肖海凤

[关键词] 环丝氨酸;胸腺肽肠溶片;肺结核;细胞免疫功能

[中图分类号] R521          [文献标识码] B          [文章编号] 1673-9701（2021）16-0068-04

Effect of cycloserine combined with thymosin enteric-coated tablet in treatment of multidrug resistant tuberculosis and its effect on patients′ cellular immune function

XIAO Haifeng

Department of Internal Medicine，Jiamusi Hospital of Traditional Chinese Medicine in Heilongjiang Province，Jiamusi 154002， China

[Abstract] Objective To observe the effect of cycloserine combined with thymosin enteric coated tablets in the treatment of multidrug resistant tuberculosis （MDR-TB）， and to analyze the effect on the cellular immune function of patients. Methods A total of 69 patients with MDR-TB admitted to our hospital from May 2016 to August 2017 were selected as the research objects. By random number table method， the patients were divided into the cycloserine group （n=34） and the control group （n=35）. The control group was treated with the standard treatment plan of MDR-TB， and the cycloserine group was treated with cycloserine combined with thymosin tablets on the basis of the control group. The treatment period was 24 months. The clinical effect and the changes of immune indexes before and after treatment were evaluated in the two groups. Results In the cycloserine group， the cavity reduction， chest X-ray lesion absorption and turning negative sputum tuberculosis bacterium after 24 months of treatment were significantly higher than those after 3 months of treatment， and which was higher than those in the control group，with significant difference（P<0.05）. The CD4+， CD4+/CD8+ in the cycloserine group were significantly higher than those in the control group， and the CD8+ in the cycloserine group was significantly lower than that in the control group， with significant difference（P<0.05）. Conclusion Cycloserine combined with thymosin enteric-coated tablet in the treatment of multidrug resistant tuberculosis has a good clinical outcome and can further improve the curative effect of tuberculosis diagnosis and treatment.

[Key words] Cycloserine; Thymosin enteric-coated tablet; Tuberculosis; Cellular immune function

肺結核是临床上常见的肺部恶性传染疾病[1]，其临床表现为干咳、乏力、消瘦等。目前，采用药物干预是治疗肺结核的主要方式。但有研究指出[2-3]，此药物治疗时间长，且治疗过程中存在众多难题[4]。因此，可在常规治疗方案的基础上，采用环丝氨酸联合胸腺肽肠溶片治疗耐多药肺结核可起到良好的临床转归效果。多项研究显示，胸腺肽在抗核的运用中具有良好的效果，基于此，本研究特选取69例肺结核患者，旨在探讨采用环丝氨酸联合胸腺肽肠溶片治疗肺结核的治疗效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年5月至2017年8月我院收治的耐多药肺结核患者69例，将其随机分成环丝组（n=34）及对照组（n=35）。其中环丝组男26例，女8例，年龄37～58岁，平均（47.68±10.44）岁，平均病程（6.97±2.85）个月。对照组男22例，女13例，年龄45～51岁，平均（48.53±3.12）岁，平均病程（6.88±2.34）个月。两组的性别、年龄等基线资料比较，差异均无统计学意义（P>0.05），具有可比性。本研究经我院医学伦理委员会批准实施。

1.2 纳入及排除标准

1.2.1 纳入标准  ①均符合《耐多药肺结核病化学治疗》（2015年版）诊断指南[5]者;②均同意参与本研究，并签署知情同意书者。

1.2.2排除标准  ①糖尿病、精神异常等不良疾病者;②过敏或药物不良反应者;③慢性乙肝病毒等感染者;④孕妇。

1.3方法

1.3.1 对照组  采用常规的耐多药肺结核治疗方案。

1.3.2 环丝组  在对照组的基础上采用环丝氨酸胶囊（海正药业股份有限公司，国药准字H20130063）联合胸腺肽溶片（江世药业有限公司，国药准字H19991176）治疗，具体方法为：一次口服0.5 mg环丝氨酸胶囊，每天3次。再……