中医辨证辅助治疗对肺结核痰涂片阳性患者转阴率的影响研究(1)
【摘要】 目的：探讨中医辨证辅助治疗对肺结核痰涂片阳性患者治疗效果的影响。方法：选取本院2011年1月-2013年12月治疗的100例肺结核病患者，根据随机数字表法分为观察组和对照组，每组各50例，两组患者均给予西药标准化疗方案，观察组给予中医辨证辅助治疗。治疗1、3、6个月后评价疗效，重点观察临床症状好转率、痰菌转阴率及影像学好转率。结果：治疗1个月后，两组患者的临床症状好转率、痰菌转阴率及影像学好转率比较差异均无统计学意义(P>0.05)；治疗3个月后及6个月后，观察组患者的临床症状好转率、痰菌转阴率及影像学好转率显著高于对照组，两组比较差异均有统计学意义(P<0.05)。100例患者中有7例患者在治疗过程中发生肝功能异常，其中观察组有3例，对照组有4例，两组比较差异无统计学意义(P>0.05)。结论：中医辨证论治辅助治疗肺结核痰涂片阳性患者，能起到满意的效果。
【关键词】 中医； 辨证论治； 肺结核痰涂片阳性； 转阴率
【Abstract】 Objective：To explore TCM auxiliary treatment effect on the therapeutic effect of pulmonary tuberculosis patients with sputum smear positive.Method：100 patients of pulmonary tuberculosis were selected from January 2011 to December 2013 and were divided into two groups according to randomly method，50 cases in each group.Two group patients were given medicine standard chemotherapy，the observation group was given the TCM auxiliary treatment.The curative effects after 1，3 and 6 months were evaluated，focuse on clinical symptom improvement rate，the sputum negative conversion rate and the improvement rate of image were emphatically observed.Result：After 1 months of treatment，two groups of patients with clinical symptoms improvement rate，the sputum negative conversion rate and image to learn conversion rate the differences had no statistically significant(P>0.05).After 3 months and 6 months treatment，two groups clinical symptom improvement rate，the sputum negative conversion rate and image to learn conversion rate were observed，significantly higher than the those of the control group，the differences were statistically significant(P<0.05).In 100 cases，7 cases occurred with abnormal liver function in the treatment process，the observation group had 3 cases，4 cases in the control group，the difference was not statistically significant(P<0.05).Conclusion：Chinese medicine treatment of pulmonary tuberculosis patients with sputum smear positive，can play a satisfactory effect.
, 百拇医药
【Key words】 Traditional Chinese medicine； Treatment based on syndrome differentiation； Pulmonary tuberculosis with sputum smear positive； Negative rate
First-author’s address：The Chest Hospital of Shandong Provincial，Ji’nan 250013，China
doi：10.3969/j.issn.1674-4985.2015.17.036
肺结核属于中医学“肺痨”的范畴，又名痨瘵，古称“传尸”或“疰”，是由于痨虫侵蚀肺叶而引起的一种疾病。临床特征为咳嗽、咯血、潮热、盗汗，以及胸痛、消瘦[1]。《三因方·劳瘵叙论》“疰者，注也。病自上注下，与前人相似，故日疰。”因此，由于肺脏受痨虫所侵蚀，血气败坏，肺阴不足，阴虚肺热，虚火扰动，临床以阴虚火旺为多见，病理演变过程中，也可出现气阴亏损，甚至阴阳两虚等证，症状表现为咳嗽、咯血、潮热骨蒸、盗汗自汗、胸胁疼痛、消瘦乏力、纳少泄泻、男子遗精阳萎、女子经少经闭等，即可称之为：肺痨[2]。对肺结核的治疗，西医学标准治疗方案是药物化疗[3]。但临床有效率尚不十分满意，基于此，笔者将中医辨证治疗应用于肺结核的辅助治疗，并与单纯西药治疗进行对比，现总结如下。, 百拇医药(郝红)
【关键词】 中医； 辨证论治； 肺结核痰涂片阳性； 转阴率
【Abstract】 Objective：To explore TCM auxiliary treatment effect on the therapeutic effect of pulmonary tuberculosis patients with sputum smear positive.Method：100 patients of pulmonary tuberculosis were selected from January 2011 to December 2013 and were divided into two groups according to randomly method，50 cases in each group.Two group patients were given medicine standard chemotherapy，the observation group was given the TCM auxiliary treatment.The curative effects after 1，3 and 6 months were evaluated，focuse on clinical symptom improvement rate，the sputum negative conversion rate and the improvement rate of image were emphatically observed.Result：After 1 months of treatment，two groups of patients with clinical symptoms improvement rate，the sputum negative conversion rate and image to learn conversion rate the differences had no statistically significant(P>0.05).After 3 months and 6 months treatment，two groups clinical symptom improvement rate，the sputum negative conversion rate and image to learn conversion rate were observed，significantly higher than the those of the control group，the differences were statistically significant(P<0.05).In 100 cases，7 cases occurred with abnormal liver function in the treatment process，the observation group had 3 cases，4 cases in the control group，the difference was not statistically significant(P<0.05).Conclusion：Chinese medicine treatment of pulmonary tuberculosis patients with sputum smear positive，can play a satisfactory effect.
, 百拇医药
【Key words】 Traditional Chinese medicine； Treatment based on syndrome differentiation； Pulmonary tuberculosis with sputum smear positive； Negative rate
First-author’s address：The Chest Hospital of Shandong Provincial，Ji’nan 250013，China
doi：10.3969/j.issn.1674-4985.2015.17.036
肺结核属于中医学“肺痨”的范畴，又名痨瘵，古称“传尸”或“疰”，是由于痨虫侵蚀肺叶而引起的一种疾病。临床特征为咳嗽、咯血、潮热、盗汗，以及胸痛、消瘦[1]。《三因方·劳瘵叙论》“疰者，注也。病自上注下，与前人相似，故日疰。”因此，由于肺脏受痨虫所侵蚀，血气败坏，肺阴不足，阴虚肺热，虚火扰动，临床以阴虚火旺为多见，病理演变过程中，也可出现气阴亏损，甚至阴阳两虚等证，症状表现为咳嗽、咯血、潮热骨蒸、盗汗自汗、胸胁疼痛、消瘦乏力、纳少泄泻、男子遗精阳萎、女子经少经闭等，即可称之为：肺痨[2]。对肺结核的治疗，西医学标准治疗方案是药物化疗[3]。但临床有效率尚不十分满意，基于此，笔者将中医辨证治疗应用于肺结核的辅助治疗，并与单纯西药治疗进行对比，现总结如下。, 百拇医药(郝红)