RFPを含む3方式による肺結核6ヵ月化療の対照試験 (第2報) : 治療終了後1年目の成績

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This is an one year follow up study of the cases after completing the 6 months chemothe rapy reported in our 1st report. The patients were all smear positive with cavity less than 4 cm in diameter or without cavity, and previously untreated or had been treated for less than 15 days. They were treated with 3 regimens of chemotherapy containing RFP and other companion drugs at the National Nakano Chest Hospital. A total of 113 cases were allocated to this study but 10 cases were excluded due to the reasons mentioned below. 1) atypical mycobacteria…3 cases, 2) RFP could not be used for longer than 18 days because of side effects…3 cases, 3) death by stomach surgery on the 50th day of chemotherapy…1 case, and 4) retreated elsewhere for 1-3 months after completing the 6 months chemotherapy only due to worry on relapse, although their sputum had been culture negative and without any signs of relapse by that time.3 cases. The remaining 103 cases were subjected to the follow-up study. One case could not be followed up and 5 cases were followed up only for 1, 4, 7, 8, 10 months after completing 6 months chemotherapy with negative culture until then. Frequency of sputum examinations of the remaining 97 cases was shown in Table 1. Three cases relapsed out of 97 cases (Table 2), 2 cases within 6 month and one 9 month after finishing the chemotherapy. In addition one colony of atypical mycobacterium (Runyon Group IV) was found from RHZS group 2 month after completing the chemotherapy, but this case was not retreated and remained negative so far. Relapsed cases were analysed in relation to the factors before (Table 3) and after treatment (Table 4). But the number was too few to draw any conclusion about the causes of relapse. The bacilli isolated from these relapsed cases were all sensitive to the used drugs just as before the treatment. Among 3 relapsed cases, 2 were retreated with drugs containing RFP as in-patient and within 2 and 4 months became negative, but the other one who was retreated with RHE as out-patient has not converted until 4 months. As this case had taken the drugs too irregulerly, he was rehospitalized and soon thereafter his sputum converted to negative. X-ray improvement continued even after stopping 6 months chemotherapy and it suggests that tubercle bacilli in the lesion either died or stopped of the harmful effects to the surrounding tissue. The progress of X-ray improvement until 18 months from the start of chemotherapy was just the same for 6, 12, 18 months chemotherapy groups (Fig. 1). The same result was seen as to the cavity closure rate in the remaining cavity less than 3 cm in diameter at the end of 6 months chemotherapy. These 12, 18 months groups were the cases treated with RHE from May 1974 to December 1976 in our hospital.
日本結核病学会の論文

RFPを含む3方式による肺結核6ヵ月化療の対照試験 (第2報) : 治療終了後1年目の成績

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