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中国防痨杂志 ›› 2009, Vol. 31 ›› Issue (1): 6-9.

• 论著 • 上一篇    下一篇

结核性胸膜肥厚与TNF-α表达的关系及隔蒜灸和中药熏蒸治疗的临床疗效研究

林存智1；朱新红2；戚艳1；王坚3；张海燕1；逄金岐1；葛玉香4   

  1. 1.青岛市胸科医院青岛 266043； 2.青岛市市立医院青岛 266071；3.青岛钢铁集团职工医院青岛 266043； 4.青岛大学医学院附属医院青岛 266012
  • 出版日期:2009-01-10 发布日期:2011-11-03

The relation of TNF-α and pleural pachynsis and the therapeutic effect of garlic moxibustion and herb fumigate on it

Lin Cunzhi, Zhu Xinhong, Qi Yan, Wang Jian, Zhang Haiyan, Pang Jinzhi, Ge Yuxiang.   

  1. Tuberculosis Clinical Research Laboratory, Qingdao thoracic hospital, Qingdao 266043 China
  • Online:2009-01-10 Published:2011-11-03

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摘要： 目的探讨肿瘤坏死因子（TNF-α）在结核性胸腔积液中的表达及与胸膜肥厚的关系，以及隔蒜灸和中药熏蒸治疗胸膜肥厚的临床疗效。方法选择76例结核性胸腔积液患者和健康对照30人，应用ELISA检测TNF-α在胸腔积液和外周血中的表达，分析TNF-α的表达与胸膜肥厚的关系。62例胸膜肥厚患者分成治疗组32例，给予隔蒜灸和中药熏蒸，每周5次，每次熏蒸时间均为30min，4周为1个疗程；对照组30例。2组患者服用相同抗结核药物治疗。4周后均行胸部螺旋CT检查，分析治疗前后胸膜肥厚的改善情况。结果结核性胸腔积液中TNF-α表达明显高于外周血的表达，差异有统计学意义（t=19.31，P<0.01）；外周血中TNF-α的表达结核组明显高于健康对照组，差异有统计学意义（t=2.77, P<0.01）。胸腔积液中TNF-α的表达与胸膜肥厚程度呈正相关（r=0.613, P<0.01）。治疗组经隔蒜灸和中药熏蒸治疗4周后胸膜肥厚的程度有明显的改善（t=4.92, P<0.05），对照组胸膜肥厚程度无明显的改善（t=1.51，P>0.05）。2组胸膜肥厚改善的差异有统计学意义（t=4.59, P<0.01）。结论结核，胸膜；胸腔积液中TNF-α的表达与胸膜肥厚程度呈正相关，隔蒜灸和中药熏蒸治疗可以减轻胸膜肥厚的程度。

关键词: 结核, 胸膜/病理学, 结核, 胸膜/中医疗法, 隔蒜灸, 中药蒸气吸入, 治疗结果

Abstract: ObjectiveTo explore the expression of tumor necrosis factor-alpha(TNF-α) in pleural effusion and the relation of TNF-α with pleural pachynsis, and the clinical effect of pleural pachynsis treated by garlic moxibustion and herb fumigation. MethodsSenventy-six cases of tuberculous pleurisy with pleural effusion were selected. The expression of TNF-α in pleural effusions and peripheral blood were measured by ELISA. To analyze the relation between TNF-α and pleural pachynsis, 62 cases with pleural pachynsis were divided into two groups. Thirty-two cases in therapeutic group were received garlic moxibustion and herb fumigation for 30 min for five times a week. A course of treatment was four weeks. Control group contained 30 cases. These two groups were given same routine anti-tuberculosis drug treatment regiments. The therapeutic effects were evaluated by chest spiral CT check. 30 healthy individuals were as control. ResultsThe expression of TNF-α was significantly higher in pleural effusion than that in the peripheral blood (P<0.01). There was a positive correlation between the expression of TNF-α in tuberculous pleural effusion and the degree of pleural pachynsis (r=0.613,P<0.001). The degree of pleural pachynsis was obviously improved by giving garlic moxibustion and herb fumigation after four weeks (P<0.05) in therapeutic group, while it was not improved in the control group (P>0.05). ConclusionsThe expression of TNF-α was positive correlation to the degree of residual pleural thickening. Garlic moxibustion and herb fumigation therapy could decrease the pleural pachynsis.

Key words: tuberculosis，pleural/pathology, tuberculosis，pleural/zhong yi liao fa, garlic-partitioned moxibustion, steam inhalation（TCD）, treatment outcome

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