Effectsof Pulmonary Function Rehabilitation Training Combined with MDTNutritional Intervention inPatients withMultipleDrug ResistanceTuberculosis/LIUYing，XIEShixiang，ZENGMeifang.//Medical Innovation of China， 2025，22（18）： 075-079

[Abstract] Objective： To explore the effects of pulmonary function rehabilitation training combined with multidisciplinary team （MDT） nutritional intervention in patients with multidrug-resistant tuberculosis. Method： A total of 1OO patients with multidrug-resistant tuberculosis admitted to Ganzhou Fifth People's Hospital from January to October 2O24 were selected as the research objects and randomly divided into the control group （with pulmonary function rehabilitation training intervention） and the observation group（with pulmonary function rehabilitation training + MDT nutritional intervention）， with 5O cases in each group.All patients were continuously intervened for 3 months.The nutritional status [body mass index （BMI），albumin （ALB），prealbumin （PAB）， hemoglobin （Hb）]， immune function （CD 3⁺ ，CD 4⁺ ，CD 8⁺ ，CD4+/CD8+），sputum bacteria turning negative， lesion absorption and cavity closure of the two groups were compared. Result： After the intervention，compared with the control group，the levels of BMI，ALB，PAB，Hb，CD3 f⁺ ，CD 4⁺ ，and CD4+/CD8 3⁺ in the observation group were significantly higher，and the level of CD8 ^†+ was significantly lower， the differences were statistically significant （ P lt;0.05）.After1 month，2 and 3 months of intervention，the rates of sputum bacteria turning negative in the observation group were higher than those in the control group，the differences were statistically significant （ P lt;0.05）. The total absorption rate of the lesions in the observation group was 92.00% ，which was higher than 70.00% in the control group，the difference was statistically significant （ P lt;0.05）. The total closure rate of cavities in the observation group was 74.00% ，which was higher than 54.00% in the control group，the difference was statistically significant （Plt;0.05） .Conclusion：Pulmonary function rehabilitation training combined with MDT nutritional intervention can effctively improve nutritional status，enhance immunity and reduce tuberculosis lesions in multidrug-resistant tuberculosis patients.

[Key words]Pulmonary function rehabilitation training Multidisciplinaryteam Nutritional intervention Multidrug-resistanttuberculosis

First-author'saddress：Department of Tuberculosis，Ganzhou Fifth People's Hospital， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2025.18.018

结核病是一种由称为结核分枝杆菌（MTB）的好氧菌引起的疾病，它通常感染高氧组织[，当感染者咳嗽、打喷嚏或吐痰时，它可以通过空气传播。每年有超过1000万人受到结核病的影响，结核病已成为全球第二大传染病相关死亡原因，仅次于新型冠状病毒感染（COVID-19）。利福平（RIF）[2]和异烟肼（INH）被认为是最有效的结核病药物，至少同时对RIF和INH具有耐药性的MTB菌株的存在被定义为耐多药结核病4，具有病程长、治疗难度大、复发率高的显著特点[5-。2018年至今，已经有超过 73% 的人经过细菌学检测后被确认对RIF和INH产生了耐药性，是结核病和耐多药结核病治疗的主要障碍之一凹。耐药肺结核国内外相关研究表明，由于患者普遍存在内外循环功能异常和高分解代谢状态，营养不良的发生率极高，达到 40%～100%^[8-10] 。这不仅导致患者生理功能下降、机体抗炎及免疫功能受损，也是患者病情恶化和治疗效果不佳的主要因素。MDT团队由多科室医护人员组成[]，通过定期会诊，为耐药肺结核患者制订综合考虑疾病、心理、身体健康和社会因素的最佳饮食管理方案，提供精准、个性化和全面的营养干预[12-13]，可能有助于提升患者的营养状况和增强免疫力。目前临床关于MDT模式下的营养干预对耐药肺结核患者病情影响的报道较少，本研究以耐药肺结核患者为研究对象，以肺功能康复训练为对照，旨在探究MDT模式下的营养干预的临床护理价值。

1资料与方法

1.1一般资料

选择2024年1—10月赣州市第五人民医院收治的100例耐药肺结核患者。……