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目的观察胸腺肽联合抗结核药物治疗耐多药涂阳肺结核的临床疗效。方法 121例耐多药涂阳肺结核患者随机分为对照组(单纯化疗组)67例和治疗组(胸腺肽联合化疗组)54例。对照组采用6ZEAKCFX/18ZELFX化疗方法治疗。治疗组在对照组相同抗结核化疗方案基础上联合胸腺肽治疗3个月。观察治疗后第3个月末、第6个月末及第12个月末两组患者的临床效果。结果 3个月末,痰菌阴转率治疗组为81.5%,高于对照组的58.2%,差异有统计学意义(P<0.05);病灶吸收率治疗组为85.2%,高于对照组的61.2%,差异有统计学意义(P<0.05)。6个月末,痰菌阴转率治疗组为90.7%,高于对照组的71.6%,差异有统计学意义(P<0.05);病灶吸收率治疗组为92.6%,高于对照组的73.1%,差异有统计学意义(P<0.05)。12个月末,痰菌阴转率治疗组为92.6%,高于对照组的77.6%,差异有统计学意义(P<0.05);病灶吸收率治疗组为94.4%,高于对照组的80.6%(P<0.05)。结论胸腺肽联合抗结核药治疗耐多药涂阳肺结核能明显促进痰菌转阴,病灶吸收,空洞闭合,可以作为耐多药涂阳肺结核的辅助用药之一。
Objective To observe the clinical efficacy of thymosin combined with anti-tuberculosis drugs in the treatment of multidrug-resistant pulmonary tuberculosis. Methods A total of 121 patients with multi-drug-resistant pulmonary tuberculosis were randomly divided into control group (chemotherapy group) 67 cases and treatment group (thymosin combined chemotherapy group) 54 cases. The control group was treated with 6ZEAKCFX / 18ZELFX chemotherapy. The treatment group in the control group on the basis of the same anti-tuberculosis chemotherapy combined thymosin treatment for 3 months. The clinical effects of the two groups were observed at the end of the third month, the end of the sixth month and the end of the twelfth month after treatment. Results At the end of 3 months, the sputum negative conversion rate was 81.5% in the treatment group, which was higher than that in the control group (58.2%, P <0.05). The absorption rate of the lesion was 85.2% in the treatment group and 61.2% in the control group %, The difference was statistically significant (P <0.05). At the end of 6 months, the sputum negative conversion rate was 90.7% in the treatment group, which was higher than that in the control group (71.6%, P <0.05). The absorption rate of the lesion was 92.6% in the treatment group and 73.1% , The difference was statistically significant (P <0.05). At the end of 12 months, the sputum negative conversion rate was 92.6% in the treatment group, which was higher than that in the control group (77.6%, P <0.05). The absorption rate of the lesion was 94.4% in the treatment group, which was 80.6% (P <0.05). Conclusion Thymosin combined with anti-tuberculosis drugs can effectively promote sputum bacteria to negative conversion, focal absorption and hollow closure in the treatment of multidrug-resistant pulmonary tuberculosis. It can be used as an adjuvant drug for multidrug-resistant smear-positive pulmonary tuberculosis.