目的 探討雙環(huán)醇聯(lián)合還原型谷胱甘肽治療抗結(jié)核藥物性肝炎患者的臨床療效。方法 收集2012年2月—2016年2月常州市第三人民醫(yī)院收治的抗結(jié)核藥物性肝炎患者78例，隨機(jī)分為對(duì)照組和治療組，每組各39例，對(duì)照組患者在常規(guī)治療的基礎(chǔ)上靜脈滴注注射用還原型谷胱甘肽，1.8 g加入到5%葡萄糖注射液250 mL中，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上口服雙環(huán)醇片，25 mg/次，3次/d，兩組患者均連續(xù)治療30 d。治療后，比較兩組患者的臨床療效、肝功能指標(biāo)的變化、超氧化物歧化酶（SOD）、丙二醛（MDA）、谷胱甘肽過(guò)氧化物酶（GSH-Px）和不良反應(yīng)。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為76.92%、100.00%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。兩組患者的肝功能指標(biāo)水平均比治療前明顯降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組的肝功能指標(biāo)水平明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。兩組患者SOD和GSH-Px水平均較治療前顯著升高，MDA水平降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組的上述觀察指標(biāo)的改善明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。兩組的不良反應(yīng)發(fā)生率比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 雙環(huán)醇聯(lián)合還原型谷胱甘肽治療抗結(jié)核藥物性肝炎臨床療效顯著，能明顯改善患者的肝功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of bicyclol combined with reduced glutathione in treatment of anti-tuberculosis drug-induced hepatitis. Methods Patients (78 cases) with anti-tuberculosis drug-induced hepatitis in Changzhou Third People's Hospital from February 2012 to February 2016 were randomly divided into control and treatment groups, and each group had 39 cases. Patients in the control group were iv administered with Reduced Glutathione for injection on the basis of conventional therapy, 1.8 g added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were po administered with Bicyclol Tablets, 25 mg/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the changes of liver function indexes, superoxide dismutase (SOD), methane dicarboxylic aldehyde (MDA), glutathione peroxidase (GSH-Px), and adverse reactions were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.92% and 100.00%, respectively, and there was difference between two groups (P < 0.05). Liver function indexes levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). Liver function indexes levels in the treatment were lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, SOD and GSH-Px levels in two groups were significantly increased, but MDA level was decreased, and there was difference in the same group (P < 0.05). And these indexes in the treatment group were significantly better than those in the control group (P < 0.05). There was no significant difference in adverse reactions between two groups. Conclusion Bicyclol combined reduced glutathione has clinical curative effect in treatment of anti-tuberculosis drug-induced hepatitis, and can significantly improve liver function, which has a certain clinical application value.