目的 觀察補(bǔ)肺活血膠囊聯(lián)合四聯(lián)抗結(jié)核療法治療結(jié)核性胸膜炎的療效。方法 選取2015年4月-2020年9月在新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院診治的96例結(jié)核性胸膜炎患者為研究對象，隨機(jī)分為對照組（48例）和治療組（48例）。對照組患者口服利福平片，0.6 g/次，1次/d；異煙肼片，0.3 g/次，1次/d；吡嗪酰胺片，1.25 g/次，1次/d；鹽酸乙胺丁醇片，0.75 g/次，1次/d。治療組在對照組的基礎(chǔ)上口服補(bǔ)肺活血膠囊，4粒/次，3次/d。兩組患者連續(xù)治療6周。觀察兩組患者臨床療效，比較治療前后兩組患者胸水吸收時間、住院時間、臨床癥狀緩解時間、胸膜厚度，炎癥因子白介素-6（IL-6）、C反應(yīng)蛋白（CRP）和腫瘤壞死因子-α（TNF-α）水平及肺功能第1秒用力呼氣容積（FEV1）和用力肺活量（FVC）。結(jié)果 治療后，治療組的總有效率明顯高于對照組（91.67%vs 72.92%，P<0.05）。治療后，治療組的胸水吸收時間、住院時間、臨床癥狀緩解時間明顯短于對照組，胸膜厚度小于對照組（P<0.05）。治療后，兩組患者IL-6、CRP、TNF-α水平均較治療前顯著下降（P<0.05），且治療組明顯低于對照組（P<0.05）。治療后，兩組患者FEV1、FVC均較治療前升高（P<0.05），且治療組高于對照組（P<0.05）。結(jié)論 補(bǔ)肺活血膠囊聯(lián)合四聯(lián)抗結(jié)核療法治療結(jié)核性胸膜炎，可有效阻止疾病進(jìn)展，緩解臨床癥狀，促進(jìn)肺功能改善，療效可靠。

Objective To observe the curative effect of Bufei Huoxue Capsules combined with quadruple anti-tuberculosis therapy in treatment of tuberculous pleurisy. Methods Patients (96 cases) with tuberculous pleurisy in the First Affiliated Hospital of Xinxiang Medical University from April 2015 to September 2020 were randomly divided into control (48 cases) and treatment (48 cases) groups. Patients in the control group were po administered with Rifampicin Tablets, Isoniazid Tablets, Pyrazinamide Tablets and Ethbambutoli Hydrochloridi Tablets, and they were respectively 0.6 g/time, 0.3 g/time, 1.25 g/time and 0.75 g/time, once daily. Patients in the treatment group were po administered with Bufei Huoxue Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacy was evaluated, the pleural effusion absorption time, hospital stay, clinical symptom relief time, pleural thickness, the inflammatory factors levels of IL-6, CRP, and TNF-α, and the lung function indexes of FEV1 and FVC in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was significantly higher than that in the control group (91.67% vs 72.92%, P<0.05). After treatment, the pleural absorption time, hospital stay and clinical symptom relief time in the treatment group were significantly shorter than those in the control group (P<0.05), and the pleural thickness in the treatment group was less than that in the control group (P<0.05). After treatment, the levels of IL-6, CRP and TNF-α in two groups were significantly lower than those before treatment (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of FEV1 and FVC in two groups were higher than those before treatment (P<0.05), and which in the treatment group were higher than those in the control group (P<0.05). Conclusion Bufei Huoxue Capsules combined with quadruple anti-tuberculosis therapy in treatment of tuberculous pleurisy can effectively prevent the progression of the disease, alleviate clinical symptoms, promote the improvement of lung function, and the curative effect is reliable.

R974

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃聯(lián)合共建項(xiàng)目（2018020344）