Hussein A
Abteilung für pädiatrische Pneumologie, Zentrum für Kinderheilkunde und Humangenetik, Medizinische Hochschule, Hannover.
Pneumologie. 1990 Jan;44(1):24-31.
The effectiveness of short-term drug treatment of tuberculosis is based on the use of INH, RMP and PZA (with or without SM or EMB), that have a pronounced bactericidal and sterilizing effect in all tissues and on all populations of mycobacteria which, depending upon the oxygen content and acidity of their surroundings, multiply at different rates. Treatment regimens over 6 or 9 months have proved effective in numerous studies involving 1500 children with pulmonary or extra-pulmonary tuberculosis. The recommended treatment of choice comprises a 6-month regimen with INH, RMP and PZA, with or without EMB or SM, the drugs being administered daily for two months, followed by INH and RMP applied daily, or 2 to 3 times a week for 4 months. If resistance to INH and/or SM is suspected, initially four suitable drugs are required, and are effective. Nine months of treatment with INH and RMP (with PZA and/or EMB if resistance is suspected) administered daily for two months and followed by INH and RMP applied daily or 2 to 3 times a week, is also both effective and safe. Overall side effects were observed in fewer than two per cent of the cases, and were severe in fewer than one per cent. Recurrences occurred in fewer than one per cent of the cases. Complementary measures such as bronchological treatment in the case of bronchial invasion of lymph nodes, and surgical measures in tuberculosis of the bone, joints, body cavities, etc., are of decisive importance for the success of therapy.
结核病短期药物治疗的有效性基于使用异烟肼(INH)、利福平(RMP)和吡嗪酰胺(PZA)(可加或不加链霉素或乙胺丁醇),这些药物在所有组织中以及对所有结核菌群都有显著的杀菌和灭菌作用,结核杆菌根据其周围环境的含氧量和酸度以不同速率繁殖。在涉及1500名患有肺结核或肺外结核儿童的众多研究中,6个月或9个月以上的治疗方案已证明是有效的。推荐的首选治疗方案包括一个为期6个月的使用异烟肼、利福平、吡嗪酰胺的方案,可加或不加乙胺丁醇或链霉素,这些药物每日服用两个月,随后每日服用异烟肼和利福平,或每周服用2至3次,持续4个月。如果怀疑对异烟肼和/或链霉素耐药,最初需要四种合适的药物,且这些药物是有效的。使用异烟肼和利福平进行9个月的治疗(如果怀疑耐药则加用吡嗪酰胺和/或乙胺丁醇),每日服用两个月,随后每日或每周服用2至3次异烟肼和利福平,也是有效且安全的。总体副作用在不到2%的病例中出现,严重副作用在不到1%的病例中出现。复发在不到1%的病例中发生。对于治疗的成功,诸如在淋巴结支气管侵犯情况下的支气管治疗以及在骨、关节、体腔等结核病中的手术措施等辅助措施具有决定性意义。