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生脉饮在骨关节结核抗痨治疗中增效减毒作用的研究

来源:用户上传      作者:韩贵和  曹天一  石仕元  马鹏飞  章权

  [摘要] 目的 ^察生脉饮在骨关节结核患者抗痨过程中增效减毒的作用。 方法 选取2017年1月至2019年12月于浙江省中西医结合医院骨科住院诊治,诊断为骨关节结核患者66例,依照3HRZE/15HRE抗结核方案进行治疗的患者分为治疗组和对照组。治疗组患者予以生脉饮汤剂口服,对照组患者予以利可君片口服。分别观察、记录患者2周的外周血白细胞计数、IFN-γ、淋巴细胞亚群占比、中医证候疗效及不良事件。 结果 治疗1周及2周后,治疗组患者外周血白细胞计数分别为(3.73±0.87)×109/L、(4.38±1.14)×109/L,高于对照组患者的(3.30±0.68)×109/L、(3.86±0.79)×109/L(P<0.05);治疗2周后,治疗组患者血清IFN-γ为(38.88±11.74)pg/ml,低于对照组的(45.85±13.37)pg/ml(P<0.05);治疗组患者CD3+、CD4+、CD4+/CD8+占比分别为(79.21±9.25)%、(47.52±9.80)%、(2.01±0.63),高于对照组的(73.73±11.13)%、(41.95±8.04)%、(1.72±0.47)(P<0.05);治疗组患者中医证候疗效总有效率为87.9%,高于对照组的51.5%(P<0.05)。研究期间,两组患者各有1例中止研究,无恶心呕吐、肝肾功能不全等不良事件。 结论 生脉饮可以对抗骨关节结核治疗过程中白细胞减少、乏力、食欲不振、低热盗汗等毒副反应,增强机体免疫力,起到增效减毒的作用。
  [关键词] 生脉饮;结核;骨关节;白细胞减少;免疫调节
  [中图分类号] R733.7 [文献标识码] B [文章编号] 1673-9701(2022)09-0143-05
  Study on the synergy and attenuation effects of pulse-activating decoction in the anti-tuberculosis treatment of patients with bone and joint tuberculosis
  HAN Guihe1 CAO Tianyi2 SHI Shiyuan1 MA Pengfei1 ZHANG Quan1
  1.Department of Orthopedics, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou 310003, China; 2.Zhejiang Chinese Medical University, Hangzhou 310053, China
  [Abstract] Objective To observe the synergy and attenuation effects of pulse-activating decoction in the anti-tuberculosis treatment of patients with bone and joint tuberculosis. Methods A total of 66 patients attending the Department of Orthopedics of Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine who were diagnosed with bone and joint tuberculosis and treated with anti-tuberculosis according to the 3HRZE/15HRE scheme from January 2016 to December 2018 were divided into the treatment group and the control group. Patients in the treatment group were treated with pulse-activating decoction orally, while patients in the control group were treated with leucoson tablets orally. The peripheral blood leukocyte count, interferon-γ(IFN-γ), lymphocyte subpopulation ratio, efficacy on traditional Chinese medicine syndromes and adverse events were observed and recorded respectively during the 2 weeks of treatment. Results After 1 week and 2 weeks of treatment,the peripheral blood leukocyte counts of patients in the treatment group were (3.73±0.87)×109/L and (4.38±1.14) ×109/L, respectively, which were higher than those of patients in the control group (3.30±0.68)×109/L and (3.86±0.79)×109/L(P<0.05).After 2 weeks of treatment, the serum IFN-γ of patients in the treatment group was (38.88±11.74)pg/ml,lower than that in the control group (45.85±13.37)pg/ml(P<0.05). The ratios of CD3+, CD4+, and CD4+/CD8+ in patients of the treatment group were (79.21±9.25)%, (47.52± 9.80)% and (2.01 ± 0.63),respectively, higher than those of the control group (73.73±11.13)%, (41.95±8.04)% and (1.72±0.47)(P<0.05).The total effective rate of the treatment for traditional Chinese medicine syndromes in the treatment group was 87.9%,higher than that in the control group (51.5%)(P<0.05). During the study period, one patient in each group discontinued the study, and there were no nausea and vomiting, liver and kidney insufficiency and other adverse events. Conclusion The pulse-activating decoction can counteract the toxicities such as leukopenia, fatigue anorexia, low fever and night sweating and other side effects in the treatment of bone and joint tuberculosis, and enhance the immunity of the body, thus playing the role of synergy and attenuation.

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