Effect of glucocorticoid combined with basic antituberculosis therapy on the efficacy and inflammation level of patients with active pulmonary tuberculosis
Objective To investigate the effect of glucocorticoid combined with basic anti-tuberculosis treatment on the efficacy and inflammation level of patients with active pulmonary tuberculosis,to provide reference for further regulating glucocorticoid-assisted treatment of active pulmonary tuberculosis.Methods A total of 106 patients with active pulmonary tuberculosis diagnosed in Haikou People's Hospital from February 2020 to February 2022 were included and equally and randomly divided into test group(n=53)and control group(n=53).The patients in the control group were treated with isoniazid+rifampicin+ethambutol+pyrazinamide for 2 months/isoniazid+rifampicin for 4 months(2HREZ/4HR)anti-tuberculosis drug regimen for 6 months continuously,while the test group was treated with methylprednisolone sodium succinate for 3 months before treatment on the basis of the control group.The expression levels of lung function indexes[total lung capacity(TLC),forced expiratory volume in first second(FEV1),forced vital capacity(FVC),FEV1/FVC]and serum inflammation-related indexes[interleukin-6(IL-6),IL-8,IL-17,IL-34,IL-37]were compared between the two groups.And the treatment effect and incidence of adverse reactions were compared between the two groups after 6 months of treatment.Results There were no significant differences in TLC,FEV1,FVC,FEV1/FVC,IL-6,IL-8,IL-17,IL-34 and IL-37 levels between two groups before treatment(all P＞0.05).After 6 months of anti-tuberculosis treatment,TLC,FEV,and FVC levels in two groups were significantly higher than before treatment,the differences were statistical significance(all P＜0.05);but there was no significant difference between the two groups(t=0.382,1.026,0.315;all P＞0.05);and no significant changes in FEV1/FVC before and after treatment or between groups(both P＞0.05).Serum levels of IL-6,IL-8,IL-17,IL-34 and IL-37 in two groups were significantly lower than before treatment,with statistical significance(all P＜0.05);Moreover,the levels of IL-6,IL-8,IL-17,IL-34 and IL-37 in test group were significantly decreased compared with control group,with statistical significance(t=6.856,8.873,3.762,5.116,11.587;all P＜0.05).There was no significant difference in the total effective rate between test group and control group(96.23％vs.90.57％)(x2=1.377,P=0.241).However,the therapeutic efficacy of experimental group was higher than that of control group(64.15％vs.43.40％),and the difference was statistically significant(x2=4.592,P=0.032).During treatment,there was no significant difference in the incidence of total adverse reactions between test group and control group(22.64％vs.16.98％),the difference was not statistical significance(x2=0.534,P=0.465).Conclusion Combined application of glucocorticoid on the basis of traditional anti-tuberculosis therapy could significantly improve the treatment quality,reduce the level of inflammatory reaction and improve the prognosis of patients with active pulmonary tuberculosis.
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