传染病信息

抗结核化疗药物临床应用中易诱发胃肠功能紊乱及肠道菌群失调，影响患者治疗依从性。本文选取5例初治涂阴肺结核患者，患者均接受标准HRZE抗结核化疗，治疗期间出现胃肠功能紊乱（腹泻、便秘、腹胀、食欲不振等），粪便检测提示肠道菌群失调（双歧杆菌/肠杆菌科比值<0.1）。所有患者在维持原有抗结核化疗方案不变的前提下，基于中医辨证分型（脾虚湿蕴、脾肾阳虚、阴虚肠燥、肝郁脾虚、气虚血瘀），施行个体化针灸治疗，主穴取足三里、天枢等，随证配穴并施以补泻、温针灸、电针等方法，疗程4周。治疗过程中，患者胃肠道症状显著改善，双歧杆菌/肠杆菌科比值明显回升。治疗全程无不良事件发生。提示辨证针灸能有效缓解抗结核药物所致胃肠功能紊乱，可促进微生态平衡恢复，安全性好。

The administration of anti-tuberculosis drugs frequently induces gastrointestinal dysfunction, impacting treatment adherence. This study presents five cases of newly diagnosed, smear-negative pulmonary tuberculosis patients. During standard chemotherapy, all patients developed gastrointestinal dysfunction(e.g., diarrhea, constipation, abdominal distension), and fecal analysis indicated intestinal dysbiosis(B/E ratio <0.1). While continuing chemotherapy, individualized acupuncture treatment was administered based on traditional Chinese medicine pattern differentiation(Spleen Deficiency with Dampness Accumulation, Spleen-Kidney Yang Deficiency, Yin Deficiency with Intestinal Dryness, Liver Depression and Spleen Deficiency, Qi Deficiency and Blood Stasis). Primary acupoints, including Zusanli(ST36) and Tianshu(ST25), were selected and supplemented with pattern-specific adjunct points. Manipulation techniques, such as reinforcing and reducing methods, warm needle moxibustion, and electroacupuncture, were applied accordingly. Following a 4-week treatment course, all patients demonstrated significant improvement in gastrointestinal symptoms and a notable increase in the B/E ratio. These findings indicate that pattern-differentiated acupuncture can effectively alleviate drug-induced gastrointestinal dysfunction, restore microecological balance, and has a favorable safety profile.