Email Alert | RSS    帮助

中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (2): 121-125.doi: 10.3969/j.issn.1000-6621.2020.02.008

• 论著 • 上一篇    下一篇

柴竹石膏汤对29例反复发热结核病并发其他感染患者的疗效分析

李志明(),俞珊,王涛   

  1. 100091 北京,解放军总医院第八医学中心 全军结核病研究所结核四科
  • 收稿日期:2019-11-18 出版日期:2020-02-10 发布日期:2020-02-19
  • 通信作者: 李志明 E-mail:ming2email@126.com
  • 基金资助:
    “十三五”国家科技重大专项(2018ZX10725-509)

Clinical effect analysis of Chaizhushigao Decoction in 29 recurrent fever tuberculosis patients complicated with other infections

LI Zhi-ming(),YU Shan,WANG Tao.   

  1. The 4th Department of Tuberculosis, Institute for Tuberculosis Research, the 8th Medical Center of Chinese PLA General Hospital,Beijing 100091,China
  • Received:2019-11-18 Online:2020-02-10 Published:2020-02-19
  • Contact: Zhi-ming LI E-mail:ming2email@126.com

摘要:

目的 初步分析柴竹石膏汤治疗反复发热结核病并发其他感染患者的临床疗效。方法 搜集2016年3月至2018年3月解放军总医院第八医学中心结核科收治的确诊为继发性结核病并发其他非结核性感染(均有明确细菌学感染证据),且经不同时间常规抗结核和抗感染治疗仍持续或反复发热的29例患者。所有患者均在知情同意的情况下停用抗其他细菌感染的抗生素后,采用柴竹石膏汤(自拟方)进行治疗,观察柴竹石膏汤治疗7d后的退热效果和出院后2个月的远期疗效。其中抗结核药物治疗与抗感染治疗的时间以及热程分别为1~6个月,平均(2.0±1.8)个月;7~180d,平均(43.3±36.6)d;10d至6个月,平均(20.0±4.0)d。结果 29例患者经柴竹石膏汤治疗7d后,完全控制20例(69.0%),部分控制6例(20.7%),有效2例(6.9%),无效1例(3.4%),总有效率为96.6%(28/29)。其中26例(89.7%)完全控制及部分控制患者中,12例(46.2%)3d内体温恢复正常,8例(30.8%)患者3~5d内体温恢复正常,6例(23.1%)患者5~7d内体温恢复正常,停药1个月后体温均无反复;2例有效患者中,1例在服药第9天体温降至正常,1例第10天内体温降至正常,经观察体温有反复,体温波动于37.5℃左右,继续加用中药汤剂治疗,1个月后体温恢复正常;1例无效患者重新加用抗真菌药物治疗后,2个月后体温逐渐恢复至正常。结论 柴竹石膏汤治疗反复发热结核病并发其他感染患者具有较好临床疗效,其退热机理有待在临床实践中进一步研究。

关键词: 结核, 细菌感染, 共病现象, 发热, 医疗无效, 医学,中国传统, 治疗结果, 柴竹石膏汤

Abstract:

Objective To observe the clinical effect of Chaizhushigao Decoction in recurrent fever tuberculosis complicated with other infections. Methods We collected the clinical data of 29 patients who were hospitalized in the tuberculosis department of institute for tuberculosis research, the 8th Medical Center of Chinese PLA General Hospital from March 2016 to March 2018 and were diagnosed as secondary tuberculosis complicated with other non-tuberculosis infections. These patients had clear evidence of bacteriological infection and still suffered from fever continuously or repeatedly after routine anti-tuberculosis and antiinfection treatment at different times. They were treated with Chaizhushigao Decoction (self-made prescription), and at same time the antibiotics against other bacterial infections were stopped with informed consent of all patients. The antipyretic effect of the treatment with Chaizhushigao Decoction afer 7 days and the long-term effect of 2 months after discharge were observed. These patients were treated with antituberculous drug for 1 to 6 months, with an average of (2.0±1.8) months; with anti-infection drug for 7 to 180 days, with an average of (43.3±36.6) days; and fever duration was 10 days to 6 months, with an average of (20.0±4.0) days. Results Of 29 tuberculosis patients treated with Chaizhushigao Decoction for 7 days, 20 (69.0%) patients were completely controlled, 6 (20.7%) patients were partially controlled, 2 (6.9%) patients were effective, 1 (3.4%) patient was ineffective, and the total effective rate was 96.6% (28/29). Among 26 (89.7%) patientswith complete and partial control, 12 (46.2%) patients recovered to normal temperature within 3 days, 8 (30.8%) patients recovered to normal temperature within 3 to 5 days, and 6 (23.1%) patients recovered to normal temperature within 5 to 7 days. And the temperature of these patients did not recur after one month of drug withdrawal. Among the 2 effective patients, their body temperature patient decreased to normal on the 9th and 10th day of taking medicine, respectively, but their body temperature fluctuated to about 37.5 ℃ after repeated observation, and the body temperature returned to normal after one month’s treatment with traditional Chinese medicine. After another antifungal treatment, the body temperature of one invalid patient gradually returned to normal 2 months later. Conclusion Chaizhushigao Decoction has a good clinical effect in the treatment of recurrent fever tuberculosis complicated with other infections. Its antipyretic mechanism needs further study in clinical practice.

Key words: Tuberculosis, Bacterial infections, Comorbidity, Fever, Medical futility, Medicine,Chinese traditional, Treatment outcome, Chaizhushigao decoction