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目的观察电针联合异烟肼、利福平、吡嗪酰胺、乙胺丁醇及糖皮质激素等药物治疗结核性脑膜炎的临床疗效。方法将符合病例入选标准的80例结核性脑膜炎患者都随机分为观察组、对照组,每组40例。2组患者均在诊断明确后给予异烟肼、利福平、吡嗪酰胺、乙胺丁醇及糖皮质激素等抗结核[3HRZE(s)/9HRE]治疗。观察组同时给予电针治疗,每日1次,每次30 min。2组均以治疗4周为1个疗程,治疗2个疗程后观察2组恶心、呕吐、头痛、发热、项强等症状的消失时间以及住院时间,观察2组治疗2个疗程脑脊液的变化情况,并根据上述指标评价临床疗效。结果痊愈率观察组为80.00%,对照组为55.00%,2组相比差异有统计学意义(P﹤0.05);总有效率观察组为97.50%,对照组为77.50%,2组相比差异有统计学意义(P﹤0.05)。发热、头痛、恶心呕吐、克氏征、项强等症状消失时间2组相比差异有统计学意义(P﹤0.05);住院时间2组相比差异有统计学意义(P﹤0.05)。治疗2个疗程后2组脑脊液白细胞计数、葡萄糖不、氯化物、脑脊液压力、蛋白质等指标相比差异有统计学意义(P﹤0.05)。结论电针联合异烟肼、利福平、吡嗪酰胺、乙胺丁醇及糖皮质激素等药物治疗结核性脑膜炎临床疗效显著,临床症状、体征消失快,脑脊液恢复正常快。
Objective To observe the clinical effects of electroacupuncture combined with isoniazid, rifampin, pyrazinamide, ethambutol and glucocorticoids in the treatment of tuberculous meningitis. Methods A total of 80 patients with tuberculous meningitis who met the selected criteria were randomly divided into observation group and control group, 40 cases in each group. Patients in both groups were treated with isoniazid, rifampin, pyrazinamide, ethambutol and glucocorticoid anti-TB [3HRZE (s) / 9HRE] after diagnosis. The observation group was given electroacupuncture treatment once a day for 30 minutes each time. 2 groups were treated for 4 weeks for a course of treatment, after 2 courses of treatment were observed in 2 groups of nausea, vomiting, headache, fever, Xiang Qiang symptoms such as disappearance of time and hospital stay, two groups observed two courses of cerebrospinal fluid changes , And based on the above indicators to evaluate the clinical efficacy. Results The cure rate was 80.00% in the observation group and 55.00% in the control group, the difference was statistically significant between the two groups (P <0.05); the total effective rate was 97.50% in the observation group and 77.50% in the control group, There was statistical significance (P <0.05). There were significant differences between the two groups in the disappearance time of fever, headache, nausea and vomiting, Kirschner sign, XiangQiang and other symptoms (P <0.05). There was significant difference between the two groups in hospitalization time (P <0.05). After 2 courses of treatment, the cerebrospinal fluid white blood cell count, glucose, chloride, cerebrospinal fluid pressure, protein and other indicators were significantly different (P <0.05). Conclusion Electro-acupuncture combined with isoniazid, rifampicin, pyrazinamide, ethambutol and glucocorticoid treatment of tuberculous meningitis have significant clinical efficacy, clinical symptoms and signs disappeared quickly, and CSF returned to normal quickly.