The Efficacy And Safety Studies Of Glucocorticoid Combined With Conventional Anti-tuberculosis Drugs In The Treatment Of Tuberculous Meningitis

Objective:The purpose of this study was to evaluate the efficacy and safety of glucocorticoids in the treatment of tuberculous meningitis.Method:80 patients with tuberculous meningitis admitted to the Department of Neurology and Infectious Diseases of NanChong Central Hospital and Affiliated Hospital of North Sichuan Medical University from October 2018 to March 2021 were randomly divided into two groups according to random number table,namely control group and observation group,with 40 cases in each group.The control group was treated with conventional 4HREZ/8HR treatment regimen,and the observation group was given glucocorticoid treatment for 3 months in addition to the treatment of the control group.Data of glucose,protein and chloride content in cerebrospinal fluid,liver functionand kidney function and blood routine,mental state and head MRI images were analyzed before treatment,3 weeks after treatment and 3 months after treatment.T test was used for numerical variables between groups,X2 test was used for classification variables.Recovery,improvement,inefficacy and complications were analyzed respectively between the two groups.Results:According to the inclusion and exclusion criteria of this study design,the clinical data of 80 patients were analyzed.It was found that there was no statistical difference in the composition of basic datas between the two groups at admission(there was no statistical difference in the composition ratio of age,gender,weight,tuberculosis and other underlying diseases between the two groups).After comprehensive anti-tuberculosis treatment,the total effective rate of the observation group was 92.5%,which was significantly higher than that of the control group(75%)(P<0.05).Then the two groups of patients were respectively treated for 3 weeks and 3 months.The statistic analysises of the clinical manifestations in the same period and cerebrospinal fluid were tested.We found that the improvement of the indexes of white blood cell count,the protein level,the glucose level,and the chloridein the observation groupwere more obvious.And the observation group needed shorter timefor clinical symptoms(observation group took an average of 188.25 hours,while the control group needed 262.16 hours).Moreover,the difference between the two groups was statistically significant(P<0.05).In terms of the overall incidence of adverse reactions,5-6 cases of complications occurred in both groups,and there was no statistical difference in the overall incidence of complications between groups(12.5%complication rate in the observation group V.S 15%complication rate in the control group)(P>0.05).Conclusion:Glucocorticoid combined with conventional antituberculosis drugs could further improve the cure rate of tuberculous meningitis,and there was significant statistical difference between the observation group and the control group(P<0.05).Moreover,the use of glucocorticoids did not increase the incidence of adverse reactions,and could be safely used in clinical practice(P<0.05).