Efficacy of combined Chinese and western medicine on lymph node tuberculosis based on real-world
Objective It is to compare the actual clinical efficacy of western medicine and combination of Chinese and western medicine in the treatment of lymph node tuberculosis,and to analyze the differences in efficacy among different types of tuberculosis(nodular,infiltrative,abscessed,and ulcerated),in order to provide better evidences for clinical treatment.Methods Based on the real world,the data of 2538 cases of patients with lymph node tuberculosis who met the inclusion criteria diagnosed and treated in the outpatient clinics and wards of Nanjing Hospital of Integrated Traditional Chi-nese and Western Medicine,Zhenjiang Third People's Hospital,Huai'an Fourth People's Hospital,and Nantong Sixth People's Hospital from January 2017 to January 2020 were retrospectively analyzed,and according to whether or not used traditional Chinese medicine treatment,they were divided into Chinese and western medicine combined treatment group and western medicine treatment group,the baseline characteristics,treatment duration,surgery rate,surgical incision stage I healing rate,incidence of tuberculosis drug resistance,incidence of adverse reactions,and recurrence rate at 3 years of fol-low-up were compared between the two groups.Results Among 2 538 patients with lymph node tuberculosis,there were more female patients(1 621 patients)than male patients(917 patients);the average age of the patients was about 37 years old,and the average duration of the disease was about 7 months;there were 668 cases with a history of tuberculosis or exposure(26.32%);the head and neck were the most common location of disease,followed by the axilla and groin;the abscessed and ulcerated types were more frequent(916 cases and 762 cases),abscess type and ulcer type accounted for a higher proportion of patients with comorbid underlying diseases.The course of treatment ranged from 11 to 18 months.The total effective rate and cure rate of the combined Chinese and western medicine treatment group were significantly high-er than those of the western medicine treatment group[97.79%(1724/1763)vs 78.71%(610/775),P＜0.05];the operation rate of patients with abscess and ulcerative type was significantly higher than that of patients with nodular and in-filtrative type in the same group in the two groups(P＜0.05),however,the difference in operation rate of patients with abscess and ulcerative type was not statistically significant among the two groups(P＜0.05);the incision stage I healing rates of patients with infiltrative,abscessed,and ulcerated types in the combined Chinese and Western medicine treatment group were significantly higher than those of the same type of western medicine treatment group[96.17%(176/183),94.97%(566/596),and 91.92%(455/495)than 78.16%(68/87),71.97%(190/264),69.63%(149/214),all P＜0.05];the incidence of TB drug resistance,incidence of adverse reactions,and relapse rates in the combined Chinese and western medicine treatment group were significantly lower than those in the western medicine treatment group[10.21%(180/1763),16.28%(287/1763),2.78%(49/1763)than 16.00%(124/775),23.35%(181/775),9.94%(77/775),all P＜0.05].Conclusion Real-world studies find that the combination of Chinese and western medicine can improve the clinical efficacy of lymph node tuberculosis,promote the healing of surgical incisionⅠ,and effectively reduce tuberculosis drug resistance,adverse drug reactions and recurrence.
lymph node tuberculosisreal-world studycombined Chinese and western medicine therapy
万方数据
维普
