Tuberculosis is a chronic infectious, multisystem disorder and is affecting millions globally. ATT used under DOTS has hepatotoxic potential. Silymarin, an indigenous herb is used in various traditional formulations for treating hepatic disorders. So the present study was conducted to evaluate the effect of silymarin on hepatic functions in tubercular patients receiving DOTS.
Present study was prospective, double-blind, randomized, placebo-controlled. It comprised two groups of 50 tubercular patients each receiving standard therapy DOTS as per category of the patient. One group received silymarin 140 mg thrice daily and second group received identical placebo as add on therapy to DOTS for 8 weeks. SGOT, SGPT, ALP and serum bilirubin of both the groups were measured at 0 week, 4 weeks, 8 weeks and were analyzed by student's t-test.
Baseline investigations of SGOT, SGPT, ALP and serum bilirubin in both the groups were comparable ( p > 0.05). Non-significant mean increase in SGOT (7.2%), SGPT (6%), ALP (5.9%) levels and significant mean increase in bilirubin levels (17.4%) was observed in silymarin arm as compared to significant increase in SGOT (25.6%), SGPT (28%), ALP (11.7%) levels and extremely significant mean increase in bilirubin levels (43.6%) in the placebo arm. In the silymarin arm, decrease in SGOT levels was seen in 6% of the patients, decrease in SGPT levels was seen in 4% of the patients and decrease in ALP levels was seen in 6% of the patients from 0 week (baseline values) whereas none of the patients showed decrease in levels from baseline in the placebo arm.
Silymarin has been found to suppress the deterioration in the hepatic functions associated with use of ATT in patients receiving DOTS; and found to be hepatoprotective.
Silymarin can be recommended as an adjuvant to DOTS in tubercular patients since it attenuates the hepatotoxicity caused by ATT.
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