2025 年第 3 期 第 20 卷

甘草酸制剂联合抗结核药物治疗肺结核的效果及对患者肝损伤的预防作用

Therapeutic effect of glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of patients with pulmonary tuberculosis and preventive effect on liver injury

作者：孟皎廖燕黄启文麦馨廖柳才莫兰董捷

英文作者：Meng Jiao Liao Yan Huang Qiwen Mai Xin Liao Liucai Mo Lan Dong Jie

单位：广西壮族自治区胸科医院结核科四病区，柳州545005

英文单位：The Fourth Ward of Department of Tuberculosis Chest Hospital of Guangxi Zhuang Autonomous Region Liuzhou 545005 China

关键词：肺结核；甘草酸制剂；抗结核药物；肝损伤

英文关键词：Pulmonarytuberculosis;Glycyrrhizicacidpreparation;Anti-tuberculosisdrugs;Liverinjury

• 摘要：

• 目的 探究甘草酸制剂联合抗结核药物治疗肺结核的效果及对患者肝损伤的预防作用。方法 选取2021年5月至2023年5月广西壮族自治区胸科医院120例肺结核患者，根据随机数字表法分为对照组（59例）和观察组（61例）。对照组予以基础抗结核药物（2HRZE/4HR）治疗，观察组在对照组基础上给予甘草酸制剂治疗，2组均连续治疗6个月。比较2组胸部CT病灶吸收程度、炎症因子、肝损伤血清标志物、药物性肝损伤（DILI）发生率、肝损伤患者肝功能Child分级。结果 观察组胸部CT吸收程度分级明显优于对照组（P=0.003）。治疗后，2组γ干扰素、白细胞介素2水平均低于治疗前，且观察组白细胞介素2水平低于对照组（均P＜0.05）。治疗后，2组丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素均高于治疗前，且观察组均低于对照组（均P＜0.05）。观察组DILI发生率低于对照组［8.2%（5/61）比22.0%（13/59）］（P＜0.05）。观察组肝功能Child分级优于对照组（P=0.016）。结论 甘草酸制剂联合抗结核药物治疗肺结核能够促进病灶吸收，获得更好效果，并降低DILI发生风险。

• Objective  To explore the effect of glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of patients with pulmonary tuberculosis and its preventive effect on liver injury. Methods A total of 120 patients with pulmonary tuberculosis in Chest Hospital of Guangxi Zhuang Autonomous Region from May 2021 to May 2023 were selected and divided into the control group (59 cases) and the observation group (61 cases) according to the random number table method. The control group was treated with basic anti-tuberculosis drugs (2HRZE/4HR), and the observation group was treated with glycyrrhizic acid preparation on the basis of the control group. Both groups were treated for 6 months. The degree of chest CT lesion absorption, inflammatory factors, serum markers of liver injury, incidence of drug-induced liver injury (DILI), and Child grade of liver function in patients with liver injury were compared between the two groups. Results The degree of chest CT absorption in the observation group was significantly better than that in the control group (P=0.003). After treatment, the levels of interferon-γ and interleukin-2 in the two groups were lower than those before treatment, and the level of interleukin-2 in the observation group was lower than that in the control group (all P＜0.05). After treatment, the alanine aminotransferase, aspartate aminotransferase and total bilirubin in the two groups were higher than those before treatment, and those in the observation group were lower than those in the control group (all P＜0.05). The incidence of DILI in the observation group was lower than that in the control group ［8.2%(5/61) vs 22.0%(13/59)］(P＜0.05). The Child grade of liver function in the observation group was better than that in the control group (P=0.016). Conclusion Glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of pulmonary tuberculosis can promote the absorption of lesions, obtain better effect, and reduce the risk of DILI.