利湿化浊方对DOTS化疗方案强化期肺结核患者肝毒性的影响

Effect of Lishi huazhuo Recipe on Hepatotoxicity in Pulmonary Tuberculosis Patients with DOTS Chemotherapy Regimen Intensive Phase

目的:观察利湿化浊方对现代结核病控制策略(directly-observed treatment strategy,DOTS)化疗方案强化期肺结核患者肝毒性的影响。方法:86例初治活动性肺结核、复治涂阳肺结核强化期患者,按入选标准肝功能异常出现顺序分为观察组与对照组各43例。两组均给予常规DOTS化疗方案和一般支持疗法,同时观察组给予利湿化浊方,每日1剂;对照组给予硫普罗宁针、复方甘草酸胺、门冬酸钾镁针静脉滴注,每日1次。两组疗程均为15 d。结果:观察组有效率为95.3%,对照组有效率为88.4%,观察组疗效显著优于对照组(P<0.01)。两组均可明显改善患者各主要症状、次要症状积分;治疗后,除身目发黄症状外,观察组其余主要症状、次要症状的改善均显著优于对照组(P<0.05或P<0.01)。两组均可显著降低异常肝功能指标;观察组治疗后与对照组比较,差异无统计学意义(P>0.05)。结论:利湿化浊方对DOTS化疗方案强化期肺结核患者出现的肝毒性相关中焦脏腑合病病证有较好治疗作用,且对肝脏减毒、保肝作用明显。文献引用:于首元,王静,张信鸽,等.利湿化浊方对DOTS化疗方案强化期肺结核患者肝毒性的影响[J].中医学报,2018,33(2):214-217.

Objective：To observe the effect of Lishi Huazhuo recipe on hepatotoxicity in pulmonary tuberculosis patients with directly-observed treatment strategy（DOTS） chemotherapy regimen intensive phase.Methods：86 cases of primary active pulmonary tuberculosis and retreated smear positive pulmonary tuberculosis patients were divided into groups according to the appearance order of abnormal liver function.43 cases in the observation group and 43 cases in the control group.Both groups were given conventional DOTS strategy chemotherapy regimen and general support therapy.The control group was given tiopronin,compound glycyrrhizin and potassium magnesium aspartate intravenously once a day for 15 days.Results：The effective rate of observation group was 95.3% and that of the control group was 88.4%（P0.01）.Both groups were able to significantly improve the scores of major symptoms and secondary symptoms.After treatment,the improvement of other major symptoms and secondary symptoms in the observation group was significantly better than that in the control group（P0.05 or P0.01）,except for the yellowing of the body and eyes.The abnormal liver function index was significantly decreased in both groups.There was no significant difference between the observation group and the control group after treatment（P0.05）.Conclusion：Lishi Huazhuo recipe has a good therapeutic effect on liver toxicity associated with middle Jiao and internal organs simultaneous syndrome in pulmonary tuberculosis patients with DOTS chemotherapy regimen,and obvious effect on liver detoxification and liver protection.