Objective To compare the efficacy of short-course chemotherapy regime containing moxifloxacin (4MRZE) with conventional regime containing isoniazid (2HRZE/4HR) for pulmonary tuberculosis.Methods Eighty pulmonary tuberculosis patients with positive sputum smear and culture admitted in Hangzhou Tuberculosis Control Institute from November 2013 to January 2016,were enrolled in the study.Patients were randomly assigned in two groups:40 patients received moxifloxacin,rifampicin,pyrazinamide and ethambutol for 4 months (4MRZE,study group),and 40 patients received isoniazid,rifampicin,pyrazinamide and ethambutol for 6 months (2HRZE/4HR,control group).All the patients were followed up for sputum examination,X rays and adverse reactions.Results The compliance in both groups was good,and no patient dropped out.The sputum examination and the X rays results were significant improved after treatment in both groups,there were no significant differences at month 1,2,3,4 and the end of the treatment between two groups (P ＞0.05).However,the overall incidence of the adverse reactions were significantly lower in the study group than that in the control group (P＜0.05);however,there were no significant differences in the incidence of individual adverse reactions between two groups (P ＞0.05).Conclusion The efficacy of chemotherapy regime with moxifloxacin and that with isoniazid is similar for treatment of pulmonary tuberculosis,but the overall adverse reactions are significantly lower in the regime with moxifloxacin included.%目的 探讨莫西沙星(M)替代异烟肼(H)的4MRZE超短程化疗方案治疗初始肺结核的临床疗效.方法 选择2013年11月至2016年1月收治的80例初治肺结核且痰涂片或痰培养阳性患者为研究对象,按照随机数字表法分为观察组[4MRZE化疗方案,M+利福平(R)+吡嗪酰胺(Z)+乙胺丁醇(E)化疗,疗程4个月]和对照组[2HRZE/4HR化疗方案,H+R+Z+E化疗,疗程6个月(强化期2个月、巩固期4个月)],每组40例.治疗期间每个月随访患者,观察指标包括痰菌转阴率、胸部X线病灶吸收有效率、不良反应发生率.结果 两组患者依从性良好,均无失访.治疗期间第1、2、3、4个月及疗程结束时,两组患者痰茵转阴率、胸部X线病灶吸收有效率比较,差异均无统计学意义(P＞0.05).与对照组比较,观察组总不良反应发生率较低,差异有统计学意义(P＜0.05);但每种不良反应发生率比较,两组差异均无统计学意义(均P ＞0.05).结论 治疗初始肺结核采用M替代H的超短程化疗方案(4MRZE),与传统化疗方案(2HRZE/4HR)的疗效差异不明显,同时可降低不良反应发生率.
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