Effect and Economic Evaluation of the Combination of Traditional Chinese and Western Medicine in Treatment of MDR-TB

Xing LIU; Bing OUYANG; Na LI; Ji LUO; Xu-qin SHI; Jie CHEN; Hui SUN; Hai-wen LI

doi:10.12259/j.issn.2095-610X.S20201106

Volume 41 Issue 11

Dec. 2020

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Xing LIU, Bing OUYANG, Na LI, Ji LUO, Xu-qin SHI, Jie CHEN, Hui SUN, Hai-wen LI. Effect and Economic Evaluation of the Combination of Traditional Chinese and Western Medicine in Treatment of MDR-TB[J]. Journal of Kunming Medical University, 2020, 41(11): 49-55. doi: 10.12259/j.issn.2095-610X.S20201106

Citation:

Xing LIU, Bing OUYANG, Na LI, Ji LUO, Xu-qin SHI, Jie CHEN, Hui SUN, Hai-wen LI. Effect and Economic Evaluation of the Combination of Traditional Chinese and Western Medicine in Treatment of MDR-TB[J]. Journal of Kunming Medical University, 2020, 41(11): 49-55. doi: 10.12259/j.issn.2095-610X.S20201106

Citation:

Xing LIU, Bing OUYANG, Na LI, Ji LUO, Xu-qin SHI, Jie CHEN, Hui SUN, Hai-wen LI. Effect and Economic Evaluation of the Combination of Traditional Chinese and Western Medicine in Treatment of MDR-TB[J]. Journal of Kunming Medical University, 2020, 41(11): 49-55. doi: 10.12259/j.issn.2095-610X.S20201106

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Effect and Economic Evaluation of the Combination of Traditional Chinese and Western Medicine in Treatment of MDR-TB

doi: 10.12259/j.issn.2095-610X.S20201106

1.
Dept. of Pharmacy
2.
Dept. of Tuberculosis，Kunming Third People’s Hospital，Kunming Yunnan 650041
3.
Dept. of Pharmaceutical Analysis，Nanjing University of Traditional Chinese Medicine，Nanjing Jiangsu 210023
4.
Kunming Third People’s Hospital Science and Education Section，Kunming Yunnan 650041，China

Received Date: 2020-09-21
Publish Date: 2020-11-25

Abstract

Abstract

Objective To explore the effect and cost-effectiveness ratio of Integrated Chinese and Western medicine in the treatment of MDR-TB, and to find the best treatment plan. Methods Four hundreds cases of MDR-TB patients in Kunming Third People's Hospital from April 2017 to October 2019 were collected and randomly divided into observation group （200 cases） and control group （200 cases）. The control group was treated with Western Medicine Anti Tuberculosis Program: 4D（Pto）LZEV（Mfx）AmkCsCfz/8D（Pto）LZEV（Mfx）CsCfz（D: Isoniazidp-aminosalicylate, Pro: propylthioisoniamine, L: rifapentine, Z: pyrazinamide, E: ethambutol, V: levofloxacin, MFX: moxifloxacin, AMK: amikacin, CS: cycloserine, CFZ: clofazimine）. On the basis of the control group, the observation group used antituberculosis Bufei Decoction according to the type of symptoms. The absolute values of CD3⁺, CD4⁺, CD8⁺ in peripheral blood T-lymphocyte subsets, the negative conversion rate of sputum bacteria, the effective rate of focus absorption, the rate of cavity closure, the improvement rate of symptoms in traditional Chinese medicine, the incidence of adverse reactions and the total effective rate of treatment were compared between the two groups after treatment, and the economic evaluation was made by cost-effectiveness analysis. Results At the end of treatment, the absolute values of CD3⁺, CD4⁺, CD8⁺ in the peripheral blood T lymphocyte subsets of the observation group were significantly higher than those of the control group （P < 0.05）. The negative rate of sputum bacteria was 86.5% in the observation group and 60.5% in the control group. The effective rate of absorption was 88.5% in the observation group and 58.0% in the control group. The cavity closure rate of the observation group and the control group was 52.0% / 34.5% respectively. The improvement rate of TCM symptoms in the observation group and the control group was 90.5% / 67.0% respectively. The total effective rate of the observation group and the control group was 93.5% / 80.0% respectively. There was significant difference between the two groups （ P < 0.01）. The incidence of adverse reactions in the observation group and the control group was 5.0% / 9.0% respectively, there was no significant difference between the two groups （ P > 0.05）. In the economic evaluation, the cost-effectiveness ratio of the observation group and the control group is 31205.9 yuan / 31746.4 yuan respectively, and the incremental cost-effectiveness ratio is 28002.9 yuan. The sensitivity analysis results are consistent with the cost-effectiveness ratio results. Conclusion The combination of traditional Chinese and Western medicine in the treatment of MDR-TB is better than western medicine in improving the efficacy and economic evaluation, which is worthy of clinical promotion.
- Integrated traditional Chinese and Western medicine,
- Multidrug resistance,
- Tuberculosis,
- Efficacy,
- Cost-effectiveness ratio

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References(21)

References

[1]	Ruevi I, Barii-Druko V, Glava-Obrovac L, et al. Vitamin D endocrine system and psoriasis vulgaris-review of the literature[J]. Acta Dermatovenerol Croat, 2009, 17（3）: 187-192.
[2]	唐神结. 耐药结核病防治手册[M]. 北京: 人民卫生出版社, 2009: 44-150.
[3]	何芳. 有关肺结核中医古籍文献的初探[J]. 中华中医药学刊, 2011, 3（1）: 52-54.
[4]	欧阳兵, 李海雯. 中西医结合治疗阴阳两虚型耐药肺结核的疗效观察[J]. 云南中医中药志, 2019, 40（9）: 32-34.
[5]	中华人民共和国卫生部疾病预防控制局, 中华人民共和国卫生部医政司, 中国疾病预防控制中心. 中国结核病防治规划实施工作指南[M]（2008年版）. 北京: 中国协和医科大学出版社, 2009: 140-350.
[6]	郑筱萸. 中药新药临床研究指导原则[M]（试行）. 北京: 中国医药科技出版社, 2002: 32-78.
[7]	周颖, 朱建民, 周志英, 等. 中医辅助治疗对耐多药肺结核患者细胞免疫状态改善的影响[J]. 中国防痨杂志, 2016, 38（1）: 33-37.
[8]	陈伦圣, 李志波, 尚宝明, 等. 亚胺培南西司他丁钠和美罗培南应用于重症肺部感染的治疗成本效果分析[J]. 贵州医药, 2019, 43（2）: 233-234.
[9]	吴家宝, 陈颖盈, 季萍, 等. 抗结核治疗中特异性T细胞免疫反应动态分析及其临床意义[J]. 现代免疫学, 2017, 37（3）: 198-205.
[10]	周玲霞, 黄金鹏, 楼敏. 中西医联合治疗耐多药肺结核病的临床疗效观察[J]. 中华中医药学刊, 2013, 31（4）: 942-944.
[11]	李芳, 左美容, 贺卫国. 中西医结合治疗耐多药肺结核60例临床分析[J]. 中国医药指南, 2013, 11（1）: 1-13. doi: 10.3969/j.issn.1671-8194.2013.01.003
[12]	樊凯芳, 赵建平, 冯振字. 玉屏风散配方颗粒汤剂与传统饮片汤剂对免疫抑制小鼠T细胞亚群影响的比较[J]. 中国中医急症, 2013, 4（4）: 550-551. doi: 10.3969/j.issn.1004-745X.2013.04.014
[13]	蒋文明, 邱赛红, 程纬民, 等. 牛角地黄冲剂对大鼠免疫性血小板减少模型T细胞亚群的影响[J]. 中国中医基础医学杂志, 2002, 8（8）: 20-21. doi: 10.3969/j.issn.1006-3250.2002.08.010
[14]	周伸瑛. 中医内科学[M]. 北京: 中国中医药出版社, 2003: 108-113.
[15]	陈利民, 周逸. 中西医结合治疗空洞性肺结核临床对照研究[J]. 实用中西医结合临床, 2010, 10（3）: 5-6. doi: 10.3969/j.issn.1671-4040.2010.03.003
[16]	刘红艳, 南琴. 百合固金汤加味配合西药治疗肺结核咯血82例[J]. 陕西中医, 2008, 29（4）: 397-398. doi: 10.3969/j.issn.1000-7369.2008.04.010
[17]	肖洁. 中药联合化疗治疗耐多药肺结核的临床观察[J]. 湖南中医药大学学报, 2008, 2（4）: 60-62. doi: 10.3969/j.issn.1674-070X.2008.04.019
[18]	王群. 含结核灵片复治方案治疗45例耐多药肺结核疗效观察[J]. 重庆医学, 2009, 38（1）: 88-90. doi: 10.3969/j.issn.1671-8348.2009.01.043
[19]	詹丽, 戴华成, 杨治平, 等. 小毛茛内酯影响耐药结核患者外周血淋巴细胞SHSP和GLS表达的研究[J]. 中国中药杂志, 2002, 27（9）: 677-679. doi: 10.3321/j.issn:1001-5302.2002.09.011
[20]	何颖. 中药猫爪草对结核分枝杆菌作用机制的蛋白质组学研究[D]. 重庆: 西南师范大学硕士论文, 2005.
[21]	侯海龙, 许礼发. 中药在耐多药结核分支杆菌感染中的应用前景[J]. 医学动物防制, 2007, 23（11）: 825-827. doi: 10.3969/j.issn.1003-6245.2007.11.011

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