基于倾向匹配回顾不同预防护肝药物对抗结核期肝功能的影响

Review the effects of different preventive liver protective drugs on liver function during anti-tuberculosis stage based on propensity matching method

目的探讨水飞蓟宾胶囊、甘草酸二铵胶囊预防性护肝对初治肺结核患者抗结核治疗期肝功能的影响。方法选取2018年1月至2020年12月就诊于浙江中医药大学附属丽水中医院结核科的初治肺结核患者234例进行回顾性分析,按照使用护肝药的不同分为水飞蓟宾胶囊组(水飞组,n=120)和甘草酸二铵胶囊组(甘草酸组,n=114)。采用倾向匹配法筛选临床基线资料,最终两组入组各106例,比较两组患者肝损害发生率、发生时间、肝损伤严重程度分级情况。结果两组患者肝损伤发生时间比较,差异无统计学意义(P>0.05),而水飞组的肝损害发生率显著高于甘草酸组(P<0.05);两组的肝损伤严重程度比较,差异无统计学意义(P>0.05)。结论采用甘草酸二胺胶囊预防性护肝治疗可减少抗结核药所致的药物性肝损伤发生。

Objective To explore the effect of preventive liver protection of silibinin capsule and diammonium glycyrrhizinate capsule on liver function during anti-tuberculosis treatment.Methods A total of 234 patients with primary pulmonary tuberculosis who attended the tuberculosis department of Zhejiang University of Traditional Chinese Medicine Affiliated Lishui Hospital from January 2018 to December 2020 were selected for retrospective analysis,and were divided into the silibinin capsule group(the silibinin group,n=120)and the diammonium glycyrrhizinate capsule group(the glycyrrhizinate group,n=114)according to the use of liver protection drugs.The propensity matching method was used to screen clinical baseline data,and the final two groups were enrolled in 106 cases each,compared the incidence of liver damage,time of occurrence,and grading of severity of liver damage in the two groups.Results There was no statistically significant difference in the time of liver injury between the two groups(P>0.05),while the incidence of liver injury was significantly higher in the silibinin group than that in the glycyrrhizinate group(P<0.05);and there was no significant difference in the severity of liver damage between the two groups(P>0.05).Conclusion Preventive liver protectors therapy with diammonium glycyrrhizinate capsule can reduce the occurrence of drug-induced liver injury caused by anti-tuberculosis drugs.