CAJ | 학술논문

目的：探讨抗结核药物联合滋阴利肺汤对老年复治涂阳肺结核患者血清炎症因子的影响及其临床意义。方法复治涂阳老年肺结核患者60例，随机分为两组，治疗组30例给予抗结核药物联合滋阴利肺汤治疗；对照组30例单纯应用抗结核药物治疗。两组抗结核治疗方案相同，疗程均为6个月。于治疗前后分别检测患者血清白细胞介素-6（ IL-6）、白细胞介素-10（ IL-10）和肿瘤坏死因子-α（ TNF-α）水平，同时观察痰菌阴转率、肺部病灶的吸收显效率、临床症状完全消失及不良反应情况。结果两组治疗前血清IL-6、IL-10、TNF-α水平比较差异无统计学意义（ P＞0．05）。治疗后，两组IL-6、TNF-α水平均下降，且治疗组水平低于对照组（ P＜0．05）；IL-10水平均有升高，但治疗组水平高于对照组（ P＜0．05）；治疗后，两组血清IL-6、TNF-α水平均低于治疗前（P＜0．05），两组IL-10水平均高于治疗前（P＜0．05）。疗程结束后治疗组痰菌阴转率为96．6％，对照组为76．7％，两组比较差异有统计学意义（P＜0．05）。治疗结束后治疗组病灶吸收显效率为86．7％，对照组为63．3％，两组比较差异有统计学意义（P＜0．05）；治疗3个月后治疗组临床症状完全消失率为90．0％，对照组为63．3％，两组之间比较差异有统计学意义（P＜0．05）。两组不良反应发生率比较，差异无统计学意义（P＞0．05）。治疗组未发现明确为滋阴利肺汤出现的严重不良反应。结论抗结核药物联合滋阴利肺汤治疗可有效改善老年复治涂阳肺结核患者血清 IL-6、IL-10、TNF-α水平，明显改善临床症状，提高病变吸收率和痰菌转阴率，无严重不良反应。
목적：탐토항결핵약물연합자음리폐탕대노년복치도양폐결핵환자혈청염증인자적영향급기림상의의。방법복치도양노년폐결핵환자60례，수궤분위량조，치료조30례급여항결핵약물연합자음리폐탕치료；대조조30례단순응용항결핵약물치료。량조항결핵치료방안상동，료정균위6개월。우치료전후분별검측환자혈청백세포개소-6（ IL-6）、백세포개소-10（ IL-10）화종류배사인자-α（ TNF-α）수평，동시관찰담균음전솔、폐부병조적흡수현효솔、림상증상완전소실급불량반응정황。결과량조치료전혈청IL-6、IL-10、TNF-α수평비교차이무통계학의의（ P＞0．05）。치료후，량조IL-6、TNF-α수평균하강，차치료조수평저우대조조（ P＜0．05）；IL-10수평균유승고，단치료조수평고우대조조（ P＜0．05）；치료후，량조혈청IL-6、TNF-α수평균저우치료전（P＜0．05），량조IL-10수평균고우치료전（P＜0．05）。료정결속후치료조담균음전솔위96．6％，대조조위76．7％，량조비교차이유통계학의의（P＜0．05）。치료결속후치료조병조흡수현효솔위86．7％，대조조위63．3％，량조비교차이유통계학의의（P＜0．05）；치료3개월후치료조림상증상완전소실솔위90．0％，대조조위63．3％，량조지간비교차이유통계학의의（P＜0．05）。량조불량반응발생솔비교，차이무통계학의의（P＞0．05）。치료조미발현명학위자음리폐탕출현적엄중불량반응。결론항결핵약물연합자음리폐탕치료가유효개선노년복치도양폐결핵환자혈청 IL-6、IL-10、TNF-α수평，명현개선림상증상，제고병변흡수솔화담균전음솔，무엄중불량반응。
Objective To investigate the effect of antituberculosis drugs combined with Nourishing Yin and Clearing Lung Soup on serum inflammatory cytokines of elderly patients with retreated smear positive pulmonary tuberculosis and its clinical significance.Methods Sixty elderly patients with retreated smear positive pulmonary tuberculosis were randomly divided into two groups:30 cases in the treatment group were treated with antituberculosis drugs combined with Nourishing Yin and Clearing Lung Soup ,30 cases in the control group were given antituberculosis drugs alone .Both groups were given a same antituberculosis therapy,and the treatment lasted for 6 months.The levels of interleukin-6(IL-6),interleukin-10 (IL-10) and tumor necrosis factor(TNF-α) were detected before and after treatment in both groups .The sputum negative conversion rate ,effective absorption rate of lung lesions ,clinical symptoms and adverse reactions were observed .Results Before treatment,the levels of serum IL-6,IL-10 and TNF-αshowed no significant difference between two groups ( P>0 .05 ) .After treatment ,the levels of serum IL-6,TNF-αin two groups decreased ,which were significantly lower in the treatment group compared with the controls (P<0.05);The levels of IL-10 increased in both groups,which was significantly higher in the treatment group compared with the controls (P<0.05).The levels of serum IL-6,TNF-αafter treatment were lower than those before treatment in two groups ( P<0 .05 ) , and the levels of IL-10 after treatment were higher than those before treatment in two groups (P<0.05).After the end of treatment,the sputum negative conversion rate was 96.6%in the treatment group,while in the control group was 76.7%,there was significant difference between two groups ( P<0 .05 ) .After the end of treatment ,the effective absorption rate of lung lesions in the treatment group was 86.7%,while in the control group was 63.3%,there was significant difference between two groups (P<0.05).Three months after treatment ,the complete disappearance rate of clinical symptoms in the treatment group was 90 .0%,while in the control group was 63.3%,there was significant difference between two groups (P<0.05).The adverse reaction rates showed no significant difference between two groups(P>0.05).No severe adverse reactions caused by Nourishing Yin and Clearing Lung Soup occurred in the treatment group .Conclusion Antituberculosis drugs combined with Nourishing Yin and Clearing Lung Soup can effectively improve the levels of serum IL-6,IL-10 and TNF-αof elderly patients with retreated smear positive pulmonary tuberculosis,it can significantly improve the clinical symptoms,improve the effective absorption rate of lung lesions and sputum negative conversion rate,and no severe adverse reactions are observed.