The preventive effect of Silibinin capsules and bicyclol tablets on drug-induced liver injury in anti-tuberculosis patients over 60 years old

Gong Xitao; Chen Weiwei; Dou Tengfei; Zhou Ran

doi:10.3969/j.issn.1674-3245.2024.04.023

Abstract：Objective To observe the value of preventive hepatoprotection in reducing drug-induced liver injury(DILI)in patients over 60 years old with newly treated tuberculosis,and to further compare the hepatoprotective effect of bicyclol tablets and silibinin capsules.Methods 186 tuberculosis patients admitted from February 2018 to October 23 were selected,and all received intensive treatment.The control group was not given hepatoprotective drugs,group A was given silybin capsules,and group B was given bicyclol tablets.Compare the incidence of DILI in three groups of 2 weeks,4 weeks,and 8 weeks of treatment.Serum glutathione peroxidase(GSH Px)and superoxide dismutase(SOD)were detected,and the level changes in the three groups before treatment,2 weeks,4 weeks,and 8 weeks of treatment were compared.Compare the incidence of adverse reactions among the 3 groups.Results In the second and fourth weeks of treatment,the incidence rates of DILI in Group A were 6.34％and 11.11％and in Group B were 1.58％and 9.52％,both of which were lower than those in the control group(11.11％and 23.8％).The difference between Group B and the control group was statistically significant(x2=4.805,4.628,P＜0.05).At the 8th week of treatment,the DILI incidence rate in Group A and Group B were 12.69％and 14.28％,both lower than the control group's 28.57％(x2=4.846,3.818,P＜0.05).In weeks 2,4,and 8,the SOD levels of Group B were(338.59±36.25)U/L,(342.68±25.62)U/L,and(345.28±37.36)U/L,which were higher than those of Group A,which were(228.06±23.83)U/L,(239.98±19.58)U/L,and(246.25±28.73)U/L and the control group at(217.69±15.66)U/L,(205.92±29.64)U/L,(226.34±28.51)U/L(F=2.187、2.664、2.823,P＜0.05).The GSH Px levels of Group B at weeks 2 and weeks 4 were(88.78±9.47)U/ml,(94.56±10.09)U/ml,which were higher than those in Group A at(80.66±6.26)U/ml,(88.89±9.35)U/ml,and the control group at(82.23±8.44)U/ml,(86.65±7.39)U/ml(t=5.677,3.271,4.098,5.019,P＜0.05).Except for DILI,the incidence rates of adverse reactions in the three groups were 9.52％,12.69％,and 11.11％respectively.The differences were not statistically significant difference(P＞0.05).Conclusion For patients over 60 years old who are newly treated for tuberculosis,preventive hepatoprotective treatment can be considered.Both silybin capsules and bicyclol tablets can reduce the incidence of DILI,with bicyclic alcohol tablets having a faster onset of effect.