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短期療法을 包含하는 保健所 肺結核 初治療處方 比較試驗成績

Comparison of Initial Treatment Regimens Including Short Course Chemotherapy for Pulmonary Tuberculosis Under Programme Conditions

결핵및호흡기질환 1982년 29권 3호 p.117 ~ 138
홍영표, 장승칠, 김성진,
소속 상세정보
홍영표 ( Hong Young-Pyo ) - 대한결핵협회 결핵연구원
장승칠 ( Chang Sung-Chil ) - 대한결핵협회 결핵연구원
김성진 ( Kim Sung-Chin ) - 대한결핵협회 결핵연구원

Abstract


Under the programme conditions, 5 daily regimens of initial treatment for pulmonary tuberculosis patients at Health Centres were compared. They were allocated at random to: HPS: isoniazid (24 months) plus PAS (12 months) plus streptomycin (6 months) ; HES: isoniazid (24 months) plus ethambutol (12 months) plus streptomycin (6 months) ; HEM: isoniazid (24 months) plus ethambutol (12 months) plus morphazinamide (6 months) ; 9HER: isoniazid plus ethamtutol and rifampicin (9 months) ; and 6HER: isoniazid plus ethambutol and rifampicin (6 months) In all, 1,339 patients were admitted to the trials; 145(11%) were subsequently excluded due to various pretreatment reasons, leaving 1,194(89%) for analysis. There were 233 HPS, 237 HES, 231 HEM, 220 9HER, and 273 6HER. The background factors were remarkably similar for each regimen. Of 1,194 Patients for the main analysis, 260(22%) had terminated their treatment prematurely either before one year of treatment with HPS, HES, and HEM, or before the termination of short course chemotherapy. As assessed at 12 month, a bacteriologically favourable response was achieved in 96 (77%) of 124 HPS, 134(83%) of 162 HES, and 134(81%) of 165 HEM. In short course chemotherapy, a favourable response was achieved in 164(94%) of 172 9HER and 222(94%) of 236 6HER at the time of termination. Bacteriological relapse rates calculated by Life Table Method, in the second pear of treatment was 3% in HPS, 16% in HES, and 10% in HEM. And the relapse rates after the termination of short course regimens were 3% in 9HER and 14% in 6HER respectively. The therapeutic efficiency was best in 9HER, in regard to bacteriological response, relapse rate, adverse reaction and drop out rate.

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