Curative effect of thalidomide combined with anti-tuberculosis drugs on treating pulmonary tuberculosis / 中国综合临床

ABSTRACT

Objective To analyze the clinical efficacy of thalidomide combined with anti tuberculosis drugs in the treatment of pulmonary tuberculosis,in order to evaluate its application value and safety. Methods Seventy-two pulmonary tuberculosis patients in the Qianshan Hospital of Anshan from Jan. 2012 to Aug. 2014 were selected as the subject. Patients were randomly divided into control group and observation group with 36 cases in each group. Patients in the control group were only received anti-tuberculosis drug treatment,while in the treatment group were given thalidomide combined with anti tuberculosis drug treatment. Efficacy rate of thalidomide treatment after two weeks was evaluated by X-ray examination. Incidence of sputum smear negative conversion rate and adverse reaction were recorded. Results There were 10 cases with obvious tuberculosis absorption,19 cases with lesions absorption,7 cases with no absorption in observation group. In control group, there were 5 cases with obvious tuberculosis absorption,12 cases with lesions absorption,17 cases with no absorption and the lesion increased in 2 cases. The focus absorption in observation group was superior to the control group( Z =11. 854,P ﹤0. 001 ). There were 6 cases with void closure,4 cases with decreased void closure,1 cases with unchanged and 1 cases with new cavity in observation group. There were 1 cases with void closure,3 cases with decreased void closure,6 cases with unchanged and 3 cases with new cavity in control group,and there was significant difference(Z=15. 536,P﹤0. 001). Sputum smear negative rate in observation group after treatment was 85. 0%(17/20),significantly higher than that in control group(50. 0%(11/22),χ2=5. 775,P=0. 016). Cases of adverse reactions in observation group was 8(22. 2%),lower than that in control group(17 cases,(47. 2%);χ2 =4. 963,P=0. 026). There were 2 cases with abnormal liver function without changing the original treatment symptomatic liver after treatment,in observation group. Of 8 cases with abnormal liver function in control group,5 cases change treatment schedule including 3 cases of modified pyrazinamide for streptomycin,2 cases converted to rifampicin for Levofloxacin. The syndromes including eukopenia,skin rash, anorexia and lethargy were disappeared after treatment. Conclusion The effect of Thalidomide combined with anti tuberculosis drugs in the treatment of pulmonary tuberculosis is significant and safety,which can be used as a routine drug treatment of tuberculosis in clinical trials.