月华丸合百合固金汤加减联合标准化抗结核治疗方案治疗阴虚火旺型肺结核临床研究

Clinical Study of Modified Yuehua Pills Plus Baihe Gujin Decoction Combined with Standard Anti-Tuberculosis Treatment for Pulmonary Tuberculosis of Yin Deficiency and Fire Excess Type

摘要:

目的：观察月华丸合百合固金汤加减联合标准化抗结核治疗方案治疗阴虚火旺型肺结核的临床疗效。方法：选取2023年2月—2025年2月郑州市第六人民医院收治的阴虚火旺型肺结核患者106例，采用随机数字表法分为对照组和研究组各53例。对照组给予标准化抗结核治疗方案，研究组在对照组基础上给予月华丸合百合固金汤加减治疗。2组均治疗6个月。评价2组临床疗效，比较2组治疗前后中医证候积分、炎症因子水平、T 细胞亚群水平，统计不良反应发生率。结果：研究组总有效率为96.23% （51/53），高于对照组83.02% （44/53）（P＜0.05）。治疗后，2组中医证候积分较治疗前降低（P＜0.05），且研究组中医证候积分低于对照组（P＜0.05）。治疗后，2组白细胞介素-10（IL-10）、转化生长因子-β（TGF-β） 水平较治疗前降低，白细胞介素-17（IL-17）、干扰素-γ（INF-γ） 水平较治疗前升高（P＜0.05）；且研究组IL-10、TGF-β水平低于对照组，IL-17、INF-γ水平均高于对照组（P＜0.05）。治疗后，2组CD3+、CD4+、CD4+/CD8+水平较治疗前升高，CD8+水平较治疗前降低（P＜0.05）；且研究组CD3+、CD4+、CD4+/CD8+水平高于对照组，CD8+水平低于对照组（P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：月华丸合百合固金汤加减联合标准化抗结核治疗方案可改善阴虚火旺型肺结核患者炎症反应，调节T细胞亚群水平，减轻症状，提高疗效，且安全性高。

Abstract:

Abstract： Objective： To observe the clinical efficacy of modified Yuehua Pills plus Baihe Gujin Decoction combined with standard anti-tuberculosis treatment for pulmonary tuberculosis of yin deficiency and fire excess type. Methods： A total of 106 patients with pulmonary tuberculosis of yin deficiency and fire excess type admitted to the Sixth People's Hospital of Zhengzhou from February 2023 to February 2025 were selected and randomly divided into a control group and a study group using the random number table method，with 53 cases in each group. The control group received standard anti-tuberculosis treatment， while the study group received additional modified Yuehua Pills plus Baihe Gujin Decoction based on the control group's regimen. Both groups were treated for six months. Clinical efficacy was evaluated，and changes in traditional Chinese medicine syndrome scores，inflammatory factor levels，T cell subset levels，and the incidence of adverse reactions were compared before and after treatment. Results：The total effective rate was 96.23%（ 51/53） in the study group，significantly higher than that of 83.02%（ 44/53） in the control group（ P＜ 0.05）. Traditional Chinese medicine syndrome scores decreased in both groups after treatment （P＜0.05），with lower scores in the study group （P＜0.05）. Interleukin-10 （IL-10） and transforming growth factor- β （TGF- β） levels decreased in both groups （P＜0.05），while interleukin-17 （IL-17） and interferon-γ （IFN-γ） levels increased （P＜ 0.05）. The study group had lower IL-10 and TGF- β levels and higher IL-17 and IFN- γ levels than the control group （P＜0.05）. CD3⁺， CD4⁺， and CD4⁺/CD8⁺ levels increased in both groups （P＜0.05）， while CD8⁺ levels decreased（ P＜0.05）. The study group had higher CD3⁺，CD4⁺，and CD4⁺/CD8⁺ levels and lower CD8⁺ levels than the control group （P＜0.05）. No significant difference was observed in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： Modified Yuehua Pills plus Baihe Gujin Decoction combined with standard antituberculosis treatment can improve inflammatory responses， regulate T cell subset levels， alleviate symptoms， enhance efficacy，and demonstrate high safety in pulmonary tuberculosis patients of yin deficiency and fire excess type.