初回治療肺結核患者に対する3種類の化学療法術式SM・INH・PAS,SM・INH・PAS・EB週2日およびSM・INH・PAS・EB毎日の治療効果の比較に関する研究
1971 年 46 巻 8 号 p. 325-333
詳細
1971 年 46 巻 8 号 p. 325-333
Tuberculosis Research Committee (Ryoken) investigated comparatively the therapeutic effects of three regimens, i. e., standard triple treatment with SM⋅INH⋅PAS (EB0 group), standard triple treatment plus EB twice weekly (EB2 group) and standard triple treatment plus EB daily (EB7 group), in order to intensify the initial treatment for pulmonary tuberculosis.
The cases with positive tubercle bacilli and cavities were subjected to this study and were allocated at random for three regimens.
The total number of the c a ses was 272 at the beginning of the treatment, but 48 cases were excluded from the analysis because of the primary drug resistance, etc. Finally, 74cases of EB0 group, 74 cases of EB2 group and 76 cases of EB7 group were analyzed.
SM was injected 1 g a day twice weekly, INH was given O.4 g daily in two divided doses, PAS was administered 10 g daily in three divided doses, and EB was given 750 mg daily or twice weekly at the same day when SM was injected.
The background factors of the cases in ea c h group were almost similar, but the cases with abundant bacilli on smear and (_??_) by culture were observed somewhat less frequently in EB2 group than in the other two groups.
As to the rates of the radiological improvement and the sputum conversion rate, there was no significant difference among three groups. However, the moderate improvement of the fibrocaseous lesions and cavities were recognized sooner in EB2 and EB7 groups than in EB0 group.
The number of cases, in which the regimens were changed because of side effects or ineffectiveness, were 8 cases in EB0, group, 9 cases in EB2 group and 5 cases in EB7 group. The number of cases with positive sputum by smear or culture after 12 month's treatments were 3 in EB0 group, none in EB2 group and 1 in EB7 group. Therefore, the rate of these unsuccesful cases in EB0, group, EB2 group and EB7 group was 16.7%, 13.6% and 8.3%, respectively.
In order to prove the difference in the effectiveness among three regimens, the follow up-studies for longer period might be required.
