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目的护肝治疗在肺结核合并慢性乙肝肝硬化治疗中起到重要作用,探讨患者抗病毒抗结核疗效及肝功能指标的影响。方法将96例肺结核合并慢性乙肝患者采用随机数字表分为对照组与观察组,每组48例,其中对照组予以2HRZE/4HR抗结核和替比夫定抗病毒治疗,总疗程为6个月,观察组在对照组基础上加用保肝药物甘草酸二胺治疗,直至化结束。治疗后比较两组患者肺结核病灶改善情况及治疗前后肝功能指标谷丙氨酸转移酶(ALT)、天冬氨酸转氨酶(AST)、血清总胆红素(TBi L),并观察其不良反应。结果经治疗,对照组肺结核痊愈率64.58%,明显低于观察组83.33%(P<0.05);两组AST、ALT、TBi L较治疗前均显著上升,观察组上升幅度明显低于对照组,差异有统计学意义(P<0.05);对照组不良反应总发生率20.83%,观察组12.50%,两组比较差异无统计学意义(P>0.05)。结论在进行肺结核合并慢性乙肝患者临床治疗中,同期还应予以护肝治疗,可有效减轻肝损伤。
Objective Liver protection treatment plays an important role in the treatment of pulmonary tuberculosis complicated with chronic hepatitis B cirrhosis, and explore the effect of antiviral anti-TB efficacy and liver function index. Methods Ninety-six patients with pulmonary tuberculosis and chronic hepatitis B were divided into control group and observation group with 48 patients in each group. The control group was given 2HRZE / 4HR anti-TB and telbivudine antiviral therapy for a total of 6 months , The observation group in the control group based on the use of liver protection drugs glycyrrhizic acid diamine treatment, until the end. After treatment, the improvement of pulmonary tuberculosis and the indexes of hepatic function such as ALT, AST and TBiL were compared between two groups before and after treatment, and their adverse reactions were observed . Results After treatment, the cure rate of tuberculosis in the control group was 64.58%, which was significantly lower than that in the observation group (83.33%, P <0.05). The levels of AST, ALT and TBi L increased significantly in both groups, The difference was statistically significant (P <0.05). The total incidence of adverse reactions in the control group was 20.83%, and the observation group was 12.50%. There was no significant difference between the two groups (P> 0.05). Conclusion In the clinical treatment of patients with pulmonary tuberculosis complicated with chronic hepatitis B, hepatoprotective therapy should be given in the same period, which can effectively reduce liver injury.