水飞蓟宾防治抗结核药物致肝损害的临床分析

目的 观察水飞蓟宾治疗抗结核药物肝损害的临床疗效.方法 （1）预防治疗比较：选择住院及经门诊确诊为活动性肺结核180例患者,随机将其分为预防组与未预防组,每组各90例,未预防组只进行抗结核治疗,预防组在抗痨基础上加服水飞蓟宾;（2）治疗药物性肝损害疗效比较：选择住院及门诊确诊为出现药物性肝损害的120例抗结核治疗患者,随机将其分成治疗组与对照组,每组各60例,治疗组口服水飞蓟宾,对照组行常规治疗.结果 （1）预防治疗比较：预防组丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、血清总胆红素（TBIL）明显低于未预防组,有显著性差异（P＜0.05）.（2）治疗药物性肝损害疗效比较：治疗组ALT、AST和TBIL复常时间明显短于对照组,治疗组总有效率（93.3％）明显高于对照组（60％）,有显著性差异（P＜0.05）.结论 水飞蓟宾对治疗抗结核药物性肝损害有较好疗效,降酶效果显著,毒副作用少且易于耐受,安全性良好,值得临床推广应用.

Clinical Efficacy of Silymarin in the Treatment of Hepatic Lesion of Antituberculotic Drug

Objective To observe the effect of sylimarin in the treatment of hepatic lesion of antituberculotic drug. Methods （ 1 ） In preventive treatment comparison, selecting 180 inpatients and outpatients with active pulmonary tuberculosis, and randomly dividing them into prevention group and non - prevention group, with 90 eases in each group. Non - prevention group only had anti - tuberculosis treatment, and prevention group also had sylimarin on the basis of antituberculosis treatment. （2）In curative effect comparison, selecting 120 inpatients and outpatients with drug - induced liver injury, and randomly dividing them into the treatment group and the control group with 60 cases in each group. The treatment group was treated with silymarin, and the control group received conventional treatment. Results In prevention treatment comparison, ALT, AST and TBIL was significantly lower in prevention group than in the non -prevention group, with statistically significant difference （ P 〈 0.05 ）. （ 2 ） In the treatment of drug - induced liver injury comparison, ALT, AST and TBIL was significantly shorter in the treatment group than in the control group. The total efficiency in the treatment group （93.3%）was significantly higher than in the control group（60% ） , with significant difference （ P 〈 0.05）. Conclusion Silymarin on TB prevention and treatment of druginduced liver injury has good effect, particularly has significant effect on reducing enzyme activity with little side effect and good tolerance, and good security, and it is worth clinical application.