目的 探究療肺寧片聯(lián)合2HRZE/4HR方案治療活動(dòng)性肺結(jié)核的療效及其對(duì)降鈣素原（PCT）、白細(xì)胞介素-10（IL-10）、腫瘤壞死因子-α（TNF-α）水平的影響。方法 選取2018年2月-2020年6月在鄭州市第六人民醫(yī)院治療的80例活動(dòng)性肺結(jié)核患者作為研究對(duì)象，按照隨機(jī)數(shù)字表法分為對(duì)照組（40例）和觀察組（40例）。對(duì)照組患者口服吡嗪酰胺片，0.25 g/次，1次/d，鹽酸乙胺丁醇片，0.15 g/次，1次/d，利福平膠囊空腹口服，0.45~0.60 g/次，1次/d，異煙肼片，0.1 g/次，1次/d，聯(lián)合化療的常規(guī)抗結(jié)核治療方案。觀察組在對(duì)照組的基礎(chǔ)上口服療肺寧片，10片/次，3次/d。兩組均治療4個(gè)月。觀察兩組患者的臨床療效，同時(shí)比較兩組患者的血清PCT、IL-10、TNF-α水平，X線病灶吸收情況及痰菌轉(zhuǎn)陰率。結(jié)果 治療后，與對(duì)照組總有效率67.50%相比，觀察組87.50%明顯升高（P<0.05）。治療后，兩組血清PCT、IL-10、TNF-α水平均明顯降低（P<0.05）；且觀察組PCT、IL-10、TNF-α水平明顯低于對(duì)照組（P<0.05）。治療后，觀察組總吸收率95.00%，與對(duì)照組75.00%比較明顯升高（P<0.05）。治療3個(gè)月、6個(gè)月，觀察組痰菌轉(zhuǎn)陰率分別為52.50%、87.50%，顯著高于對(duì)照組的30.00%、67.50%（P<0.05）。治療期間，兩組患者不良反應(yīng)發(fā)生率比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 療肺寧片聯(lián)合2HRZE/4HR方案治療活動(dòng)性肺結(jié)核可有效降低炎性因子水平，提高病灶吸收及痰菌轉(zhuǎn)陰率，且不會(huì)增加不良反應(yīng)發(fā)生率，安全有效。

Objective To investigate the therapeutic effect of Liaofeining Tablets combined with 2HRZE/4HR regimen in treatment of active pulmonary tuberculosis, and its effect on the levels of PCT, IL-10 and TNF-α. Methods A total of 80 patients with active pulmonary tuberculosis treated in The Sixth Peoples Hospital of Zhengzhou from February 2018 to June 2020 were selected as the research subjects, and divided into control group (40 cases) and observation group (40 cases) according to random number table method. After admission, all patients were po administered with Pyrazinamide Tablets, 0.25 g/time, once daily; Ethambutol Hydrochloride Tablets, 0.15 g/time, once daily; Rifampicin Capsules, 0.45-0.60 g/time, once daily; Isoniazid Tablets, 0.1 g/time, once daily. The conventional anti-tuberculosis treatment regimen was combined with chemotherapy. Patients in the observation group were po administered with Liaofeining Tablets on the basis of control group, 10 tablets/time, three times daily. Both groups were treated for 4 months. The clinical efficacy of two groups was observed, and the levels of serum PCT, IL-10, TNF-α, X-ray lesions absorption, and sputum bacteria negative rate of two groups were compared. Results After treatment, the total effective rate of observation group was 87.50%, which was significantly higher than 67.50% of control group (P < 0.05). After treatment, the levels of serum PCT, IL-10 and TNF-α in two groups were significantly decreased (P < 0.05), the levels of PCT, IL-10 and TNF-α in observation group were significantly lower than those in control group (P < 0.05). After treatment, the total absorption rate of observation group was 95.00%, which was significantly higher than 75.00% of control group (P < 0.05). After 3 months and 6 months of treatment, the sputum negative conversion rate of the observation group was 52.50% and 87.50%, respectively, which were significantly higher than 30.00% and 67.50% of the control group (P < 0.05). During treatment, there was no significant difference in the incidence of adverse reactions between two groups. Conclusion Liaofeining Tablets combined with 2HRZE/4HR regimen in treatment of active pulmonary tuberculosis can effectively reduce the level of inflammatory factors, improve the absorption of lesions and the rate of sputum bacteria turning negative, and do not increase the incidence of adverse reactions, which is safe and effective.

R974

河南省高等學(xué)校重點(diǎn)科研項(xiàng)目（21B310003）