OBSERVATION ON THE EFFICACY OF GLUCOCORTICOID COMBINED WITH SHREZ/6HR IN THE TREATMENT OF PATIENTS WITH TUBERCULOUS MENINGITIS

Ruiqing Diao, Shujing Zhao, Qingzheng Jiao, Dongwei Diao, Chunyang Han, Yan Xu^* 

Department of Neurology, Gucheng County Hospital of Hebei Province, Hengshui 253800, PR China

Objective: To investigate the effect of glucocorticoids combined with SHREZ/6HR on patients with tuberculous meningitis. 

Methods: Sixty-eight patients with tuberculous meningitis – admitted into our hospital from April 2016 to April 2019 – were selected as research subjects and randomly divided into a combined group (34 cases) and a control group (34 cases). Patients in the control group were treated using the traditional SHREZ/6HR regimen, and patients in the combination group were treated with glucocorticoids based on the patients in the control group. After 6 months of treatment, the clinical efficacy, adverse reactions, and cerebrospinal fluid indicators of the two groups were compared. 

Results: The results showed that the number of significant and effective cases in the combined group was more than that in the control group, and the total effective rate of clinical efficacy was 97.06%, which was higher than 82.35% in the control group; this difference was statistically significant (P<0.05). When comparing the adverse reactions (diarrhoea, joint pain, impaired liver function, and gastrointestinal bleeding) between the two groups of patients, no statistically significant difference was found (P>0.05). Before treatment, there was no significant difference in the levels of glucose, chlorides, WBC, and Pro in the cerebrospinal fluid indexes of the two groups of patients (P>0.05). After treatment, the levels of glucose and chlorides in the cerebrospinal fluid index of the two groups of patients were higher than those before treatment, while the contents of WBC and Pro were lower than those before treatment. The difference was statistically significant (P<0.05). The chloride contents were (2.89±0.27) mmol/L and (134.76±5.73) mmol/L, which were higher than those in the control group, (2.26±0.30) mmol/L and (115.35±4.47) mmol/L. WBC and Pro content was (11.70±1.07) × 109/L and (0.36±0.31) g/L, respectively, which was lower than that in the control group, (26.44±2.78) × 109/L and (1.01±0.26) g/L; the difference was statistically significant (P<0.05). 

Conclusion: A glucocorticoids combined with SHREZ/6HR regimen is effective in treating patients with tuberculous meningitis, and has few adverse reactions. It can clearly improve the cerebrospinal fluid index and promote the rehabilitation of patients. It has potential in clinical applications.