PURPOSE: To study the effect of liquorice as an adjuvant to DOTS therapy, in sputum smear positive patients and its outcome on sputum conversion, cough, fever, gastrointestinal side effects, AST, ALT and serum uric acid levels.
METHODS: A randomized, double-blind placebo-control study was conducted in sixty patients of newly diagnosed sputum smear positive pulmonary tuberculosis on 2(HRZE)<sub>3</sub> 4(HR)<sub>3</sub>. The patients were divided in two groups of thirty each. Liquorice or matched placebo capsules (500 mg) were given as add-on therapy to the usual daily medication in the designated group for duration of 12 weeks. Sputum examination and monitoring of adverse events were done at 0 and 8 weeks; estimation of AST, ALT and serum uric acid levels were performed at 0 and 12 weeks.
RESULTS: At the end of 8 weeks, sputum conversion was seen in 80% patients in liquorice group and 70% in placebo group. Fever was relieved in all patients in liquorice group and 80.95% in placebo group; cough was respectively relieved in 96.15% and 81.48% patients. Gastrointestinal side effects were observed in 20% patients belonging to the placebo group. At the end of 12 weeks, raised ALT and AST levels (> 40 IU/L) were observed in 6.6% patients in liquorice group; in the placebo group, ALT was raised in 30% and AST in 26.6% of patients. Elevated serum uric acid levels (> 6 mg/dl) were observed in 3.3% patients in liquorice group and 16.6% in placebo group. Average gain in health related quality of life score (Dhingra & Rajpal, 2003) was better in patients in liquorice group.
CONCLUSION: Use of liquorice as an adjuvant in conjunction with anti-TB drugs used as DOTS showed a favorable effect in patients with pulmonary TB.
CLINICAL IMPLICATIONS: The supervised use of liquorice can improve patient compliance to anti-TB drugs by providing early relief of symptoms and prevention of adverse events thus leading to early rehabilitation of tubercular patients.
DISCLOSURE: Inderpal Grover, None.