| 摘要: |
| 目的：观察加味补阳还五汤联合常规抗结核疗法治疗气阴两虚兼瘀血痹阻型肺结核的临床疗效。方法：将130 例气阴两虚兼瘀血痹阻型肺结核患者按1∶1随机、平行对照的方法分为治疗组和对照组，每组各65 例。对照组采用常规抗结核疗法治疗，治疗组在对照组基础上加用加味补阳还五汤治疗，观察2组治疗前后中医证候疗效、分子生物学痰菌转阴率、病灶吸收情况、肺空洞变化情况以及不良反应发生情况。结果：中医证候疗效总有效率、分子生物学痰菌转阴率、病灶吸收率、空洞吸收率治疗组分别为100.0%（65/65）、80.0%（52/65）、75.4%（49/65）、80.0%（48/60），对照组分别为66.1%（43/65）、58.5%（38/65）、55.4%（36/65）、55.0%（33/60），2组比较，差异均有统计学意义（P＜0.05）。治疗期间，治疗组有7 例患者出现恶心、纳差，对照组有13 例患者出现恶心、呕吐、纳差，经对症治疗后，均恢复正常。结论：加味补阳还五汤联合常规抗结核疗法治疗气阴两虚兼瘀血痹阻型肺结核，可提高分子生物学痰菌转阴率，促进肺部病灶吸收、空洞愈合，疗效显著，且安全性较好。 |
| 关键词: 肺结核 气阴两虚兼瘀血痹阻型 加味补阳还五汤 抗结核 2HRZE/4HR 分子生物学检测 |
| DOI： |
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| Clinical effect of Jiawei BuyangHuanwu decoction in treatment of pulmonary tuberculosis with deficiency of both Qi and Yin and blood-stasis obstruction：An analysis of 65 cases |
| ZHOU Jianwei,ZHOU Zhiquan,ZHANG Jin |
| (Department of Infectious Diseases，Xiangdong Hospital Affiliated to Hunan Normal University，Liling 412200，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Jiawei BuyangHuanwu decoction combined with conventional antituberculous therapy in the treatment of pulmonary tuberculosis with deficiency of both Qi and Yin and blood-stasis obstruction.Methods：A total of 130 patients with pulmonary tuberculosis with deficiency of both Qi and Yin and blood-stasis obstruction were randomly divided into treatment group and control group at a ratio of 1∶1 using a parallel-controlled design，with 65 patients in each group.The patients in the control group received conventional antituberculous therapy，and those in the treatment group received Jiawei BuyangHuanwu decoction in addition to the treatment in the control group.The two groups were compared in terms of the treatment of traditional Chinese medicine (TCM) syndrome，sputum bacteria clearance rate based on molecular biology，lesion absorption，changes in pulmonary cavity，and adverse reactions.Results：There were significant differences between the treatment group and the control group in the overall response rate of TCM syndrome ［100.0%(65/65) vs 66.1%(43/65)，P＜0.05］，sputum bacteria clearance rate based on molecular biology ［80.0%(52/65) vs 58.5%(38/65)，P＜0.05］，lesion absorption rate ［75.4%(49/65) vs 55.4%(36/65)，P＜0.05］，and cavity absorption rate ［80.0%(48/60) vs 55.0%(33/60)，P＜0.05］.During treatment，7 patients in the treatment group experienced nausea and poor appetite，while 13 patients in the control group experienced nausea，vomiting，and poor appetite，and all patients were fully recovered after symptomatic treatment.Conclusion：In the treatment of pulmonary tuberculosis with deficiency of both Qi and Yin and blood-stasis obstruction，Jiawei BuyangHuanwu decoction combined with conventional antituberculous therapy treatment can improve sputum bacteria clearance rate based on molecular biology and promote the absorption of pulmonary lesions and the healing of pulmonary cavity，with a marked clinical effect and a favorable safety profile. |
| Key words: pulmonary tuberculosis deficiency of both Qi and Yin and blood-stasis obstruction Jiawei BuyangHuanwu decoction antituberculous therapy 2HRZE/4HR molecular biology testing |
