中西医结合治疗阴阳两虚型耐药肺结核的疗效观察

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　　摘要：目的 观察中西医结合治疗阴阳两虚型耐药肺结核的临床疗效。方法 选择2016年4月—2018年3月在本院确诊为耐药肺结核且辨证分型为阴阳两虚证的患者200例，随机分为治疗组和对照组各100例，对照组予常规治疗，在此基础上，治疗组予自拟“抗痨补肺汤”合地黄饮子加减口服，观察2组患者治疗后各项指标及疗效。结果 治疗后治疗组CD3+、CD4+、CD8+及CD4+/CD8+改善情况优于对照组;中医证候改善情况优于对照组，总有效率优于对照组，且不良反应率低于对照组，差异均具有统计学意义（P<0.05）。结论 中西医结合治疗阴阳两虚型耐药肺结核，可显著提高免疫力，改善患者证候，提高疗效。
　　关键词：中西医结合;阴阳两虚;耐药肺结核
　　中图分类号：R521   文献标志码：B   文章编号：1007-2349（2019）09-0032-03
　　【Abstract】Objective：To observe the clinical effect of integrated traditional Chinese and Western medicine on the treatment of drug-resistant tuberculosis patients with yin and yang deficiency type. Methods：200 patients with drug-resistant tuberculosis diagnosed and differentiated from yin-yang deficiency syndrome in our hospital from April 2016 to March 2018 were enrolled and were randomly divided into a treatment group and a control group，100 cases each group. On the basis of this treatment，the treatment group was given the self-made “Anti tuberculosis and Lung-tonifying Decoction” and Radix Rehmanniae Decoction with modified oral administration，and the indexes and curative effects of the two groups after treatment were observed. Results：The improvement of CD3+，CD4+，CD8+ and CD4+/CD8+ in the treatment group was better than that in the control group after treatment and the improvement of TCM syndrome of the treatment group was better than that of the control group. The total effective rate of the treatment group was better than that of the control group，and the adverse reaction rate of the treatment group was lower than that of the control group. The differences were statistically significant（P<0.05）. Conclusion：The combination of traditional Chinese and western medicine for the treatment of the drug-resistant tuberculosis patients with yin and yang deficiency type can significantly enhance immunity and improve patient syndrome，thus increasing curative effect.
　　【Key words】integrated traditional Chinese and Western medicine，yin and yang deficiency，drug-resistant tuberculosis
　　 結核病是由结合分值杆菌感染引起的具有传染性的慢性疾病，是表现为特殊炎症的免疫相关性疾病。世界范围内有近三分之一的人曾感染过结核分枝杆菌[1]。结核杆菌可侵犯人体多种器官，而肺是主要的靶器官，发为肺结核，占结核病的80%。我国每年活动性肺结核患者约450万，复发肺结核占15%～20%，其中耐药性肺结核占35%～55%[2]。中医中药在治疗耐药肺结核中有较好疗效，本研究采用中西医结合治疗阴阳两虚型耐药肺结核，取得较好疗效，现报道如下。
　　1 资料与方法
　　1.1 一般资料 选择2016年4月—2018年3月在昆明市第三人民医院住院治疗的确诊为耐药肺结核且辨证分型为阴阳两虚证的患者200例，按随机数字表法将2组患者分为治疗组和对照组各100例。其中治疗组男60例，女40例，年龄22～65岁，平均（39.3±7.4）岁，病程6个月～4 a，平均（1.59±0.55）a，初治42例，复治58例;耐1种药物者26例，耐2种者50例，耐3种及以上者24例;对照组男66例，女34例，年龄16～61岁，平均（40.8±7.9）岁，病程6个月～3 a，平均（1.54±0.51）a，初治46例，复治54例;耐1种药物者22例，耐2种者52例，耐3种及以上者26例。经统计学分析，2组患者一般资料无统计学意义（P>0.05），具有可比性。所有患者知情同意并签署知情同意书。
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