CAJ | 학술논문

目的探讨铁皮石斛处方辅助治疗肺结核患者 IL-10、IL-18、OPN 水平变化与治疗效果。方法将2013年5月～2014年3月确诊为浸润性肺结核的76例患者随机分为治疗组和对照组两组，每组38例，治疗组用铁皮石斛处方加西药抗结核药物治疗；对照组单纯用西药抗结核药物治疗，两组疗程均为6个月。比较两组患者治疗前后的血清白细胞介素-10（IL-10）、白细胞介素-18（IL-18）和骨桥蛋白（OPN）水平，并与于2014年3月在本院行健康体检的32例健康组比较。结果两组治疗前血清 IL-10、IL-18、OPN 均值高于健康组（P ＜0.05）；提示浸润性肺结核患者细胞因子水平异常增高，治疗后两组患者 IL-10、IL-18、OPN 均有不同程度降低（P ＜0.05），提示细胞因子水平异常与浸润性肺结核患者临床转归相关；治疗组治疗后血清 IL-10、IL-18均值与健康组比较差异无统计学意义（P ＞0.05），OPN 均值高于健康组（P ＜0.05），对照组治疗后血清 IL-10、IL-18、OPN 均高于健康组（P ＜0.05），提示治疗组对患者免疫损伤的改善作用优于单纯用西药治疗组。结论铁皮石斛处方辅助治疗肺结核对改善患者的细胞因子功能紊乱的治疗效果优于单纯用西药治疗。
목적탐토철피석곡처방보조치료폐결핵환자 IL-10、IL-18、OPN 수평변화여치료효과。방법장2013년5월～2014년3월학진위침윤성폐결핵적76례환자수궤분위치료조화대조조량조，매조38례，치료조용철피석곡처방가서약항결핵약물치료；대조조단순용서약항결핵약물치료，량조료정균위6개월。비교량조환자치료전후적혈청백세포개소-10（IL-10）、백세포개소-18（IL-18）화골교단백（OPN）수평，병여우2014년3월재본원행건강체검적32례건강조비교。결과량조치료전혈청 IL-10、IL-18、OPN 균치고우건강조（P ＜0.05）；제시침윤성폐결핵환자세포인자수평이상증고，치료후량조환자 IL-10、IL-18、OPN 균유불동정도강저（P ＜0.05），제시세포인자수평이상여침윤성폐결핵환자림상전귀상관；치료조치료후혈청 IL-10、IL-18균치여건강조비교차이무통계학의의（P ＞0.05），OPN 균치고우건강조（P ＜0.05），대조조치료후혈청 IL-10、IL-18、OPN 균고우건강조（P ＜0.05），제시치료조대환자면역손상적개선작용우우단순용서약치료조。결론철피석곡처방보조치료폐결핵대개선환자적세포인자공능문란적치료효과우우단순용서약치료。
Objective To explore curative effect of dendrobium officinale prescription in the adjuvant treatment of pulmonary tuberculosis and the level changes of IL-10,IL-18 and OPN of the patients with pulmonary tuberculosis. Methods 76 patients who were diagnosed with infiltrative pulmonary tuberculosis from May 2013 to March 2014 were randomly divided into the treatment group and the control group with 38 in each.Patients in the treatment group were received dendrobium officinale prescription combined with western(anti-tuberculosis)medicine while patients in the control group were only received western (anti-tuberculosis)medicine.Course of treatment of two groups were both 6 months. Levels of serum interleukin-10(IL-10),interleukin-18(IL-18)and osteopontin(OPN)before and after treatment of patients in two groups were compared.They were also compared with the health group including 30 people who were received health examination in March 2014 in our hospital. Results Means of the serum IL-10,IL-18 and OPN before treatment of the two groups were higher than those in the health group(P < 0.05).Cytokines level of patients with infiltrative pulmonary tuberculosis were abnormally increased and IL-10,IL-18 and OPN of the two groups were all decreased in various degrees after the treatment(P < 0.05).Abnormal cytokines level was related to clinical outcome of patients with infiltrative pulmonary tuberculosis.Differences between means of the serum IL-10 and IL-18 after treatment of the treatment group and those of health group were not statistically significant(P > 0.05).Mean of OPN in the treatment group was higher than that in the health group(P < 0.05).Serum IL-10,IL-18 and OPN after treatment of the control group were all higher than those of the health group(P < 0.05).The improvement of immune injury in the treatment group is better than that in the control group only with western medicine. Conclusion Dendrobium officinale in the adjuvant treatment of pulmonary tuberculosis has a better curative effect on improving cytokines dysfunction than only usage of western medicine.