护肝药对肺结核并药物性肝损伤的预防及疗效观察  

Prevention and curative effect of hepatoprotectants on pulmonary tuberculosis complicated with drug-induced liver injury

作　　者：李钊 黄宛香 莫耀素 李繁 Li Zhao;Huang Wanxiang;Mo Yaosu;Li Fan(Department of Infectious Diseases,Hezhou People’s Hospital,Hezhou 542899,Guangxi,China)

机构地区：[1]广西贺州市人民医院感染性疾病科,广西贺州542899

出　　处：《右江民族医学院学报》2022年第1期38-42,共5页Journal of Youjiang Medical University for Nationalities

基　　金：贺州市科学研究与技术开发计划项目(贺科转1908022)。

摘　　要：目的探讨护肝药物对肺结核并药物性肝损伤的预防及疗效。方法选取2019年4月—2020年11月本院收治的肺结核患者200例,予抗结核(标准方案)治疗,同时随机将其分为甘草酸二胺胶囊组(A组)、复方甘草酸苷片组(B组)、谷胱甘肽片组(C组)、无护肝药组(D组),比较各组出现药物性肝损伤的比例,评估护肝药物的预防效果,并对出现药物性肝损伤患者继续治疗及肝功能各项指标进行检测,对比3种护肝药物的治疗效果。结果A组、B组、C组药物性肝损伤发生率低于D组(P<0.05);A组、B组、C组药物性肝损伤发生率,差异无统计学意义(P>0.05)。而药物性肝损伤的治疗有效率A组>B组>C组,但差异无统计学意义(P>0.05);临床症状好转的时间比较:A组和B组>C组,差异有统计学意义(P<0.05)。3组治疗期间出现皮肤瘙痒、头痛、乏力、纳差等不良反应,差异均无统计学意义(P>0.05)。运用成本效果分析,A组有效率最高,成本最低最合理。结论护肝药物能降低肺结核药物性肝损伤发生比例,对药物性肝损伤有良好的疗效及安全性。Objective To explore the prevention and curative effect of hepatoprotectants on pulmonary tuberculosis complicated with drug-induced liver injury.Methods This study selected 200 patients with pulmonary tuberculosis,who received standard anti-tuberculosis treatment in our hospital from April 2019 to November 2020.Meanwhile,they were randomly divided into the group taking glycyrrhizin diamine capsule(group A),the group taking compound glycyrrhizin tablet(group B),the group taking glutathione tablet(group C)and the group taking no hepatoprotectants(group D).The proportions of patients with drug-induced liver injury in these four groups were compared.The research evaluated the preventive effect of hepatoprotectants and the effect of continuous treatment for the patients with drug-induced liver injury.Their liver function indexes were also detected and therapeutic effects of three kinds of hepatoprotectants were compared.Results Group A,group B and group C all had lower incidence of drug-induced liver injury than group D(P<0.05).There were not statistically significant differences in incidence of drug-induced liver injury among group A,group B and group C(P>0.05).Comparison in the effective rate of treating drug-induced liver injury indicated group A>group B>group C,but the differences were not statistically significant(P>0.05).Comparison of time for alleviating clinical symptoms indicated group A and group B>group C,and the difference was statistically significant(P<0.05).There was no significant difference in adverse reactions such as skin pruritus,headache,fatigue and anorexia among the three groups(P>0.05).Cost-effectiveness analysis showed that group A had the highest efficiency and the lowest cost.Conclusion Hepatoprotectants can reduce the incidence of drug-induced liver injury caused by pulmonary tuberculosis.They have good curative effect and safety in the treatment of drug-induced liver injury.

关 键 词：护肝药物 结核 肺 化学性与药物性肝损伤 

分 类 号：R521[医药卫生—内科学] R571[医药卫生—临床医学]