Abstrakt

Clinical efficacy of astragalus injection combined with anti-tuberculosis drugs on children with pulmonary tuberculosis complicated with type II diabetes and its influence on serum levels of LEP and APN

Xueqing Zhang, Yan Zhang, Zongwen Sun, Liuxin Wang

Objective: To investigate the clinical efficacy of astragalus injection combined with antituberculosis drugs on children with pulmonary tuberculosis complicated with diabetes and its influence on serum levels of leptin (LEP) and adiponectin (APN).

Methods: 90 cases of children with newly diagnosed smear positive pulmonary tuberculosis complicated with type II diabetes treated in our hospital from February 2015 to February 2017 were selected as the research objects and randomly divided into control group and observation group through random number table method, with 45 cases in each group. All the children were given subcutaneous insulin injection to control blood sugar after admission. The control group was treated with anti-tuberculosis regimen of 2HREZ/4HR while the observation group was treated with astragalus injection on the basis of the control group. Blood glucose, serum levels of LEP and APN, and negative conversion rates of sputum bacteria were detected before and after treatment. The changes of lung lesions and cavities were evaluated by X-ray and CT. Safety was observed as well.

Results: Before treatment, there was no significant difference in the levels of FPG, HbA1c and 2hPG between two groups (P>0.05); After treatment, the levels of FPG, HbA1c and 2hPG were significantly lower than those before treatment in both groups (P<0.05), and the levels decreased more in observation group (P<0.05). After treatment, the serum level of LEP was significantly decreased (P<0.05) while the level of APN was significantly increased (P<0.05) in both groups. Compared with control group, the serum level of LEP was significantly lower (P<0.05) while the level of APN was significantly higher in observation group (P<0.05). After treatment, there were no changes in peripheral T lymphocyte subsets in control group (P>0.05), however, in observation group, the levels of CD3+, CD4+ and CD4+/CD8+ were significantly increased (P<0.05), and the level of CD8+ was significantly decreased (P<0.05). After treatment, the levels of the levels of CD3+, CD4+ and CD4+/CD8+ in observation group were significantly higher than those in control group (P<0.05), and the level of CD8+ was significantly lower than that in control group (P<0.05). At the end of 1 month, 3 months and 6 months after treatment, the sputum negative conversion rate of observation group was significantly higher than that of control group (P<0.05). At the end of 6 months after treatment, the changes of lung lesions and the changes of cavities were better in observation group than those in control group (P<0.05).

Conclusion: Astragalus injection combined with anti-tuberculosis drugs could effectively improve the blood glucose level and immune function, reduce the level of LEP, improve the level of APN, and promote the absorption of tuberculosis focus and sputum negative conversion in children with pulmonary tuberculosis complicated with type II diabetes.