CAJ | 학술논문

目的：对首次复治涂阳肺结核临床疗效观察,为制定合理的化学治疗方案提供科学依据。方法采用随机、对照、开放、前瞻性队列研究方法将48例首次复治涂阳肺结核患者,随机分为A组(标准方案组)2HREZS/6HRE方案,B组(氧氟沙星组)2OfxPaREZ/6OfxPaR方案,C组(左氧氟沙星组)2LfxPaREZ/6LfxPaR方案,D组(超短程化疗组)5MfxPaRfbZE方案抗痨治疗。观察临床症状、肺部X线影像、空洞变化、痰细菌学阴转及药物不良反应。结果 ABCD四组疗程结束痰菌阴转率依次为66．67%、55．56%、80．00%、88．89%；病灶吸收50%、55．56%、70%、88．89%；空洞缩小50%、55．56%、66．67%、85．71%；治愈率66．67%、55．56%、80．00%、88．89%；血小板降低16．67%、22．22%、10．00%、11．11%；肝功能损害16．67%、33．33%、30．00%、11．11%；尿酸升高66．67%、55．56%、50．00%、66．67%；2月末病灶吸收标准方案组与超短程化疗组之间比较差异有统计学意义(P<0．05)。余差异无统计学意义(P>0．05)。 D组药物成本明显高于A、B、C组。结论首次复治涂阳肺结核患者采用超短程化疗方案治疗疗效与其他各组差异无统计学意义(P>0．05),疗程较标准方案缩短3个月,不良反应发生率较低,但治疗成本相对较高。
목적：대수차복치도양폐결핵림상료효관찰,위제정합리적화학치료방안제공과학의거。방법채용수궤、대조、개방、전첨성대렬연구방법장48례수차복치도양폐결핵환자,수궤분위A조(표준방안조)2HREZS/6HRE방안,B조(양불사성조)2OfxPaREZ/6OfxPaR방안,C조(좌양불사성조)2LfxPaREZ/6LfxPaR방안,D조(초단정화료조)5MfxPaRfbZE방안항로치료。관찰림상증상、폐부X선영상、공동변화、담세균학음전급약물불량반응。결과 ABCD사조료정결속담균음전솔의차위66．67%、55．56%、80．00%、88．89%；병조흡수50%、55．56%、70%、88．89%；공동축소50%、55．56%、66．67%、85．71%；치유솔66．67%、55．56%、80．00%、88．89%；혈소판강저16．67%、22．22%、10．00%、11．11%；간공능손해16．67%、33．33%、30．00%、11．11%；뇨산승고66．67%、55．56%、50．00%、66．67%；2월말병조흡수표준방안조여초단정화료조지간비교차이유통계학의의(P<0．05)。여차이무통계학의의(P>0．05)。 D조약물성본명현고우A、B、C조。결론수차복치도양폐결핵환자채용초단정화료방안치료료효여기타각조차이무통계학의의(P>0．05),료정교표준방안축단3개월,불량반응발생솔교저,단치료성본상대교고。
Objective For the first time the retreatment smear-positive tuberculosis clinical curative effect observation,To provide scientific evidence for reasonable chemical treatments. Methods Using open,randomized,controlled,prospective cohort study method to 48 cases of recurrent smear-positive pulmonary tuberculosis patients for the first time,Were randomly divided into group A(Standard solutions group)shall be 2HREZS/6HRE plan, group B( ofloxacin group)shall be 2OfxPaREZ/6OfxPaR plan, group C(levofloxacin group)shall be 2LfxPaREZ/6LfxPaR plan,Group D(Super the short-range chemotherapy group )using 5MfxPaRfbZE plan the chemotherapy treatment. To observe the clinical symptoms, chest x-rays, empty change, sputum bacteriolo-gy Yin turn and adverse drug reactions. Results The ABCD four groups of treatment rate of end phlegm germ feminine changed in the order 66. 67%, 55. 56%, 80. 00%, 88. 89%;Lesions absorption were 50%, 55. 56%, 50%, 55. 56%;Empty decreased 50%, 55. 56%, 66. 67%, 85. 71%;The cure rate were 66. 67%, 55. 56%, 66. 67% and 55. 56%;Platelet reduced by 16. 67%、22. 22%、10. 00%、11. 11%;Liver damage by 16. 67%、33. 33%、30. 00%、11. 11%;Uric acid increased by 66. 67%, 55. 56%, 50. 00% and 66. 67%, respectively. In late February lesions absorption comparison between standard solution and ultra dots group difference was statistically significant ( P <0. 05 ) , There was no statistically significant difference more ( P >0. 05 ).Drug costs D group was obviously higher than that of group A, B, C groups. Conclusion For the first time the retreatment smear-positive pulmonary tuberculosis were treated by super compact chemotherapy regimen for curative effect is excellent ( P>0. 05),Course of a standard solution to shorten for 3 months,Low incidence of adverse reactions,But the treatment cost is relatively high.