リンパ節結核に対するRifampicinの治療効果に関する研究

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The therapeutic effects of Rifampicin (RFP) for tuberculous lymphadenitis were observed.<BR>The patients subjected to this study were 29 cases who were diagnosed as tuberculous lymphadenitis at seven hospitals and the background factors of these cases were as follows; as to sex distribution, female was 69% and male 31%; nearly half were in the age group 21 to 30, previously treated cases were 44.9%, all positive for tuberculin skin test, chest X-ray was normal in 37.9% and abnormal findings requiring treatment in 44.9%, and tubercle bacilli were positive on culture from sputum in 6 and from menses blood in 1. Six cases were examined for tubercle bacilli in affected nodes and three cases showed positive culture. Out of five cases whose lymphnodes was biopsied, 4 were confirmed to be tuberculous lymphadenitis. The location of affected lymphnodes was as follows; 26 in neck, 5 in axilla, 2 in supraclavicular fossa and 4 in hilum or mediastinum, the size of those nodes varied from 60mm to 9mm and the mode was from 10 to 19mm, and ten nodes had tenderness and three node reddness.<BR>RFP was administered every day in a dose of 450 mg and combined with INH-EB in 15 cases, NH in 7 cases, INH-VM in 2 cases, INH-PAS, INH-CS, KM-EB, INH-SM-EEB in each 1 case.<BR>When the number of the affected nodes were over two, only two lymph nodes with large size or the node showing most acute condition were observed. Observation was possible for over 6 months in 15 cases, for 5 months in 1, 4 months in 1, 3 months in 4, 2 months in 4, 1 month in 3 and one case dropped out at two weeks and the follow-up was impossible.<BR>Thirty seven affected lymph nodes could be observed over one month. Out of twenty nine lymph nodes with initial swelling type thirteen nodes showed marked regression within six months and sixteen disappeared within four months. Out of six lymph nodes with sclerotic type, four regressed markedly within three months and one unchanged at six months. One node with abscess was unchanged at one month, one with ulcer and fistula regressed markedly within three months. Accordingly 94.6% of 37 affected nodes were improved and only 5.4% were unchanged. Three lymph nodes were completely extirpated under the coverage of the regimens including RFP, and no complications were observed.<BR>It is concluded that the therapeutic effects of the regimens including RFP for tuberculous lymphadinitis are evaluated as excellent, as 44.9% of the cases were previously treated and 95% showed good response.
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