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