Analysis Of Dietary And Clinical Therapeutic Efficacy Of Short Term In Pulmonary Tuberculosis Patients With Diabetes Mellitus

Objective The pulmonary tuberculosis patients with diabetes mellitus (PTB-DM) is different from the pulmonary tuberculosis (PTB) patients in nutritional status and clinical treatment. The objective was to study the characteristics of dietary structure and find out the clinical characteristics of the PTB-DM and provide the diet guidance and the reference basis for their clinical treatment.Methods188inpatients with pulmonary tuberculosis complicated with diabetes mellitus in a Chest Hospital from December2011to June2013were recruited as objects in the study. And188pulmonary tuberculosis inpatients without diabetes mellitus in the same period were selected as the control group. Between the two groups, analyzed and compared the dietary characteristics and the treatment effectiveness in short-term of two months.Results The dietary survey showed that DDS of the two groups are all higher than3. There was no significant statistic difference between the two groups (P>0.05). It was showed that the consumption of vegetables, meat and milk in PTB-DM patients were471.45g,103.76g and126.78g, which were obviously higher than414.75g,89.92g and87.83g in PTB group (P>0.05). The intakes of meat in both two groups were higher than the suggested value (50g-70g) in Dietary Guideline and Balance Diet Pagoda for Chinese Residents. The analyses of Body Mass Index showed that the underweight people is18.62%of PTB group which is higher than10.64%of PTB-DM.(χ2=4.792, P＜0.05). Overweight people had a29.26percentage of PTB-DM group which is higher than10.64%of PTB.(P<0.05).The analyses of nutrition status showed that TC and TG in PTB-DM group were4.39mmol/L and1.67mmol/L which is higher than3.97mmol/L and1.01mmol/L in PTB group (all P<0.05).The incidences of hyperlipidaemia, hypercholesterolemia and hypertension in PTB-DM group were23.4%,19.7%and31.7%respectively, which were all higher than5.9%,8.5%and19.1%in PTB group with significant statistic differences (all P<0.05).The incidences of hemoptysis, positive sputum smear and pulmonary cavity in PTB-DM patients with admitted to hospitals for treatment before were32.5%,76.1%and56.4%, which were significantly higher than18.6%,68.6%and45.7%in the control group (all P＜0.05). After two months, the incidences of expectoration, improvement of chest tightness and sputum smear negative conversion in PTB-DM patients were20.9%,56.3%and52.4%, which were significantly lower than36.8%,74.1%and69.8%(all P＜0.05). The lung lesion in PTB-DM patients were extensive, the number of involved lobe and the incidence of lower lung field tuberculosis were higher than the PTB group (all P<0.05).Conclusion Compared with PTB group, the dietary structure in PTB-DM patients was irrational. Under the circumstances that malnutrition is common; part of the overweight people had an overnutrition problem. The PTB-DM patients’ clinical manifestation are more serious and have less effect after2months intensive treatment. So we should direct rational diet, adjust and enhance the treatment for the PTB-DM patients and extend the treatment time suitably.