微卡(VACCAE)联合2H3R3Z3E3/4H3R3方案治疗初治涂阳肺结核的临床效果(1)
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[摘要] 目的 应用微卡(VACCAE) 联合常规抗结核药物2H3R3Z3E3/4H3R3治疗初治涂阳肺结核的临床疗效。 方法 选取100例初始涂阳肺结核患者，随机分为对照组50例和观察组50例，两组均采用“世界银行贷款+中国结核病控制项目”的2H3R3Z3E3/4H3R3 方案治疗，观察组在上述常规化疗药基础上联用微卡22.50 μg深部肌肉注射；观察两组的痰菌阴转率、病灶吸收率、空洞闭合率、临床症状改善情况、不良反应发生率。结果 治疗1个月后，观察组临床症状完全消失率显著高于对照组(P < 0.05)。观察组的痰菌转阴率、病灶吸收率、空洞闭合率均优于对照组(P < 0.05)。微卡注射后无严重不良反应。结论 微卡联合常规抗结核药物2H3R3Z3E3/4H3R3方案治疗初治涂阳肺结核能够快速缓解临床症状，且疗效显著不良反应小，具有临床应用价值。
[关键词] 微卡；常规抗结核药物；初治涂阳肺结核
[中图分类号] R521 [文献标识码] B [文章编号] 1673—9701(2012)27—0058—02
A clinical trial of Mycobaeterium Vaccae Vaccine combining 2H3R3Z3E3/4H3R3 in treating new pulmonary tuberculosis
LE Shifeng1 CHENG Xiaoxing2
1.Department of Infectious Diseases，the People's Hospital of Cixi City in Zhejiang Province，Cixi 315300，China；2.TB Institute，the PLA 309 Hospital，Beijing 100091，China
[Abstract] Objective To study the efficacy of Mycobacterium Vaccae Vaccine (VACCAE) combining 2H3R3Z3E3/4H3R3 in treating new smear positive tuberculosis(TB). Methods One hundred new smear—positive TB patients were randomly divided into treatment group and control group(each n = 50). The treatment group received 2H3R3Z3E3/4H3R3 plus 22.50 μg VACCAE treatment for 6 months and the control group only received 2H3R3Z3E3/4H3R3 treatment for 6 months. The sputum conversion rate， the absorption rate of lung lesions， the rate of cavity closure， the improvement of clinical symptoms and the adverse reactions of mycobacterium vaccae were observed. Results One month after treatment， the rate of clinical symptoms completely disappearing in treatment group was significantly higher than those in control group (P < 0.05). The sputum conversion rate， the absorption rate of lung lesions， the rate of cavity closure of treatment group were separately higher than the control group (P < 0.05). No serious adverse reactions after injection of VACCAE were appeared. Conclusion VACCAE combined with conventional anti—TB drugs 2H3R3Z3E3/4H3R3 in treating new smear positive tuberculosis would have great clinical value which can quickly relieve clinical symptoms， got significant effects with no serious side effects.
[Key words] Mycobaeterium Vaccae vaccine；Conventional anti—TB drugs；New pulmonary tuberculosis
结核病疫情在全球范围内回升，引起世界各国的高度重视并纷纷采取应对举措[1]。中国是世界上第二个结核病高负担国家，政府对此做出大量控制措施[2]。临床研究表明，结核病与患者自身免疫调节密切相关，病患的免疫机制在该病的发生、发展过程中起着重要作用[3]。微卡为冻干治疗用母牛分枝杆菌菌苗，是一种良好的双向免疫调节剂，在世界卫生组织20 世纪90 年代制定的《结核病研究与发展战略》中是唯一被推荐用于结核病防治的免疫治疗制剂，已有报道微卡联合其他抗结核药物治疗肺结核获得了显著疗效[4]。本文主要探讨微卡联合常规抗痨药物2H3R3Z3E3/4H3R3方案治疗初治涂阳肺结核的临床疗效和不良反应，现报道如下。
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