Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Female patient, 26 years old, hospitalized with fever, dyspnea, left pleural effusion, pleural fluid test: lactate dehydrogenase 680. high sedimentation: 40mm/h. pumped 3 times, total 750ml. now taking: inosine tablets prednisone acetate tablets ethambutol hydrochloride tablets isoniazid tablets glucuronolactone tablets vizinamide tablets. My next-door patient also had TB pleurisy, but it was different from my medicine. He didn’t have hormones. No isoniazid tablets, but took rifampin. The problem I want to solve:1. Do I have to take hormones? This one is fattening. 2. Is isoniazid a big side effect? Is there any way to reduce the side effects? Do I need to take it together with rifampin? Jiang Yan, Department of Respiratory Oncology, Xiamen Second Hospital: Under the strong treatment of anti-tuberculosis drugs, tuberculous pleurisy can be treated with some oral hormones at the same time, which can reduce inflammation, speed up the absorption of pleural fluid and reduce the sequelae of pleural thickening in the future, because if pleural thickening occurs in the future, it may cause chest pain or affect breathing. When the amount is reduced after the absorption of pleural fluid, it is usually not significantly fattened because of the short time. Anti-tuberculosis drug treatment: Generally, 2 months of treatment with 3-4 drugs is called intensive period, such as isoniazid, rifampin, pyrazinamide, ethambutol, and formerly streptomycin was also used for 2 months of intramuscular injection (now it is used less because of inconvenient treatment and pain at the intramuscular injection site); then 2-3 more drugs are taken for 4-7 months for consolidation period, and the total course of treatment is 6-9 months (according to the condition), and pyrazinamide is usually stopped first after 2 months. The side effects of isoniazid are mainly skin peripheral neuritis and “excitement”, rifampicin is mainly liver damage, if the liver function is not good, you may not take it temporarily, or slowly add several drugs in stages to see if there are obvious side effects, while taking liver-protective drugs. The drug, regular review of liver function.