Analyze the therapeutic effect of bedaquiline combined with enteral nutrition support on multi-drug-resistant pulmonary tuberculosis (MDR-PTB).

The clinical data of 57 MDR-PTB patients admitted to our hospital were collected and divided into an observation group with 26 cases and a control group with 31 cases according to the treatment methods. Patients in the control group received conventional anti-tuberculosis treatment (levofloxacin, linezolid, clofazimine, cycloserine, and pyrazinamide) combined with enteral nutrition support (oral enteral nutrition powder 500~1 000 ml/d, with appropriate supplementary homogenate meals such as milk and vegetable puree, for 24 consecutive weeks). Patients in the observation group, on the basis of the control group′s regimen, took bedaquiline fumarate tablets orally, with an initial dose of 400 mg/d for 2 consecutive weeks, then reduced to 200 mg per dose, 3 times a week, for 22 consecutive weeks. The clinical efficacy, sputum smear conversion of Mycobacterium tuberculosis, serum immune function indexes [immunoglobulin (Ig) A, IgG, IgM, the ratio of CD4⁺ /CD8⁺ T lymphocytes], pulmonary function indexes [forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), percentage of FEV₁ to predicted value (FEV₁%)], computed tomography (CT) signs [thick-walled cavity, calcification shadow, pulmonary consolidation and pleural thickening], nutritional status [hemoglobin (Hb), total lymphocyte count (TLC), albumin (ALB) level and Short Form 36 Health Survey Questionnaire (SF-36) score] and the occurrence of adverse reactions were compared between the two groups.

The clinical efficacy of the observation group was 23 cases (88.46%), which was higher than 19 cases (61.29%) in the control group. The sputum smear negative conversion rate, sputum culture negative conversion rate, IgA, IgG, IgM, the CD4⁺ /CD8⁺ ratio, PEF, FEV₁, FEV₁%, TLC, Hb, ALB levels and SF-36 scores of the observation group were (84.62%), (80.77%), (3.91±0.82) g/L, (20.18±3.97) g/L, (2.57±0.34) g/L, (1.41±0.16), (6.91±1.23) L/s, (1.41±0.22) L, (80.83±9.58)%, (1.94±0.47)×10⁹/L, (117.52±19.68) g/L, (40.14±8.75) g/L, (78.15±12.29) points respectively, all of which were higher than those of the control group [(67.74%), (61.29%), (3.32±0.79) g/L, (17.94±2.68) g/L, (2.31±0.48) g/L, (1.29±0.14), (6.28±1.07) L/s, (1.28±0.19) L, (75.19±9.64)%, (1.68±0.42)×10⁹/L, (105.73±21.56) g/L, (35.29±7.63) g/L, (71.03±13.48) points]. The incidences of thick-walled cavity, calcification shadow, pulmonary consolidation and pleural thickening in the observation group were 23.08%, 15.38%, 11.54%, 15.38% respectively, which were lower than those in the control group 48.39%, 45.16%, 38.71%, 41.94%, (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Bedaquiline combined with enteral nutrition support therapy has an obvious efficacy in the treatment of MDR-PTB, which can improve the nutritional status of patients, regulate the immune function, promote the recovery of the pulmonary structure and function of patients, and the safety feature is of significant importance.