目的:观察在抗结核治疗基础上加用加味玉屏风散联合卡介菌多糖核酸治疗老年结核性胸膜炎患者的临床疗效。方法:将86例结核性渗出性胸膜炎老年患者随机分为对照组和观察组,2组均采用国家标准化疗方案2HRZS/4HR治疗和胸腔置管引流胸水。对照组给予胸腔内注射卡介菌多糖核酸注射液,观察组在对照组治疗基础上加用加味玉屏风散内服。疗程均为2月。记录患者的胸水引流量、胸水消失时间、住院时间和胸膜厚度;检测治疗前后T淋巴细胞亚群和自然杀伤(NK)细胞水平。结果:观察组总有效率为93.18%,高于对照组的76.19%,差异有统计学意义(P<0.05)。治疗后,观察组胸水引流量少于对照组,胸水消失时间、住院时间均短于对照组,胸膜厚度低于对照组,差异均有统计学意义(P<0.01)。2组CD3~+、CD4~+和NK细胞水平均较治疗前上升(P<0.01),CD8~+水平均较治疗前下降(P<0.01);观察组CD3~+、CD4~+和NK细胞水平均高于对照组(P<0.01),CD8~+水平低于对照组(P<0.01)。结论:采用中西医结合免疫调节疗法治疗老年结核性胸膜炎患者能缩短疗程,调节免疫功能,提高临床疗效。 Objective: To observe the clinical effect of adding Yupingfeng powder combined with BCG polysaccharide nucleic acid in the treatment of senile tuberculous pleurisy on the basis of antituberculosis treatment. Methods: A total of 86 elderly patients with tuberculous exudative pleurisy were randomly divided into control group and observation group. Both groups were treated with national standard chemotherapy 2HRZS / 4HR and pleural catheter drainage. The control group was injected intraperitoneal injection of BCG polysaccharide nucleic acid injection, the observation group in the control group based on the addition of flavored Yupingfeng San oral administration. Treatment are February. The pleural effusion, pleural effusion time, hospitalization time and pleural thickness were recorded. The levels of T lymphocyte subsets and natural killer (NK) cells were measured before and after treatment. Results: The total effective rate in the observation group was 93.18%, which was higher than that in the control group (76.19%), the difference was statistically significant (P <0.05). After treatment, the drainage volume of pleural effusion in the observation group was less than that in the control group, and the time of pleural effusion and hospitalization were shorter than that of the control group. The pleural thickness was lower than that of the control group (P <0.01). The level of CD3 ~ +, CD4 ~ + and NK cells in two groups were significantly higher than those before treatment (P <0.01), while the level of CD8 + (P <0.01). The level of CD8 + was lower than that of the control group (P <0.01). Conclusion: The treatment of elderly patients with tuberculous pleurisy with traditional Chinese medicine and western medicine can shorten the course of treatment, regulate the immune function and improve the clinical curative effect.