新疆医科大学学报

目的分析康复新液联合二线药物对老年耐多药结核病的影响。方法选取2015年1月1日-2018年12月31日在河北省胸科医院结核四科接受治疗的老年耐多药结核病患者316例,随机数字表法分成对照组(158例),采用常规二线药物治疗,观察组(158例)在对照组基础上使用康复新液治疗。对比2组患者的咯血症状变化情况、痰菌阴转情况、空洞闭合情况、临床疗效及药物不良反应发生状况。结果观察组患者在治疗3个月时咳血症状变化总有效率为100%,对照组为91.47%,差异有统计学意义(P<0.05);观察组治疗3个月、6个月末时的痰菌转阴率为89.87%和100%,高于对照组的82.91%和91.57%(P<0.05);治疗6个月后,观察组患者空洞闭合的总有效率高于对照组(P<0.05);观察组患者的临床总有效率高于对照组(P<0.05);观察组患者出现不良反应例数合计26例,占比16.46%,对照组出现不良反应例数合计30例,占比18.99%,治疗前后2组无明显差异(P>0.05),但观察组胃肠道反应发生率明显低于对照组。结论康复新液联合二线药物可有效治疗老年耐多药结核病,显著提高患者的痰菌阴转率,有效控制咳血,促进空洞闭合,降低患者胃肠道反应发生率,临床效果较好。

Objective To analyze the effect of Kangfuxin fluid combined with the second-line drugs on the elderly with multidrug-resistant tuberculosis(MDR-TB). Methods From January 1 st 2015 to December 31 st 2018, a total of 316 elder MDR-TB patients who were treated in four departments of tuberculosis of Hebei Chest Hospital were randomly divided into control group(158 cases) and observation group(158 cases) respectively. The changes of hemoptysis symptoms, sputum negative transformation, cavity closure, clinical efficacy and adverse drug reactions were compared between the two groups. Results The total effective rate of hemoptysis was 100% in the observation group and 91.47% in the control group(P<0.05). At the end of 3 and 6 months. The negative conversion rate of sputum bacteria was 89.87% and 100%, which were higher than that in the control group(P<0.05). After 6 months of treatment, the total effective rate of cavity closure in the observation group was higher than that of the control group(P<0.05). The clinical efficacy of the observation group was higher than that of the control group(P<0.05). A total of 26 cases(16.46%) were found in the observation group and 30 cases(18.99%) in the control group. There was no significant difference between the two groups(P>0.05), but the incidence of gastrointestinal reaction in the observation group was significantly lower than that in the control group. Conclusion Kangfuxin fluid combined with the second-line drugs can effectively treat multidrug-resistant tuberculosis in the elderly, significantly improve the rate of sputum turnover, effectively control hemoptysis, promote cavity closure, reduce the incidence of gastrointestinal reactions in patients, and have a good clinical effect.