目的 探討復方柳菊膠囊聯(lián)合四聯(lián)抗結(jié)核藥物治療結(jié)核性滲出性胸膜炎的臨床療效及安全性。方法 選取2020年6月—2020年12月在新鄉(xiāng)醫(yī)學院第一附屬醫(yī)院就診的120例結(jié)核性滲出性胸膜炎患者，按照隨機數(shù)字表法分為對照組和治療組，每組各60例。對照組給予標準四聯(lián)抗結(jié)核藥物治療，口服異煙肼片，3片/次，1次/d；利福平片，3片/次，1次/d；鹽酸乙胺丁醇片，3片/次，1次/d；吡嗪酰胺片，2片/次，3次/d。治療組在對照組的基礎(chǔ)上口服復方柳菊膠囊，5粒/次，3次/d。兩組均治療4個月。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀和體征改善情況，白細胞介素-4（IL-4）、腫瘤壞死因子-α（TNF-α）和γ干擾素（IFN-γ）水平，及Th1細胞比例和Th1/Th2。結(jié)果 治療后，對照組和治療組總有效率分別為85.00%和96.66%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，與對照組相比，治療組胸水排出量、胸腔積液消退時間均顯著降低（P<0.05）。治療后，兩組胸膜厚度、TNF-α和IFN-γ水平均顯著降低（P<0.05），且治療組降低更顯著（P<0.05）。治療后，兩組Th1和Th1/Th2均顯著降低（P<0.05），且治療組患者降低更明顯（P<0.05）。結(jié)論 復方柳菊膠囊聯(lián)合四聯(lián)抗結(jié)核藥物治療方案能顯著改善結(jié)核性滲出性胸膜炎患者的臨床癥狀和體征，可能與糾正Th1/Th2細胞比例失衡有關(guān)。

Objective To investigate the clinical efficacy and safety of Compound Liuju Capsules combined with quadruple anti-tuberculosis regimen in treatment of tuberculous exudative pleurisy. Methods Patients (120 cases) with tuberculous exudative pleurisy in the First Affiliated Hospital of Xinxiang Medical University from June 2020 to December 2020 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were administered with standard quadruple antituberculous drugs, 3 Isoniazid Tablets orally each time, once daily, 3 Rifampicin Tablets orally each time, once daily, 3 Ethambutol Hydrochloride Tablets orally each time, once daily, 2 Pyrazinamide Tablets orally each time, three times daily. Patients in the treatment group were po administered with Compound Liuju Capsules, 5 grains/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical evaluation was evaluated, the improvement of symptoms and signs, the serum level of IL-4, TNF-α, and IFN-γ, the percentage of Th1 and Th2, Th1/Th2 cells in two groups before and after treatment were compared. Results After treatment, the clinical effective rates of the control group and the treatment group were 85.00% and 96.66% respectively (P < 0.05). After treatment, the pleural effusion output, and pleural effusion regression time were significantly lower than those in the control group (P< 0.05). After treatment, the pleural thickness, levels of TNF-α and IFN-γ were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the proportion of Th1 cells and Th1/Th2 cells were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Compound Liuju Capsules combined with quadruple anti-TB regimen can significantly improve the clinical symptoms and signs of patients with tuberculous exudative pleurisy, which may be related to correcting the imbalance of Th1/Th2 cells.

R974