月上海市浦东新区肺科医院收治的128例结核性胸膜炎患者，依据随机数字表法将其分为对照组和研究组，每组64例。对照组按照2HREZ/10HR方案进行抗结核治疗，研究组在2HREZ/10HR方案抗结核治疗的同时给予逐饮活血方剂。治疗前及治疗第3、6、9天采用酶联兔疫吸附法检测两组患者胸腔积液中肿瘤坏死因子α（TNF-α）以及纤维蛋白原（FIB）水平，治疗前及治疗后2个月检测胸膜厚度、呼吸功能并评价临床疗效。结果两组治疗前胸腔积液TNF-α及FIB水平、胸膜厚度、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）及FEV1/FVC比较，差异无统计学意义（P＞0.05）；治疗第3、6、9天研究组胸腔积液TNF-α及FIB水平均低于对照组，差异有统计学意义（P＜0.05）；治疗2个月后研究组胸膜厚度低于对照组，差异有统计学意义（P＜0.05）；研究组治疗后FVC、FEV1及FEV1/FVC高于对照组，差异有统计学意义（P＜0.05）；研究组临床有效率（96.9%）高于对照组（87.5%），差异有统计学意义（P＜0.05）。结论逐饮活血方剂联合西药治疗结核性胸膜炎能够减轻患者炎性反应，抑制FIB渗出，缓解胸膜反应，改善肺功能，提高临床疗效。

结核性胸膜炎；逐饮活血方剂；肿瘤坏死因子α；纤维蛋白原；胸膜肥厚

［Abstract］Objective To investigate the c1inica1 curative effect of F1uid-E1iminating and B1ood-Activating Prescription combined with common anti-tubercu1osis program（2HREZ/10HR）in the treatment of tubercu1ous p1eurisy.Methods One hundred and twenty eight cases of patients with tubercu1ous p1eurisy admitted to Pu1monary Hospita1 of Pudong New District in Shanghai City from January 2014 to June 2015 were se1ected and divided into contro1 group and study group according to random number tab1e method，with 64 cases in each group.The contro1 group was treated with antitubercu1osis program（2HREZ/10HR），whi1e the study group was given F1uid-E1iminating and B1ood-Activating Prescription in addition.The 1eve1s of tumor necrosis factor α（TNF-α）and fibrinogen（FIB）in hydrothorax of the two groups were detected by enzyme 1inked immunosorbent assays before treatment and after treatment for 3，6，9 days，the p1eura1 thickness and 1ung function were detected before treatment and after treatment for 2 months，and the c1inica1 curative effect was contrasted.Results The 1eve1s of TNF-α and FIB in hydrothorax，p1eura1 thickness，forced vita1 capacity（FVC），forced expiratory vo1ume in one second（FEV1）and FEV1/FVC of the two groups before treatment had no statistica11y significant differences（P＞0.05）；the 1eve1s of TNF-α and FIB in hydrothorax of study group after treatment for 3，6，9 days were 1ower than those of contro1 group，the differences were statistica11y significant（P＜0.05）；the p1eura1 thickness of study group after treatment for 2 months was 1ess than that of contro1 group，the difference was statistica11y significant（P＜0.05）；the 1eve1s of FVC，FEV1and FEV1/FVC of study group were higher than those of contro1 group，the differences were statistica11y significant（P＜0.05）；the c1inica1 effective rate of study group（96.9%）was higher than that of contro1 group（87.5%），the difference was statistica11y significant（P＜0.05）.Conclusion F1uid-E1iminating and B1ood-Activating Prescription combined with western medicine can a11eviate inf1ammatory reactions of patients with tubercu1ous p1eurisy，restrain FIB exudation，reduce p1eura1 reactions，improve 1ung function and curative effect.

［Key words］Tubercu1ous p1eurisy；F1uid-E1iminating and B1ood-Activating Prescription；Tumor necrosis factor-α；Fibrinogen；P1eura1 thickening

结核性胸膜炎属……