Therapeutic measures: mainly chemotherapy, commonly used drugs are isoniazid, rifampin, streptomycin, pyrazinyl hi, ethambutol and aminothiourea.
The application of chemotherapy should follow the following five principles.
① Early. Administer the drug as soon as the diagnosis is confirmed.
② Combination. Combine two or more anti-tuberculosis drugs to ensure efficacy and prevent drug resistance and reduce toxic side effects.
(3) Appropriate dosage.
④Regulation. Do not miss or interrupt.
⑤ The whole course. At present, China mainly adopts short-term intensive treatment, which is supervised by doctors throughout the course of treatment, and the duration of treatment is generally 6-8 months.
Anti-tuberculosis chemotherapy plays a decisive role in the control of tuberculosis, and reasonable chemotherapy can make all lesions sterilized and cured. Traditional rest and nutrition play a supportive role.
Criteria for diagnosis and staging of disease
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis and can involve many organs of the body; however, pulmonarytuberculosis is the most common. Patients with tuberculosis are the source of social transmission. The disease does not necessarily develop after infection with M. tuberculosis, but only when resistance is low. The pathology of the disease is characterized by tuberculosis nodules and caseous necrosis, with easy formation of cavities. Except for a few cases with acute onset, the clinical course is mostly chronic. There are often systemic symptoms such as low-grade fever, malaise and respiratory manifestations such as cough and hemoptysis. Since the 1950s, the overall epidemic of tuberculosis in China has decreased, but due to the large population and uneven control of the epidemic in various regions, it is still an important public health problem and one of the top ten causes of death in the country, which should cause us serious concern.
Diagnostic points.
I. Weakness, weight loss, fever, night sweats.
Second, coughing sputum, X-ray chest film shows infiltrative changes in the lungs.
III. Positive tuberculin test.
IV. Sputum smear with positive antacid staining.
Sputum culture is positive for Mycobacterium tuberculosis.
Diagnostic criteria (formulated by the National Conference on Tuberculosis Control, Liuzhou, June 1978)
Five principles for the treatment of tuberculosis.
There are clinical differences between primary and secondary treatment, patients with and without bacillary excretion, and TB bacilli in the reproductive growth phase and the dormant quiescent phase. There are anti-TB drugs that act on the acidic environment and the acidic intracellular environment, and drugs that act on the alkaline or neutral environment outside the bacteria. A reasonable and regular chemotherapy regimen must have two or more bactericidal drugs, a reasonable dose, a scientific method of administration, a sufficient course of treatment, and also regular and early administration of drugs to cure. The lack of which can lead to treatment failure.
First, early: early diagnosis and early treatment are emphasized for any disease, especially for must be early diagnosis, early treatment, early treatment to avoid tissue destruction, resulting in repair difficulties, early, inflammatory cell infiltration and fibrin exudation in the alveoli, alveolar structure still remains intact, reversible large. At the same time, bacterial reproduction is vigorous, phagocytes are active in the body, and anti-TB drugs are most effective in inhibiting and killing the metabolically active growth and reproduction of the exuberant bacteria. Early treatment can facilitate the absorption and dissipation of lesions without leaving traces. If not timely treatment of minor diseases dragged into a major disease, major diseases lead to no cure, a harm to themselves, two harm to others around.
Second, the combination: whether the initial treatment or re-treatment of patients are to be combined with drugs, clinical treatment failure is often caused by a single drug difficult to treat patients. Combination of drugs must be combined with two or more kinds of drug therapy, so as to avoid or delay the emergence of drug resistance, but also to improve the bactericidal effect. There are both intracellular and extracellular bactericidal drugs, and there are bactericidal drugs suitable for the acidic environment, so that the chemotherapy program to achieve the best efficacy. And can shorten the course of treatment, reducing unnecessary economic waste.
Third, the right amount: drugs for any disease treatment must have an appropriate dose. Almost all anti-tuberculosis drugs have toxic effects, such as too large a dose, the drug concentration in the blood is too high, the digestive system, nervous system, urinary system, especially the liver and lungs can produce toxic reactions, insufficient dose, the blood concentration is too low to achieve the purpose of folding bacteria, sterilization, easy to produce drug resistance. So must use the appropriate dose of drugs, under the guidance of a specialist.
Fourth, regular: must be under the guidance of a specialist in the regular use of drugs, because the tubercle bacillus is a long division cycle, slow growth and reproduction of the stubborn bacteria difficult to kill. In treatment, it must be used regularly. If the drug is not used properly, the symptoms will be relieved and stopped, which will surely lead to the occurrence of drug resistance and treatment failure. Later treatment is more difficult, the regular use of drugs must be meticulous, a meal is not missed, must not be self-righteous.
Fifth, the whole process: the so-called full course of medication is the doctor according to the patient’s condition to determine the chemotherapy program, the time required to complete the chemotherapy program, a course of three months. The full course of treatment for a year or a year and a half. Shortening no less than six months or 10 months.
In order to treat thoroughly must follow the above five principles, early, combined, appropriate amount, regular, the whole process, in order to ensure that the detection must be treated, treatment must be complete.