| Summary: | Tuberculosis treatment with the combination of anti-TB drugs isoniazid,
rifampicin, pyrazinamide and ethambutol provide effectiveness in killing the TB
bacteria, but also potentially causes hepatotoxicity. The occurence of
hepatotoxicity in TB patients may increase morbidity and mortality in patients.
Efforts to prevent hepatotoxicity in TB patients during their treatment can be done
by giving some herbal hepatoprotective. Phyllanthus niruri (meniran), Curcuma
xanthorrhiza (temulawak) and Curcuma longa (kunyit) are some Indonesian
medicinal plants that have been shown hepatoprotective effects in preclinical
study. The aim of the study to determine the effectiveness the administration of
poliherbal combination of meniran, temulawak and kunyit in preventing the
elevation of ALT levels during patients TB treatment.
This research is a clinical trial, designed with randomized, single blind,
placebo-controlled and retrieval data pre-post study. Data were collected from
June to October 2013 in Jember Lung Hospital, Ajung primary health center,
Kaliwates primary health center, Panti primary health center and Patrang primary
health center in Jember. Thirty four patients of newly diagnosed with TB, who
involved in this study were divided into 2 groups. As control group, 17 patients
receive TB drugs and placebo. While for trial group, the other 17 patients receive
TB drugs and poliherbal, each given for 4 weeks. The measurement of ALT were
performed at week 0 (before starting therapy) and week 4.
The results showed that there is only one patient from the control group
who experienced mild hepatotoxicity, with levels of ALT 68 U/L. While the mean
of ALT in both groups after 4 weeks of treatment did not show the level of
hepatotoxicity. Significant differences can be seen in the mean of ALT levels after
treatment of the two groups. In the control group, the mean of ALT increased by
80,68% (from 14,65 � 6,08 to 26,47 � 13,32), whereas in the trial group the mean of ALT decreased by 31.65 % (from 22,12 � 8,75 to 15,12 � 6,83). Difference from the mean of ALT levels in both groups showed significant differences
(p=0,000). Giving poliherbal combination of meniran, temulawak and kunyit for 4
weeks in TB patients who received anti tuberculosis drugs can prevent elevation
of ALT levels.
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