甘草酸二铵肠溶胶囊预防抗结核药物所致肝损伤的临床观察

Clinical Observation of Diammonium Glycyrrhizinate Enteric-coated Capsule in Preventing Liver Injury Induced by Anti-tuberculosis Drugs

目的:观察甘草酸二铵肠溶胶囊在抗结核治疗过程中预防性保肝的临床疗效。方法:选取2013年3月至2014年12月大理大学第六附属医院收治的127例初治涂阳肺结核患者为研究对象,所有患者均接受规范化抗结核治疗,并根据随机数字表原则分为观察组和对照组,其中观察组患者抗结核治疗期间同时给予甘草酸二铵肠溶胶囊预防性保肝治疗,对照组治疗期间未接受保肝治疗。对比两组肝损害发生率、发生时间及肝损害的程度。结果:观察组共11例发生肝损害,发生率为18.0%;对照组共16例发生肝损害,发生率为26.7%,两组肝损害的发生率差异无统计学意义(P>0.05);观察组发生肝损害的平均时间为治疗2个月后,对照组发生肝损害的时间为半个月后,两组肝损害发生的时间比较差异有统计学意义(P<0.05);两组发生肝损害的程度比较,对照组ALT、AST、TbiL指标均高于观察组,比较差异无统计学意义(P>0.05)。结论:甘草酸二铵肠溶胶囊在抗结核治疗过程中预防性保肝可有效预防药物性肝损害的发生,但对于无基础性肝病患者,也无肝损害易感因素的人群,可以考虑不用保肝药治疗,综合考虑对患者有益。

Objective: To observe the clinical efficacy of diammonium glycyrrhizinate enteric-coated capsule on preventive liver protection during anti-tuberculosis treatment. Methods: A total of 127 patients with newly diagnosed smear-positive pulmonary tuberculosis admitted to the Sixth Affiliated Hospital of Dali University from March 2013 to December 2014 were enrolled. All patients received standardized anti-tuberculosis treatment and were divided into observation group and control group according to the principle of random number table. The patients in the observation group were given liver protection treatment with diammonium glycyrrhizinate enteric-coated capsule during anti-tuberculosis treatment,while the control group did not receive liver protection treatment during the treatment period. The incidence of liver damage, the time of occurrence, and the extent of liver damage were compared between the two groups. Results: In the observation group, 11 cases had liver damage, the incidence rate was 18.0%;in the control group,16 cases had liver damage, the incidence rate was 26.7%. There was no significant difference in the incidence of liver damage between the two groups(P>0.05). The average time of liver damage in the observation group occurred after 2 months of treatment, while that of the control group was half a month later, and the time of liver damage occurred in the two groups was statistically different(P<0.05).Compared the degree of liver damage between the two groups, the ALT, AST, and TbiL indexes of the control group were all higher than the observation group, and there was no statistical difference between the two groups(P>0.05). Conclusion: Diammonium glycyrrhizinate enteric-coated capsule can effectively prevent the occurrence of drug-induced liver damage during anti-tuberculosis treatment, but for patients without basic liver disease, and people without susceptibility to liver damage, we can consider taking no liver protection drugs for treatment. Comprehensive consideration is beneficial to patients.