母牛分枝杆菌辅助治疗复治涂阳肺结核疗效观察

目的观察和评价母牛分枝杆菌（微卡）作为免疫调节剂辅助治疗复治涂阳肺结核的临床疗效与安全性。方法选取本院2006年3月～2008年11月期间93例复治涂阳肺结核患者,采用入院随机分组分成治疗组47例和对照组46例,两组化疗均采用3DRtSLE/6DRtE方案,治疗组加用母牛分枝杆菌（微卡）每2周1次,共9个月。观察治疗后两组患者肺部病灶吸收、痰菌阴转、临床症状等改变情况。结果疗程结束时治疗组与对照组胸部X线病灶显效率分别为89.4%和71.7%（P〈0.05）;空洞闭合率分别为87.2%和67.4%（P〈0.05）;治疗3、6、9个月末痰菌阴转率治疗组为65.9%、83.0%、95.7%,对照组为47.8%、65.2%、78.3%（P〈0.05）;疗程结束时治疗组与对照组临床症状改善无显著差异（P〉0.05）。治疗组母牛分枝杆菌不良反应：发热1例,皮下硬结1例。结论母牛分枝杆菌辅助治疗复治涂阳肺结核,能增强免疫细胞活性,促进肺部病灶吸收,提高痰菌转阴率,且安全性好,是较好的结核病免疫治疗制剂。

Mycobacterium vaccae adjuvant treatment of smear-positive pulmonary tuberculosis retreatment efficacy

Objective To observe and evaluate Mycobacterium vaccae（micro-card） as an immune modulator adjuvant treatment of smear-positive pulmonary tuberculosis retreatment of clinical efficacy and safety.Methods 93 cases of retreatment smear-positive TB patients from March 2006 to Dec 2008,were divided into treatment group of 47 cases and control group of 46 patients,two groups of chemotherapy were used 3DRtSLE/6DRtE program,the treatment group plus with Mycobacterium vaccae（M.vaccae） every 2 weeks one time,a total of 9 months.Two groups after treatment in patients with lung lesions absorption,sputum conversion,clinical symptoms such as changes in the situation.Results End of treatment,the treatment group and control group lesions in chest X-ray absorption rates were a significant 89.4%and 71.7%（P〈0.05）;pore closure rates were 87.2% and 67.4%（P〈0.05）;treatment of 3,6,9 the end of sputum conversion rate in the treated group was 65.9%,83.0%,95.7%,control group was 47.8%,65.2%,78.3%（P〈0.05）;end of treatment,the treatment group and control group had no significant clinical remission differences（P〉0.05）.Mycobacterium vaccae treatment group,adverse reactions：fever in 1 case,skin sclerosis in 1 case.Conclusion Mycobacterium vaccae adjuvant therapy for retreatment smear-positive tuberculosis,can enhance immune cell activity,promote absorption of lung lesions,increase sputum negative conversion rate,and the security is good,is a better TB immunotherapy agents.