探讨益肝灵联合甘草酸二铵治疗抗结核药物性肝损伤的疗效

To Explore the Curative Effect of Yiganling Combined with Diammonium Glycyrrhizinate on Anti-tuberculosis Drug-induced Liver Injury

目的 探讨益肝灵联合甘草酸二铵治疗抗结核药物性肝损伤(ATB-DILI)的疗效,并分析其对肝功能、炎性因子水平、免疫功能的影响。方法 选取2021年6月至2023年6月鹿邑县疾病预防控制中心收治的80例ATB-DILI患者为研究对象,随机分为单一组40例、联合组40例。单一组予以甘草酸二铵治疗,联合组予以益肝灵联合甘草酸二铵治疗。统计对比两组临床疗效、不良反应、临床症状积分及治疗前后肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、γ-谷氨酰转肽酶(γ-GT)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平变化。结果 联合组治疗有效率高于单一组,差异有统计学意义(P <0.05);治疗后,联合组临床症状积分低于单一组,差异有统计学意义(P <0.05);治疗后,联合组血清ALT、AST、TBIL、γ-GT、IL-6、TNF-α、IL-1β水平低于单一组,差异均有统计学意义(P <0.05);治疗后,联合组CD3^(+)、CD4^(+)高于单一组,CD8^(+)低于单一组,差异均有统计学意义(P <0.05);联合组不良反应发生率与单一组比较差异无统计学意义(P> 0.05)。结论 益肝灵联合甘草酸二铵治疗ATB-DILI的疗效确切且具有一定安全性,可改善临床症状,促进免疫功能、肝功能恢复,抑制炎性反应。

Objective To investigate the efficacy of Yiganling combined with diammonium glycyrrhizinate in the treatment of anti-tuberculosis drug-induced liver injury(ATB-DILI),and to analyze its effects on liver function,inflammatory level and immunological functioning.Methods A total of 80 patients with ATB-DILI admitted to Luyi County Center for Disease Prevention and Control hospital from June 2021 to June 2023 were selected as the study objects and randomly divided into a single group of 40 cases and a combination group of 40 cases.The single group was treated with diammonium glycyrrhizinate,and the combined group was treated with Yiganling combined with diammonium glycyrrhizinate.Count and compare the clinical efficacy,adverse reactions,and clinical symptom scores of the two groups,as well as changes in liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),γ-glutamyl transpeptidyase(γ-GT)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)],and peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+))levels before and after treatment.Results The total effective rate of combined group was higher than that of single group,and the difference was statistically significant(P<0.05);after treatment,the clinical symptom score of combination group was lower than that of single group,and the difference was statistically significant(P<0.05);after treatment,the serum ALT,AST,TBIL,γ-GT,IL-6,TNF-αand IL-1βlevels in combined group were lower than those in single group,and the differences were statistically significant(P<0.05);after treatment,the CD3^(+)and CD4^(+)levels in the combined group were higher than those in the single group,while the CD8^(+)levels were lower than those in the single group,and the difference was statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between the combined group and the single group(P>0.05).Conclusion Yiganling combined with diammonium glycyrrhizinate is effective and safe in the treatment of ATB-DILI,which can improve clinical symptoms,immune function,promote liver function recovery,and inhibit inflammatory reactions.