| 引用本文:张军国1，王新宏2，万月强2，王丽萍2，孙燕3.加味葶苈大枣泻肺汤对肺结核免疫调节及临床疗效研究[J].世界中医药,2016,(09):. |
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| 加味葶苈大枣泻肺汤对肺结核免疫调节及临床疗效研究 |
| Clinical Efficacy of Supplemented Pepperweed and Jujube Lung-Draining Decoction on Tuberculosis Patients and Regulation of T-lymphocyte Subsets |
| 投稿时间：2016-05-12 |
| DOI：10.3969/j.issn.1673-7202.2016.09.020 |
| 中文关键词: 加味葶苈大枣泻肺汤 肺结核 T淋巴细胞亚群 疗效 |
| English Keywords:Supplemented Pepperweed and Jujube Lung-Draining Decoction Tuberculosis,T lymphocyte subsets Clinical efficacy |
| 基金项目:陕西省科学技术研究发展计划项目(编号:2014k11-03-04-05) |
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| 中文摘要: |
| 目的:观察加味葶苈大枣泻肺汤在提高肺结核患者临床疗效及其免疫力方面的效果和作用机制。方法:选取2015年8月至2016年1月陕西省结核病防治院收治的90例肺结核患者,随机分成对照组和观察组,每组45例。对照组采取2HRZE/4HR方案进行抗结核治疗,同时给予保护胃黏膜、保肝的药物以及支持治疗10 d,观察组在对照组治疗的基础上加用加味葶苈大枣泻肺汤,2次/d,水煎,取汁100 mL,早晚分次鼻饲,2组均10 d为1个疗程,1个疗程后观察2组治疗的临床疗效、各免疫因子评分、药物不良反应、临床受益情况分析及血浆IL-2、IL-6、IL-10及TNF-α水平变化等情况。结果:1)治疗后观察组有效率86.67%,对照组有效率68.89%,2组有效率比较差异有统计学意义(P<0.05);2)2组患者治疗前各免疫功能比较,差异无统计学意义(P>0.05),治疗15 d后,观察组各免疫动能均较治疗前稍提高,但对照组较治疗前无变化,差异有统计学意义(P<0.05);3)2组患者治疗过程中均出现不同程度的不良反应,比如可表现为腹痛、腹泻、恶心、呕吐、白细胞、血小板和血红蛋白减少等,对照组出现1例(2.22%),观察组2例(4.44%),观察组不良反应与对照组比,差异无统计学意义(P>0.05),与葡萄糖注射液相比,该药不会增加患者用药不良反应(P>0.05)。观察组KPS和体重变化的稳定率和改善例数明显高于对照组(P<0.05);4)2组患者治疗前血浆IL-2、IL-6、IL-10及TNF-α水平比较差异无统计学意义(P>0.05)。治疗15 d后,上述指标均较治疗前下降,但观察组下降更明显。结论:加味葶苈大枣泻肺汤可明显改善肺结核患者抗结核治疗后的免疫力,效果显著,同时可提高其临床疗效,且不良反应及药物不良反应并不升高,值得临床推广应用。 |
| English Summary: |
| To observe the effect of the Supplemented Pepperweed and Jujube Lung-Draining Decoction in the treatment of tuberculosis，and to discuss the regulating effect of T-lymphocyte subsets.Methods:A total of 90 non-small cell lung cancer who were admitted to our department from August 2015-January 2016，was randomly divided into control group and observation group，45 cases each.The control group were given 2HRZE / 4HR anti-TB treatment，and support medicine to protect the gastric mucosa and liver for 10 days.The observation group were treated based on the Supplemented Pepperweed and Jujube Lung-Draining Decoction，100 mL per time，twice a day，by nasal feeding at morning and evening.After 10 days’ treatment，the clinical efficacy，all immune factors score，adverse reactions，clinical benefit and plasma IL-2，IL-6，IL-10 and TNF-α level changes were detected.Results:After treatment，the effective rate of observation group was 86.67%，the control group 68.89%，the difference was statistically significant(P<0.05)； Before treatment，the immune function of the two groups had no statistically significant difference(P>0.05)，after 15 days’ treatment，the immunized kinetic energy of the observation group slightly improve but the treatment did not show the result，the difference was statistically significant(P<0.05)； During the treatment，adverse reactions such as abdominal pain，diarrhea，nausea，vomiting，and reduced white blood cells，platelets，hemoglobin happened，the control group had 1 case(2.22%),but observation group 2 cases(4.44%)，the difference was not statistically significant，and the decoction would not increase side effects(P>0.05).The observation group had higher stability rate than another group in KPS and body weight changes(P<0.05)； Before treatment，the comparison of two groups in plasma IL-2，IL-6，IL-10 and TNF-α level was no different(P>0.05).But after 15 days’ treatment，the index decreased，but the observation group decreased more significantly.Conclusion:Supplemented Pepperweed and Jujube Lung-Draining Decoction can significantly improve the tuberculosis patients’ radiotherapy and chemotherapy immunity，with significant effect，and less adverse reactions and side effects，which is worth of clinical promotion. |
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