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百令胶囊联合左氧氟沙星治疗耐多药肺结核
孙辉,陈洁,欧阳兵,杨永锐,李池川,刘幸,李萌
0
(昆明市第三人民医院药学部;昆明市第三人民医院中西医结合结核病科;昆明市第三人民医院科教学术部;昆明市第三人民医院预防保健与慢病管理中心)
摘要:
【摘要】 目的 观察百令胶囊联合左氧氟沙星治疗耐多药肺结核(MDRTB)的治疗效果。方法 研究选取2017年1月~2018年6月我院收治的400例MDRTB患者,采用分层区组随机化分组法分成观察组220例和对照组180例。对照组采取6Z Am PAS Pto/6 Z PAS Pto方案+左氧氟沙星治疗,观察组在对照组之上,联合百令胶囊治疗。连续治疗12个月后,比较两组痰菌阴转率、病灶吸收、空洞闭合情况;检测患者治疗前后T淋巴细胞水平;监测用药期间不良反应。结果 观察组治疗3个月、6个月、9个月、12个月累计痰菌阴转率均显著高于对照组(均P<0.05);观察组治疗6个月、治疗12个月病灶吸收有效率均显著高于对照组(均P<0.05);观察组治疗6个月、治疗12个月空洞闭合有效率均显著高于对照组(P<0.05);治疗后,两组LY、CD4+、CD4+/CD8+水平较治疗前均显著升高、CD8+显著降低(P<0.05),且观察组LY、CD4+、CD4+/CD8+水平均显著高于对照组(P<0.05);观察组肾功能异常、药物性肝损伤、血液系统损伤不良反应发生率均显著低于对照组(P<0.05)。结论 百令胶囊联合左氧氟沙星用于MDRTB治疗利于患者痰菌阴转、病灶吸收及空洞闭合,有效改善患者免疫功能,降低不良反应发生率。
关键词:  耐多药肺结核  左氧氟沙星  百令胶囊  痰菌阴转率  空洞闭合
DOI:
基金项目:昆明市卫生和计划生育委员会医药卫生科技计划项目(2018-13-01-001)
Efficacy of Bailing capsule combined with levofloxacin in the treatment of multidrug resistant tuberculosis
SUN Hui,CHEN Jie,OU Yangbing,YANG Yongrui,LI Chichuan,LIU Xing,LI Meng
(Department of Pharmacy, Kunming Third People′s Hospital;Department of Integrated Traditional Chinese and Western Medicine;Department of Science and Technology, Kunming Third People′s Hospital;Center of Preventive Health Care and Chronic Disease Management, Kunming Third People′s Hospital)
Abstract:
【Abstract】 Objective To observe the therapeutic effects of Bailing capsule combined with levofloxacin in the treatment of multidrugresistant tuberculosis (MDRTB). Methods 400 patients with MDRTB admitted to the hospital from January 2017 to June 2018 were enrolled. The patients were divided into observation group (220 cases) and control group (180 cases) according to stratified block randomization method. Control group was treated with 6Z Am PAS Pto/6 Z PAS Pto regimen+levofloxacin. The observation group was combined with Bailing capsule on the basis of control group. They were continuously treated for 12 months. The sputum negative conversion rate, lesion absorption and void closure were compared between the two groups. T lymphocytes levels were detected before and after treatment. The adverse reactions during medication period were monitored. Results The cumulative sputum negative conversion rates after 3 months, 6 months, 9 months and 12 months of treatment were 4409%, 6227%, 7312% and 7909% in observation group, which were significantly higher than those in corresponding time point in control group with 2833%, 4444%, 5167% and 5667% (P<0.05). The effective rates of lesion absorption after 6 months and 12 months of treatment were 7909% and 9681% respectively in observation group, which were significantly higher than those in corresponding time point in control group with 5611% and 8667% (P<0.05). The effective rates of void closure after 6 months and 12 months of treatment were 7955% and 9148% in observation group, which were significantly higher than those in corresponding time point in control group with 6765% and 7574% (P<0.05). After treatment, the levels of LY, CD4+ and CD4+/CD8+ in the two groups were significantly increased compared with those before treatment while the CD8+ was significantly decreased (P<0.05), and the levels of LY, CD4+ and CD4+/CD8+ in observation group were significantly higher than those in control group (P<0.05). The incidence rates of adverse reactions of renal dysfunction, druginduced liver injury and blood system injury in observation group were significantly lower than those in control group (P<0.05). Conclusion Bailing capsule combined with levofloxacin for MDRTB is beneficial for sputum negative conversion, lesion absorption and void closure, and can effectively improve immune function and reduce incidence rate of adverse reactions.
Key words:  Multidrug resistant tuberculosis  Levofloxacin  Bailing capsule  Sputum negative conversion rate  Void closure

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