冬虫夏草制剂对抗结核药物致肝肾损伤的“减毒”作用及其机制

The"Attenuation"Actions and the Mechanism of Dongchong Xiacao Preparation on Liver and Kidney Injury of Antituberculosis Drugs

目的:探讨冬虫夏草制剂对抗结核药物致肝肾损伤的"减毒"作用及其机制。方法:将抗结核药物致肝肾损伤患者76例随机分为对照组与观察组各38例,对照组采用2HRZE/4HR方案治疗,观察组在此基础上口服冬虫夏草制剂,每次1.0 g,每日3次,治疗6个月后比较两组患者肝肾功能损伤发生率、外周血CD3^+、CD4^+、CD8^+、CD4^+/CD8^+及超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、还原型谷胱甘肽(reduced glutathione hormone,GSH)含量,并记录不良反应发生情况。结果:对照组肝功能损伤率为42.1%(16/38)、肾功能损伤率为34.2%(13/38),高于观察组的15.8%(16/38)、10.5%(4/38),差异有统计学意义(P<0.05)。治疗后对照组和观察组外周血CD3^+分别为(69.86±4.25)%、(73.06±4.35)%,CD4^+分别为(40.35±4.26)%、(43.57±4.68)%,CD4^+/CD8^+分别为(2.04±0.25)、(2.27±0.26),SOD分别为(92.35±19.68)U/m L、(108.52±17.24)U/m L,MDA分别为(4.67±1.58)noml/L、(3.36±1.24)noml/L,GSH分别为(6.24±1.25)μmol/L、(7.45±1.34)μmol/L,上述指标两组比较差异有统计学意义(P<0.05)。结论:冬虫夏草制剂辅助治疗对抗结核药物所致肝肾损伤的"减毒"作用可能与提高患者免疫功能,抗氧化作用相关,且患者耐受性好。

Objective:To investigate the"attenuation"effects and its mechanism of Dongchong Xiacao(cordyceps)preparations on liver and kidney injury of antituberculosis drugs.Methods:All 76 patients were randonly allocated to the control group and the observation group,38 cases each group,the control group adopted2 HRZE/4 HR scheme,and the observation group took Dongchong Xiacao preparations orally,1.0 g each time,three times each day,to compare the incidence of liver and kidney injury,the contents of GSH,MDA,SOD,CD3^+,CD4^+,CD8^+,CD4^+/CD8^+in peripheral blood six months after treating,and record the incidence of adverse reactions.Results:Liver injury rate and kidney injury rate of the control group were 42.1%(16/38)and 34.2%(13/38),higher than 15.8%(16/38)and 10.5%(4/38)of the observation group,and the difference had statistical meaning(P<0.05).After treating,the contents of CD3^+in peripheral blood of the control group and the observation group were(69.86±4.25)%and(73.06±4.35)%,the contents of CD4^+(40.35±4.26)%and(43.57±4.68)%,CD4^+/CD8^+(2.04±0.25)and(2.27±0.26),SOD(92.35±19.68)U/mL and(108.52±17.24)U/mL,MDA(4.67±1.58)noml/L and(3.36±1.24)noml/L,GSH(6.24±1.25)μmol/L and(7.45±1.34)μmol/L,and the difference had statistical meaning between both groups in the comparisons of the indexes above(P<0.05).Conclusion:Dongchong Xiacao preparations as adjunctive therapy against liver and kidney injury of antituberculosis drugs might be related to raising immunologic function and the effects of oxidative stress,and the patients show good tolerance.