Prevention of hepatotoxicity due to anti tuberculosis treatment: A novel integrative approach

作     者：Meghna R Adhvaryu Narsimha M Reddy Bhasker C Vakharia 

作者机构：Bapalal Vaidya Botanical Research Centre Department of Biosciences Veer Narmad South Gujarat University Shree Gurudev Sarvajanik Charitable Trust Mobile Clinic Ramnagar Rander Road 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第30期

页      面：4753-4762页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：(in part)The Mukul Trust Bardoli  India 

主　　题：肝中毒 抗结核治疗 姜黄色素 预防方法 

摘      要：AIM: To evaluate the ability of Curcuma longa (CL) and Tinospora cordifolia (TC) formulation to prevent anti-tuberculosis (TB) treatment (ATT) induced hepatotoxicity. METHODS: Patients with active TB diagnosis were randomized to a drug control group and a trial group on drugs plus an herbal formulation. Isoniazid, rifampicin, pyrazinamide and ethambutol for first 2 mo followed by continuation phase therapy excluding Pyrazinamide for 4 mo comprised the anti-tuberculous treatment. Curcumin enriched (25%) CL and a hydro-ethanolic extract enriched (50%) TC 1 g each divided in two doses comprised the herbal adjuvant. Hemogram, bilirubin and liver enzymes were tested initially and monthly till the end of study to evaluate the result. RESULTS: Incidence and severity of hepatotoxicity was significantly lower in trial group (incidence: 27/192 vs 2/316, P 0.0001). Mean aspartate transaminase (AST) (195.93 ± 108.74 vs 85 ± 4.24, P 0.0001), alanine transaminase (ALT) (75.74 ± 26.54 vs 41 ± 1.41, P 0.0001) and serum bilirubin (5.4 ± 3.38 vs 1.5 ± 0.42, P 0.0001). A lesser sputum positivity ratio at the end of 4 wk (10/67 vs 4/137, P = 0.0068) and decreased incidence of poorly resolved parenchymal lesion at the end of the treatment (9/152 vs 2/278, P= 0.0037) was observed. Improved patient compliance was indicated by nil drop-out in trial vs 10/192 in control group (P 0.0001). CONCLUSION: The herbal formulation prevented hepatotoxicity significantly and improved the disease outcome as well as patient compliance without any toxicity or side effects.