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目的探讨慢性阻塞性肺疾病合并肺结核患者治疗中联合采用综合疗法与免疫调节剂的临床效果,并分析该方案的具体作用。方法选取慢性阻塞性肺疾病合并肺结核患者74例为研究对象,按照PEMS 3.0软件随机分为常规组与联合组,其中前者实施常规综合治疗,后者采用综合治疗联合免疫调节剂进行治疗。观察临床疗效、治疗前后细胞免疫功能指标变化、治疗后不同时刻痰菌阴转率,并采用SPSS 20.0统计软件检验两组数据之间的差异。结果联合组患者显著控制、好转和无效分布情况与常规组差异有统计学意义(P<0.05),且联合组临床总有效率远高于常规组(P<0.05);治疗前两组CD_4~+、CD_4~+/CD_8~+、CD_8~+水平比较差异均无统计学意义(均P>0.05),治疗后两组患者的CD8+均显著降低,CD4+、CD4+/CD8+均显著升高(P<0.05),且治疗后联合组上述细胞免疫功能指标与常规组比较差异均有统计学意义(均P<0.05);治疗3个月后、6个月后和12个月后联合组患者痰菌阴转率均远低于常规组(P<0.05)。结论对慢性阻塞性肺疾病合并肺结核患者实施综合疗法与免疫调节剂联合治疗能够显著改善细胞免疫功能,提高痰菌阴转率,提升临床疗效。
Objective To investigate the clinical effects of combined therapy and immunomodulatory agents in the treatment of patients with chronic obstructive pulmonary disease and pulmonary tuberculosis, and to analyze the specific role of this regimen. Methods Totally 74 patients with chronic obstructive pulmonary disease and pulmonary tuberculosis were enrolled in this study. They were randomly divided into routine group and combined group according to PEMS 3.0 software. The former was treated by conventional combination therapy, the latter by combination therapy and immunomodulator. To observe the clinical curative effect, the changes of cellular immune function before and after treatment, sputum negative conversion rate at different time after treatment, and the differences between the two groups were tested by SPSS 20.0 statistical software. Results There was significant difference between the control group and the control group (P <0.05), and the total effective rate in the combined group was much higher than that in the conventional group (P <0.05) There was no significant difference in the levels of CD_4 ~ + CD_8 ~ + and CD_8 ~ + between the two groups (all P> 0.05). After treatment, CD8 + and CD4 +, CD4 + / CD8 + <0.05). After the treatment, the above-mentioned cellular immune function indexes in the combined group were significantly different from those in the conventional group (all P <0.05). After 3 months of treatment, sputum of patients in the combined group after 6 months and 12 months Negative rate of bacteria were far lower than the conventional group (P <0.05). Conclusion Combined treatment of combination therapy and immunomodulator in patients with chronic obstructive pulmonary disease and pulmonary tuberculosis can significantly improve cellular immune function, improve sputum negative conversion rate and improve clinical efficacy.