五药联合方案治疗耐多药结核病的疗效分析

目的　评价异烟肼 (H)、对氨基水杨酸钠 (P)、卷曲霉素 (C)、氧氟沙星 (O)或左氧氟沙星 (L V)和丙硫异烟胺 (Th)方案治疗耐多药结核病 (MDR- TB)的疗效。方法　将 85例 MDR- TB随机分为两组 :治疗组 (4 5例 )应用 H、P、C、O或 L V、Th;对照组 (4 0例 )应用 H、丁胺卡那霉素、利福喷丁、吡嗪酰胺和乙胺丁醇。结果　痰菌阴转率 :治疗组 86 .7% ,对照组 5 5 % ,有高度显著性差异 (P<0 .0 1) ;病灶吸收好转率治疗组 6 4 .4 ,对照组 4 0 ,有显著性差异 (P<0 .0 5 ) ;空洞闭合率 :治疗组 6 8.9 ,对照组 4 0 ,有高度显著性差异 (P<0 .0 1)。随访 2年 ,治疗组和对照组总治愈率分别为 84 .4和 5 0 ,有高度显著性差异 (P<0 .0 1)。结论　 H、P、C、O或 L V、Th方案治疗 MDR- TB疗效满意 ,可作为首选方案

Therapeutic effect of a combination regimen with 5 drugs in the treatment of multi-drug resistant tuberculosis

Objective To evaluate the therapeutic efficacy of a combination therapy with isoniazid (INH),sodium para-aminosalic ylate (PAS),capreomycin (CPM),ofloxacin (OFLX) or levofloxacin (LVFX) and prothionamidam (Th) in the treatment of multi-drug resistant tuberculosis (MDR-TB).Methods 85 cases with MDR-TB were assigned to a study group (45 cases),treated with INH,PAS,CPM,OFLX or LVFX and the control group (40 cases),treated with INH,amikacin,rifapentine,pyrazinamide and ethambutol.The course of treatment was 21 months. Results The sputum negative conversion rates were 86.7% in the study group and 55% in the control group:p<0.01.The radiographic improvement rates were 64.4% in the study group and 40% in the control group:p<0.05).The closure rate of the lung cavities in the study group (68.9%) was significantly higher than that in the control group (40%) (p<0.01).The 2 year follow up showed that the total cure rates were 84.4% in the study group and 50% in the control group:p<0.01.Conclusion The therapeutic regimen including INH,PAS,CPM,OFLX or LVFX and Th was effective in treating patients with MDR-TB.