不同时间应用保肝药拮抗结核药肝损害的临床研究

The clinical study of liver - protective drugs before, during, or after chemotherapy on antagonisting live lesion induced by antituberculosis drugs

目的观察化疗前后应用保肝药拮抗结核药肝损害的效果，寻找有效的预防方法。方法360例初治涂阳肺结核患者分为三组，均采用“2HRZS／4HR”方案抗结核化疗。其中实验组120例，化疗前先用保肝药1～3d，继之与化疗药同服至强化期停药；治疗组150例，化疗药、保肝药同时启用，至疗程结束；对照组90例，直接化疗，出现肝功能异常后给予保肝药，至肝功能恢复正常时停止。结果实验组，治疗组药物性肝损害发生率分别为5．8％和6．7％；中断化疗比例各为2．5％，2．7％；调整化疗方案为1．7％和2％；与对照组的16.7％，10.0％及7．8％比较，差异均有统计学意义（P〈0.05）。结论化疗前或同时应用保肝药，能显著提高抗结核药肝损害的能力。可避免不必要的停药，提高化疗成功率。两种用法简便易行、安全可靠、经济实用，应常规使用。

Objective To observe the curtive effect of liver - protective drugs chemotherapy, and find out the effective preventive methods. Methods Three hundred and sixty positive initial treated pulmonary tuberculosis were randomly divided into three group,study group（ n = 150） ,control group （ n =90） and test group （ n = 120） ,which were treated by chemotherapy regimen of 2HRZS/4HR. In study group,these patients took antituberculosis drugs and liverprotective drugs in the whole course;Test group patients began to take liverprotective drugs 1 - 3 days before chemotherapy until 3 months of taking antituberculosis drugs; In control group, these patients only took chemotherapy, and began to take liverprotective drugs when liver lesion occurred. Results In study group and test group, the incidence rate of liver lesion was 6.7% and 5.8% ; in control group, incidence rate of liver lesion was 16.7%. There were very significant differences between them. Conclusion Patients should take liver - protective drugs,before chemotherapy or while which could enhance the effect of antagonisting liver lesion induced by antituberculosis drugs and increase the successful rate of chemotherapy. The two methods are simple, safe and effective.