1. 南京中医药大学研究生院
2. 南京中医药大学附属南京市中西医结合医院
纸质出版:2020
移动端阅览
[1]钱佳燕,黄子慧,余洋,朱思洵,高璐珏,高敏行.中西医综合治疗瘰疬病患者520例前瞻性队列研究[J].中医杂志,2020,61(02):130-135.
QIAN Jiayan, HUANG Zihui, YU Yang, et al. Cohort Study on Traditional Chinese Medicine and Western Medicine Comprehensive Treatment in 520 Patients with Cervical Scrofula[J]. Journal of Traditional Chinese Medicine2020, 61(2): 130-135.
[1]钱佳燕,黄子慧,余洋,朱思洵,高璐珏,高敏行.中西医综合治疗瘰疬病患者520例前瞻性队列研究[J].中医杂志,2020,61(02):130-135. DOI: 10.13288/j.11-2166/r.2020.02.010.
QIAN Jiayan, HUANG Zihui, YU Yang, et al. Cohort Study on Traditional Chinese Medicine and Western Medicine Comprehensive Treatment in 520 Patients with Cervical Scrofula[J]. Journal of Traditional Chinese Medicine2020, 61(2): 130-135. DOI: 10.13288/j.11-2166/r.2020.02.010.
目的比较不同中西医抗结核联用方案治疗瘰疬病的临床疗效
并分析其与后期是否接受手术治疗及疾病复发率的相关性。方法以2016年10月1日至2018年7月1日在南京中医药大学附属南京市中西医结合医院瘰疬科接受抗结核治疗的瘰疬病患者520例构成随访队列。患者分别进入3个队列
西医抗结核治疗联合中医内治组(对照Ⅰ组)、西医抗结核治疗联合中医外治组(对照Ⅱ组)、西医抗结核治疗联合中医综合治疗组(综合治疗组)。比较各组患者治疗4周后中医证候积分及淋巴结核最大横径
随访观察1年期间非手术治疗与手术治疗的选择情况及疾病复发情况。结果纳入分析的病例共449例。治疗后各组中医证候积分及淋巴结核最大横径均有所降低(P<0.05)
对照Ⅱ组的改善情况优于对照Ⅰ组(P<0.01)
综合治疗组的改善情况明显高于对照Ⅱ组(P<0.01)。根据治疗后的有效情况(证候积分改善率≥70%)以及手术指征有139例患者选择抗结核非手术治疗
381例选择手术治疗
其中对照Ⅰ组纳入非手术治疗的患者29例
对照Ⅱ组纳入非手术治疗的患者38例
综合治疗组纳入非手术治疗的患者72例。入组患者失访率为8.85%(46/520)
疾病总复发率为2.22%(10/449)。其中非手术治疗患者疾病复发率为2.24%(3/134)
手术治疗患者复发率2.22%(7/315)
手术治疗与非手术治疗的患者疾病复发率差异无统计学意义(P>0.05)。结论中西医抗结核联用能有效治疗瘰疬病
其中中医综合治疗联合抗结核西药的临床疗效更为显著
手术治疗与非手术治疗的患者手术复发率无明显相关性
但中医综合治疗联合抗结核西药能有效降低瘰疬病患者手术率。
Objective To compare the clinical efficacy of different Chinese and western medicine anti-tuberculosis regimens in the treatment of cervical scrofula
and to analyze the correlation with use of surgical therapy and disease recurrence rate. Methods From October 1
2016 to July 1
2018
520 patients with cervical scrofula who received anti-tuberculosis treatment in Nanjing Hospital of Integrated Traditional Chinese and Western Medicine constituted a follow-up cohort. They entered the 3 queues including western medicine anti-tuberculosis treatment combined with traditional Chinese medicine(TCM) internal treatment group(control group Ⅰ)
western medicine anti-tuberculosis treatment combined with TCM external treatment group(control group Ⅱ) and western medicine anti-tuberculosis treatment combined with TCM comprehensive treatment group(observation group). The TCM syndrome score and the maximum transverse diameter of lymphatic tuberculosis were compared after 4 weeks of treatment in each group of patients
and the selection of surgical treatment as well as recurrence were observed during the 1-year follow-up. Results A total of 449 cases were included in the analysis. After treatment
the TCM syndrome score and the maximum transverse diameter of lymph tuberculosis were reduced(P<0.05). The improvement in the control group Ⅱ was superior to that in the control group Ⅰ(P<0.01)
and the improvement in the comprehensive treatment group was significantly higher than that of the control group Ⅱ(P<0.01). According to the effective status after treatment(TCM syndrome score improving rate ≥70%) and surgical indications
139 patients chose anti-tuberculous non-surgical treatment and 381 patients chose surgical treatment. Among them
29 patients in the control group Ⅰ were included in non-surgical treatment. The control group Ⅱ included 38 patients with non-surgical treatment
and 72 patients received non-surgical treatment in the comprehensive treatment group. The lost follow-up rate was 8.85%(46/520) and the overall recurrence rate was 2.22%(10/449). The recurrence rate of non-surgical patients was 2.24%(3/134)
and the recurrence rate of surgically treated patients was 2.22%(7/315). There was no significant difference in the recurrence rate of surgically treated patients and non-surgically treated patients(P>0.05). Conclusion The combination of TCM and western medicine against tuberculosis can effectively treat cervical scrofula
and the therapeutic effect of TCM combined with anti-tuberculosis western medicine is more significant. There is no specific correlation between surgical treatment and non-surgical treatment
but the comprehensive treatment of TCM combined with anti-tuberculosis western medicine can effectively reduce the incidence of surgery in patients with cervical scrofula.
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