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中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (2): 126-132.doi: 10.3969/j.issn.1000-6621.2020.02.009

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  1. 100700 北京中医药大学东直门医院消化科(王雪迪、江锋、代倩兰),内科门诊(王京、王冬梅)
  • 收稿日期:2019-11-09 出版日期:2020-02-10 发布日期:2020-02-19
  • 通信作者: 江锋
  • 基金资助:

Comparative analysis on drug-induced liver injury of the combination of traditional Chinese and Western medicine and single Western medicine in tuberculosis treatment (Literature review 2000-2019)

WANG Xue-di,JIANG Feng(),DAI Qian-lan,WANG Jing,WANG Dong-mei.   

  1. Digestive Department,Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
  • Received:2019-11-09 Online:2020-02-10 Published:2020-02-19
  • Contact: Feng JIANG


目的 通过搜集文献分析中西医联合治疗结核病所致药物性肝损伤的发生情况,为临床合理用药提供参考。方法 通过计算机检索2000年1月至2019年7月国内外数据库(中国知网、万方数据知识服务平台、维普网、PubMed)公开发表的中西医联合治疗结核病的相关文献,纳入原发病为结核病,试验组为中西医联合抗结核药物治疗方案,对照组为西医抗结核药物治疗方案,文献中有肝损伤病例报告,肝损伤患者原发疾病、用药方法与剂量等资料的文献。通过阅读摘要和全文剔除不符合要求(非临床试验研究、文献回顾性研究、综述等)的文献、文献信息提供不完整或出现错误,以及质量较低或数据可信度差的文献,最终纳入22篇文献。采用SPSS 23.0软件对数据进行统计学分析,计数资料的比较采用χ 2检验,以P<0.05为差异有统计学意义。结果 纳入的22篇文献中,结核病患者2561例。试验组的肝损伤发生率[12.05%(156/1295)]明显低于对照组[24.33%(308/1266)](χ 2=65.096,P<0.001)。其中试验组的初治方案、复治方案、耐药结核病方案患者肝损伤的发生率[分别为10.65%(23/216)、4.35%(3/69)、10.86%(19/175)]明显低于对照组[分别为25.12%(54/215)、13.04%(9/69)、26.75%(42/157)](χ 2=15.371,P<0.001;χ 2=3.286,P=0.070;χ 2=13.940,P<0.001)。 结论 与单纯西医抗结核药物治疗方案相比,中西医联合治疗方案能在一定程度上减少抗结核药物治疗所致药物性肝损伤的发生。

关键词: 抗结核药, 中草药, 药物疗法,联合, 药物性肝损伤, 综述文献(主题), 数据说明,统计, 对比研究, 中西医联合


Objective To analyze the occurrence of drug-induced liver injury of the combination of traditional Chinese and Western medicine in tuberculosis treatment through collecting literature provide the reference for rational drug use in clinic. Methods We determined literature on the combined treatment of traditional Chinese and Western medicine for tuberculosis published in domestic and foreign databases (CNKI, WanFang Data, VIP and PubMed databases) from January 2000 to July 2019, inclusion of primary disease for tuberculosis, and inclusion criteria were research papers that reported describing liver injury case report, primary disease with liver injury, drug method and dose. Treatment regimen with the combination of traditional Chinese and Western medicine was the experimental group, while regimen with Western medicine was the control group.Twenty-two full-text studies were included and analyzed through excluding unqualified literatures including content of studies was not meet the requirements (non-clinical trial studies, literature review, review, etc),describing the information was incomplete or inaccurate,and literature of low quality or low data reliability.SPSS 23.0 software was used for statistical analysis, frequency statistical analysis was used for measurement data, and rank sum test was used for comparison of counting data, P<0.05 was presented for statistically significant difference. Results Of the 22 articles, 2561 were tuberculosis patients. The incidence rate of liver injury in the experimental group (12.05%(156/1295)) was significantly lower than the control group (24.33%(308/1266))(χ 2=65.096, P<0.001). The incidence of liver injury in initial treatment regimen, retreatment regimen and drug-resistant tuberculosis treatment regimen in the experimental group (10.65%(23/216), 4.35%(3/69) and 10.86% (19/175) respectively) was significantly lower than the control group (25.12%(54/215), 13.04%(9/69) and 26.75% (42/157) respectively)(χ 2=15.371,P<0.001;χ 2=3.286,P=0.070;χ 2=13.940,P<0.001). Conclusion The combination of Chinese and Western medicine can reduce the incidence of anti-tuberculosis drug-induced liver injury compared with the anti-tuberculosis regimen of Western medicine.

Key words: Antitubercular agents, Drugs,Chinese herbal, Drug therapy,combination, Drug-induced liver injury, Review literature as topic, Data interpretation,statistical, Comparative study, Integrated traditional and western medicine