一贯煎治疗抗结核药物性肝损害与还原型谷胱甘肽等效性随机平行对照研究

目的]观察一贯煎治疗抗结核药物性肝损害与还原型谷胱甘肽等效性。方法]使用随机平行对照方法,将118例住院患者按就诊先后顺序简单随机分为两组,常规抗结核,异烟肼0.3g/次,1次/d;利福平0.45g/次,1次/d;吡嗪酰胺0.5g/次,2次/d;乙胺丁醇0.75g/次,1次/d。对照组60例还原型谷胱甘肽1.2g/d。治疗组58例一贯煎(北沙参、麦冬、当归身、生地黄、甘杞子、香附、郁金),1剂/d,水煎200mL,早晚温服;大便秘结加栝蒌仁10g;腹胀,乏力加枳壳、陈皮各10g;食欲下降,恶心加茯苓、砂仁各10g。连续治疗4周为1疗程。观测临床症状、肝功能(谷草转氨酶-AST、血清丙氨酸氨基转移酶-ALT、总胆红素-TBIL)、不良反应。治疗1疗程,判定疗效。结果]治疗组痊愈4例,显效33例,有效19例,无效4例,总有效率93.33%。对照组痊愈6例,显效36例,有效13例,无效3例,总有效率94.83%。临床疗效两组无显著差异(P0.05)。两组肝功能均有改善(P0.05),TBIL改善治疗组优于对照组(P0.05),ALT、AST改善两组无明显差异(P0.05)。结论]一贯煎治疗抗结核药物性肝损害疗效显著,成本低廉,与还原型谷胱甘肽具有等效性,值得推广。

Yi Guanjian Treat Anti-tuberculosis Drug-induced Liver Equivalence Randomized Parallel Group Study

Objective ] To observe Yi Guanjian therapeutic efficacy of anti-TB drug-induced liver injury. Method ] random parallel control method, 118 cases of hospitalized patients were randomly divided into two treatment sequence is simple. Conventional anti-TB, isoniazid 0.3g / time, 1 time / d ; rifampicin 0.45g / second, 1 / d ; pyrazinamide 0.5g / time, 2 times / d ; ethambutol 0.75g / times, 1 times / d. A control group of 60 patients glutathione 1.2g / d. Treatment group 58 cases Yi Guanjian （ North Radix, Radix, Angelica body, REHMANNIAE, sweet wolfberries, sweet, turmeric ）, a / d, decoction 200mL, morning and evening, warm clothes. Constipation plus Gualou Ren 10g;bloating, fatigue plus Citrus aurantium, Citrus each 10g;loss of appetite, nausea plus Poria, Amomum 10g. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, liver function （ Aspartate aminotransferase-AST, serum alanine aminotransferase-ALT, total hilirubin-TBIL ）, adverse reactions. A course of treatment to determine efficacy. Results ] The cure four cases, 33 cases markedly effective in 19 cases, 4 cases, the total efficiency of 93.33%. The control group healed in 6 cases, 36 cases markedly effective in 13 cases, 3 cases, the total efficiency of 94.83%. There was no significant difference in clinical efficacy （ P〉 0.05 ） . Liver function was improved in both groups （ P 〈0.05 ）, TBIL improve the treatment group than the control group （ P 〈0.05 ）, ALT, AST There was no significant difference （ P〉 0.05 ） . Conclusion ] Yiguanjian therapeutic efficacy of anti-TB drng-induced liver significant, low cost, and reduced glutathione with equivalence, worthy of promotion.