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目的:观察中西医结合治疗结核性脑膜炎的临床疗效。方法:将129例结核性脑膜炎患者纳入研究并随机分组,对照组64例采用利福平片、盐酸乙胺丁醇片、吡嗪酰胺片及异烟肼片常规抗结核治疗,治疗组65例以中西医结合疗法治疗,2组疗程均为2月。比较2组患者的症状体征消失时间,脑脊液指标、炎症指标[肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)]的改善情况及临床疗效。结果:治疗后,治疗组头痛、发热、恶心呕吐、项强等症状的消失时间均较对照组加快,差异均有统计学意义(P<0.05)。2组TNF-α、IL-6、IL-18水平均较治疗前降低,治疗组各项指标水平均低于对照组,差异均有统计学意义(P<0.01)。2组脑脊液中白细胞数、压力蛋白质水平均较治疗前降低,氯化物、葡萄糖水平均较治疗前升高,治疗组各项指标的改善情况均优于对照组,差异均有统计学意义(P<0.05)。治疗组总有效率95.38%,对照组总有效率81.25%,2组比较,差异有统计学意义(P<0.05)。结论 :中西医结合治疗结核性脑膜炎效果显著,与单纯西医治疗比较,可更好地改善炎症反应及脑脊液指标、缩短病程。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of tuberculous meningitis. Methods: A total of 129 patients with tuberculous meningitis were enrolled in the study and were randomized. The control group was treated with rifampicin, ethambutol hydrochloride tablets, pyrazinamide tablets and isoniazid tablets conventional anti-TB therapy. The treatment group 65 Cases of Integrative Medicine treatment, two groups were treated in February. The improvement of symptoms and signs disappearance time, cerebrospinal fluid index and inflammation index [TNF-α, IL-6, IL-18] in two groups were compared And clinical efficacy. Results: After treatment, the disappearance time of headache, fever, nausea, vomiting and other items in the treatment group were all faster than those in the control group (P <0.05). The levels of TNF-α, IL-6 and IL-18 in the two groups were lower than those before treatment, and the indexes in the treatment group were lower than those in the control group (P <0.01). The levels of leukocyte and pressure protein in two groups of cerebrospinal fluid were lower than those before treatment, while chloride and glucose levels were higher than those before treatment in both groups. The improvement of each index in the treatment group was better than that in the control group (P <0.05). The total effective rate was 95.38% in the treatment group and 81.25% in the control group. There was significant difference between the two groups (P <0.05). Conclusion: Integrative treatment of tuberculous meningitis significant effect, and Western medicine treatment alone, can better improve the inflammatory response and cerebrospinal fluid markers, shorten the course.