复方甘草酸苷片联合2HRZE/4HR化疗方案对肺结核患者肝损伤的影响

Effect of Compound Glycyrrhizin Tablets Combined with 2HRZE/4HR Chemotherapy Regimen on Liver Injury in Patients with Pulmonary Tuberculosis

目的 探讨复方甘草酸苷片联合2HRZE/4HR化疗方案对肺结核患者肝损伤的影响。方法 选取2016年1月至2020年12月新疆生产建设兵团第十三师红星医院收治的90例肺结核患者作为研究对象,用抽签法随机分为观察组与对照组,各45例。对照组采用2HRZE/4HR化疗方案进行治疗,观察组在采用2HRZE/4HR化疗方案进行抗结核治疗基础上口服复方甘草酸苷片,2~3片/次,3次/d。观察两组治疗药物性肝损伤的有效率;比较两组白蛋白(ALB)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)、天冬氨酸转氨酶(AST)变化;并记录两组药物不良反应发生情况。结果 观察组治疗药物性肝损伤的有效率为95.55%(43/45),明显高于对照组的71.11%(32/45)(P<0.05);治疗1个月、3个月、6个月后,两组患者血清ALT、TBIL、AST水平明显降低(P<0.05),观察组更低(P<0.05),两组患者ALB水平明显升高(P<0.05),且观察组更高(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05)。结论 复方甘草酸苷片联合2HRZE/4HR化疗方案对肺结核患者肝损伤具有显著疗效,能明显改善肝功能,减少药物不良反应。

Objective To explore the effects of compound glycyrrhizin tablets combined with 2HRZE/4HR chemotherapy on liver injury in patients with pulmonary tuberculosis. Methods 90 patients with pulmonary tuberculosis admitted to the Red Star Hospital of the 13th Division of Xinjiang Production and Construction Corps from January 2016 to December 2020 were selected as the research objects, and randomly divided into the observation group and the control group with 45 patients each by lot drawing.The control group was treated with 2HRZE/4HR chemotherapy scheme, and the observation group was treated with compound glycyrrhizin tablets, 2~3 tablets/time, 3 times/day, on the basis of anti tuberculosis treatment with 2HRZE/4HR chemotherapy scheme. The effective rate of the two groups in treating drug-induced liver injury was observed;The changes of albumin(ALB),alanine aminotransferase(ALT), total bilirubin(TBIL) and aspartate aminotransferase(AST) were compared between the two groups;The adverse drug reactions of the two groups were recorded. Results The effective rate of the observation group was 95.55%(43/45), which was significantly higher than that of the control group 71.11%(32/45)(P<0.05);After one month, three months and six months of treatment, the levels of serum ALT, TBIL and AST in the two groups were significantly lower(P<0.05),the levels in the observation group were lower(P<0.05), the levels of ALB in the two groups were significantly higher(P<0.05),and the levels in the observation group were higher(P<0.05);The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05). Conclusion Compound glycyrrhizin tablet combined with 2HRZE/4HR chemotherapy has a significant effect on pulmonary tuberculosis patients with liver injury, can significantly improve liver function,reduce adverse drug reactions.