综合治疗和营养补充对活动性肺结核患者临床疗效的改善

V. Ivanov, T. Kalinovsky, A. Niedzwiecki, M. Rath
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引用次数: 5

摘要

尽管几十年来开发和使用了各种抗微生物药物,但全球结核病,特别是耐多药结核病的发病率一直在上升,每年导致200万人死亡。我们评估了微量营养素补充作为活动性肺结核患者标准治疗的辅助治疗对临床改善和不良事件发生频率的影响,这些患者来自基辅医学院,年龄在20至65岁之间,被诊断为活动性肺结核。所有受试者(试验组)均给予补充维生素/必需营养素的标准药物。对照组(n=100)由最近在该机构单独接受标准药物治疗的患者组成,按疾病阶段、混杂条件、性别和饮酒情况与测试患者进行匹配。标准临床和诊断方法用于确定基线值和研究结束时。经过两个月的强化化疗后,试验组98%的患者实现了腔愈合(主要措施),而对照组只有69%。此外,Ziehl-Neelson痰液试验100%阴性,而对照组只有88%阴性。试验组呼吸损伤的缓解率(87%)高于对照组(78%)。此外,补充维生素/必需营养素导致化疗不良事件的频率和严重程度显著降低;实验组中只有11%的人经历了不良事件,而对照组中有46%的人经历了不良事件。综上所述,辅助使用营养补充剂可显著提高化疗的临床疗效。此外,微量营养素的补充减少了化疗不良反应的频率和严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Improvement of Active Tuberculosis Patients with Complex Treatment and Nutritional Supplementation
Global incidence of tuberculosis, especially multiple-drug resistant tuberculosis, has been increasing, despite development and use of various antimicrobial drugs for decades, leading to 2 million deaths a year. We evaluated the ef- fect of micronutrient supplementation as an adjunct to standard treatment of patients with active pulmonary tuberculosis, on clinical improvement and frequency of adverse events on 120 patients aged 20 to 65 years diagnosed with active pul- monary tuberculosis at the Kiev Department of Phthisiatry. All participants (Test group) were prescribed standard medica- tion supplemented with vitamin/essential nutrients. A Control group (n=100) of patients recently treated with standard medication alone at this facility were selected by matching to Test patients by stage of disease, confounding conditions, gender, and alcohol consumption. Standard clinical and diagnostic methods were applied to determine baseline values and at the termination of the study. After a two-month period of intensive chemotherapy, cavity healing (primary measure) oc- curred in 98% of the Test Group, but only in 69% of the Control Group. Furthermore, the Ziehl-Neelson sputum test was negative in 100% of the Test group, but only in 88% of the Control group. Resolution of respiratory compromise was higher in the Test group (87%) than in the Control group (78%). Furthermore, supplementation with vitamin/essential nu- trients resulted in a significant decrease in the frequency and severity of adverse events from chemotherapy; only 11% in the Test group experienced adverse events while 46% did so in the Control group. In conclusion, clinical efficacy of che- motherapy was enhanced significantly with adjunctive use of nutrient supplementation. In addition, micronutrient sup- plementation decreased the frequency and severity of adverse effects from chemotherapy.
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