Clinical Study on TCM Syndrome Identification and Chemotherapy for 388 Cases of Multidrug-Resistant Pulmonary Tuberculosis

LU Zhenhui; ZHANG Huiyong; GENG Peihua; GUO Xiaoyan; ZHANG Zhongshun; XIAO Heping; ZHANG Xia; XIE Lanpin; SHANG Haozhen; ZHOU Ying; LIU Rong; LEI Jianping; JIE Li; LIANG Qiu; ZHAO Pan; CHEN Hongbing; WANG Weihua; PAN Hongqiu; CAO Zizhong; LIU Zhimin; XIAO Jun; FAN Mengbai

doi:10.13288/j.11-2166/r.2014.17.009

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Clinical Study on TCM Syndrome Identification and Chemotherapy for 388 Cases of Multidrug-Resistant Pulmonary Tuberculosis

更新时间：2021-11-17

- Clinical Study on TCM Syndrome Identification and Chemotherapy for 388 Cases of Multidrug-Resistant Pulmonary Tuberculosis
- Journal of Traditional Chinese Medicine Vol. 55, Issue 17, Pages: 1469-1474(2014)
- 作者机构：
  
  1. 上海中医药大学附属龙华医院
  2. 重庆市公共卫生医疗救治中心
  3. 同济大学附属上海市肺科医院
  4. 中国人民解放军第三○九医院
  5. 南京市胸科医院
  6. 武汉市结核病防治所
  7. 河北省胸科医院
  8. 镇江市第三人民医院
  9. 新乡医学院第一附属医院
  10. 广西壮族自治区龙潭医院
  11. 上海市徐汇区中心医院
  12. 山东省胸科医院
  13. 天津市海河医院
  14. 湖南省结核病医院
  15. 江西省胸科医院
  16. 太原市第四人民医院
  17. 新疆维吾尔自治区胸科医院
  18. 沈阳市胸科医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2014.17.009
  CLC： R521
- Published：2014
- 稿件说明：
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[1]鹿振辉,张惠勇,耿佩华,郭晓燕,张忠顺,肖和平,张侠,谢兰品,尚好珍,周颖,刘蓉,雷建平,接力,梁秋,赵攀,陈红兵,王卫华,潘洪秋,曹子中,刘志敏,肖军,范梦柏.中医辨证联合化疗治疗耐多药肺结核388例临床观察——多中心随机对照试验[J].中医杂志,2014,55(17):1469-1474.

LU Zhenhui, ZHANG Huiyong, GENG Peihua, et al. Clinical Study on TCM Syndrome Identification and Chemotherapy for 388 Cases of Multidrug-Resistant Pulmonary Tuberculosis[J]. Journal of Traditional Chinese Medicine2014, 55(17): 1469-1474.
[1]鹿振辉,张惠勇,耿佩华,郭晓燕,张忠顺,肖和平,张侠,谢兰品,尚好珍,周颖,刘蓉,雷建平,接力,梁秋,赵攀,陈红兵,王卫华,潘洪秋,曹子中,刘志敏,肖军,范梦柏.中医辨证联合化疗治疗耐多药肺结核388例临床观察——多中心随机对照试验[J].中医杂志,2014,55(17):1469-1474. DOI： 10.13288/j.11-2166/r.2014.17.009.

LU Zhenhui, ZHANG Huiyong, GENG Peihua, et al. Clinical Study on TCM Syndrome Identification and Chemotherapy for 388 Cases of Multidrug-Resistant Pulmonary Tuberculosis[J]. Journal of Traditional Chinese Medicine2014, 55(17): 1469-1474. DOI： 10.13288/j.11-2166/r.2014.17.009.

摘要

目的评价在使用抗结核化学药物基础上通过中医辨证治疗耐多药肺结核（MDR-TB）患者的临床疗效。方法基于多中心、随机、平行对照临床研究

将742例MDR-TB患者随机分为治疗组（388例）和对照组（354例）

对照组给予西药化疗抗结核治疗

治疗组在对照组基础上予中医辨证论治方案

两组疗程均为18个月。观察不同时间和不同证型患者痰菌阴转率、病灶吸收程度、空洞闭合程度、生存质量评分（SF-36）的变化。结果注射期结束时治疗组痰菌阴转率为48.45%高于对照组的38.70%（P<0.01）;疗程结束时治疗组病灶吸收总有效率为84.65%高于对照组的78.92%（P<0.05）;注射期结束时和疗程结束时

治疗组SF-36评分均高于对照组（P<0.01）。注射期结束及疗程结束时

治疗组阴虚火旺型患者痰菌阴转率、肺部病灶吸收程度、SF-36评分均明显高于同证型对照组（P<0.05或P<0.01）。两组患者不同时间、不同证型空洞闭合程度差异无统计学意义（P>0.05）。结论中医辨证联合西医抗结核化学药物治疗MDR-TB较单纯使用抗结核化学药物效佳

可明显提高痰菌阴转率、改善患者生存质量

其中以阴虚火旺型患者的治疗效果更佳。

Abstract

Objective To evaluate the efficacy of traditional Chinese medicine（ TCM） syndrome identification and chemotherapy for multidrug-resistant pulmonary tuberculosis（ MDR-PTB）. Methods A multicenter

randomized and parallel-group clinical study was conducted. Totally 742 cases of MDR-PTB were randomized into the treatment group of 388 cases and control group of 354 cases. Both groups were given chemotherapy. The treatment group was added with TCM therapy based on syndrome identification. The treatment lasted for 18 months. The changes of sputum conversion rate

lesion absorption

cavity closure and SF36 score were observed. Results The sputum conversion rate in the treatment group and control group was 48. 45% and 38. 70% respectively at the end of injection period

with a significant difference between groups（ P < 0. 01）. The lesion absorption rate in the treatment group and control group was 84. 65% and 78. 92% respectively at the end of treatment

with a significant difference between groups（ P < 0. 05）. The SF-36 scores in the treatment group were significantly higher than those in the control group at the end of injection period and treatment（ P < 0. 01）. The sputum conversion rate

lesion absorption rate and SF-36 score of patients with syndrome of hyperactivity of fire due to yin deficiency in the treatment group were significantly higher than those of patients with same syndrome in the control group at the end of injection period and treatment（ P < 0. 05 or P < 0. 01）. There was no significant difference between groups in the cavity closure at different time or with different syndromes（ P > 0. 05）. Conclusion TCM syndrome identification combined with chemotherapy is effective for MDR-PTB

with a better efficacy as compared with chemical drugs. It can obviously increase sputum conversion rate and improve quality of life

especially for patients with syndrome of hyperactivity of fire due to yin deficiency.

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